Depressive Disorders. In: Puente AE, Mccaffrey RJ, editors. Handbook of Neuropsychological Assessment. Boston: Springer US; 1992. pp. 263-307. [DOI: 10.1007/978-1-4899-0682-3_10]

Identifying neurocognitive impairment in depression using computerized testing

There is considerable interest in the identification of neurocognitive impairment in patients with depression. The purpose of this study is to illustrate a methodology for identifying frank neurocognitive impairment in clinical practice and research using a computerized battery of neuropsychological tests. Participants were 100 adult patients with depression who were not on antidepressants. They were carefully matched on age, education, gender, and ethnicity to 100 healthy adult control subjects. All participants completed the Central Nervous System Vital Signs (CNS-VS) computerized assessment battery, which takes approximately 30-40 minutes to administer. Patients with depression performed more poorly than controls on all five domain scores (Cohen's d ranged from d = .37 to .72). When using two or more scores below the 5th percentile as the cutoff for frank neurocognitive impairment, 31.0% of the depressed sample and only 5.0% of the control sample scored in this range. In this study, patients with depression were 8.5 times more likely to have two or more index scores that were below the 5th percentile. Computerized testing, using the interpretive methodology presented, represents an efficient methodology for identifying cognitive problems in patients who present with untreated depression.

Dreams by Persons with Mood Disorders

This work evaluated the structure of dreams in depressed patients. The verbal reports of dreams of 100 depressed patients were compared with 251 dreams of a control group. In accordance with the Jungian thought, which view's dreams as texts, dream reports were assessed using textual analysis processing techniques. Significant differences were found in parameter values, as well as in the role of the dreamer as an external observer. Considering the length of the dreams' texts, depressed patients used fewer words than the control group. With regard to sensory field, there were fewer lemmas referring to sight for depressed patients than for healthy participants. This work seems to confirm the value of textual analysis in the study of oneiric material

The Role of Depression in Verbal Memory Following Traumatic Brain Injury

The purpose of this study was to characterize the relationship between verbal memory and depression scores on the Personality Assessment Inventory following traumatic brain injury. Depression was associated with diminished delayed recall and recognition on the California Verbal Learning Test-II (CVLT-II), even after controlling for a neuropsychological composite score and/or a measure of motivation (i.e., the TOMM). There was no relationship between depression and recall on Verbal Paired Associates or Logical Memory when controlling for the same covariates. The findings were most consistent with depressed subjects failing to utilize the semantic organization of the CVLT-II list to enhance their learning.

Cognitive deficits in major depression

Major depression is a mood disorder that is often accompanied by the impairment of cognitive functions. Although suggestive, the large range of existing neuropsychological, neuropsychiatric, and, lately, neuroimaging investigations have not yet given a consistent picture of the psychological and biological disturbances involved in this psychiatric disorder. The present study of the cognitive functions in depression was part of an extensive investigation, including neuropsychological testing, psychiatric examination, and neuroimaging. A representative sample of 40 severely depressed hospitalized patients and a group of 49 closely matched control subjects were tested with an extensive neuropsychological test battery. Results, corrected for various confounding factors, confirmed the current notion that depressed patients suffer from wide-spread cognitive impairments. The group analysis did not allow any hypothesis on a possible pattern to the dysfunctions, but heterogeneity in the test performances calls for further analysis of the data in patient subgroups in relation to neuroimaging results.

Cognitive function in depression: its relationship to the presence and severity of intellectual decline

Cognitive dysfunction is an integral feature of depression, in some cases of sufficient severity to warrant a diagnosis of dementia. There has been little systematic investigation of whether cognitive dysfunction is an inevitable consequence of depression, or is specific to a subgroup of depressed patients. Related to this is the distribution of cognitive dysfunction, whether there is a continuum of impairment or a distinct demented subgroup. Finally, there is the question of which aspects of cognitive function are most sensitive to the intellectual decline seen in depression. A study is described which addresses these issues. The distribution of global cognition was found to be normally distributed in the sample of 29 patients assessed. Based on this distribution and the scores of a control sample, the patients were classified as unimpaired, borderline or impaired. Two sets of independent comparisons were carried out. First, the unimpaired depressed patients were compared to matched non-depressed controls. Significant deficits were found on a range of neuropsychological measures covering aspects of language function, memory, both recall and recognition, attention and behavioural regulation. These same patients were also compared with two groups of matched depressed patients, with varying degrees of global cognitive impairment. In general, the cognitive measures showed a gradient of dysfunction across the three patients groups. Significant differences between the depressed groups were shown on measures of immediate recall, attention and behavioural regulation. The possible significance of attentional factors for the observed memory dysfunction is discussed.