Is cognitive dysfunction involved in difficult-to-treat depression? Characterizing resistance from a cognitive perspective
López-Solà, Clara (Centro de Investigación Biomédica en Red de Salud Mental)
Subirà, Marta (Centro de Investigación Biomédica en Red de Salud Mental)
Serra-Blasco, Maria (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Vicent-Gil, Muriel (Institut d'Investigació Biomèdica Sant Pau)
Navarra-Ventura, Guillem (Universitat Autònoma de Barcelona. Departament de Psiquiatria i de Medicina Legal)
Aguilar, Eva (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Acebillo, Siddarta (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Palao, Diego (Universitat Autònoma de Barcelona. Departament de Psiquiatria i de Medicina Legal)
Cardoner, N. (Narcís) (Universitat Autònoma de Barcelona)

Date:	2020
Abstract:	This study aimed to identify clinical and cognitive factors associated with increased risk for difficult-to-treat depression (DTD) or treatment-resistant depression (TRD). A total of 229 adult outpatients with major depression were recruited from the mental health unit at a public hospital. Participants were subdivided into resistant and nonresistant groups according to their Maudsley Staging Model score. Sociodemographic, clinical, and cognitive (objective and subjective measures) variables were compared between groups, and a logistic regression model was used to identify the factors most associated with TRD risk. TRD group patients present higher verbal memory impairment than the nonresistant group irrespective of pharmacological treatment or depressive symptom severity. Logistic regression analysis showed that low verbal memory scores (odds ratio [OR]: 2. 02; 95% confidence interval [CI]: 1. 38-2. 95) together with high depressive symptom severity (OR: 1. 29; CI95%: 1. 01-1. 65) were associated with TRD risk. Our findings align with neuroprogression models of depression, in which more severe patients, defined by greater verbal memory impairment and depressive symptoms, develop a more resistant profile as a result of increasingly detrimental neuronal changes. Moreover, our results support a more comprehensive approach in the evaluation and treatment of DTD in order to improve illness course. Longitudinal studies are warranted to confirm the predictive value of verbal memory and depression severity in the development of TRD.
Grants:	Instituto de Salud Carlos III PI18/0036 Instituto de Salud Carlos III PI17/01205 Instituto de Salud Carlos III PI15/01478
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra, i la creació d'obres derivades, sempre que no sigui amb finalitats comercials i que es distribueixin sota la mateixa llicència que regula l'obra original. Cal que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Cognition ; Difficult-to-treat depression ; Treatment-resistant depression ; Verbal memory
Published in:	European psychiatry, Vol. 63 (june 2020) , ISSN 1778-3585

DOI: 10.1192/j.eurpsy.2020.65
PMID: 32571441

8 p, 215.7 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles