Screening for cognitive dysfunction in unipolar depression: Validation and evaluation of objective and subjective tools
Abstract
Background Persistent cognitive dysfunction in unipolar depression (UD) contributes to socio-occupational impairment, but there are no feasible methods to screen for and monitor cognitive dysfunction in this patient group. The present study investigated the validity of two new instruments to screen for cognitive dysfunction in UD, and their associations with socio-occupational capacity. Method Participants (n=53) with UD in partial or full remission and healthy control persons (n=103) were assessed with two new screening instruments, the Danish translations of the Screen for Cognitive Impairment in Psychiatry (SCIP-D) and Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) and with established neuropsychological and self-assessment measures. Depression symptoms and socio-occupational function were rated with the Hamilton Depression Rating Scale and Functional Assessment Short Test respectively. Results The SCIP-D and COBRA were valid for detection of objective and subjective cognitive impairment, respectively. The three parallel SCIP-D forms were equivalent. A combined SCIP-D-COBRA measure showed high sensitivity and good specificity for objective cognitive impairment (91% and 70%, respectively). There was no correlation between subjective and objective measures of cognition. Subjective cognitive difficulties correlated more with socio-occupational impairment (r=0.7, p<0.01) than did objective cognitive difficulties, for which there was a weak correlation with the executive skills domain only (r =-0.3, p=0.05). Limitations A modest sample size. Conclusions The SCIP-D and COBRA are valid measures of objective and subjective cognitive impairment, respectively, and should ideally be implemented together in the screening for cognitive dysfunction in UD.
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In patients with major depressive disorder, cognitive complaint is correlated more closely with depressive symptoms and psychosocial functioning than is objective cognitive impairment.
“CC in MDD patients is correlated more closely with not only depressive symptoms, but also psychosocial functioning compared to objective cognitive impairment [19-23].”
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“The Danish translation has demonstrated validity for the detection of objective cognitive impairment [53].”
BackgroundHovmand, O. R., Reinholt, N., Dichmann, K., Borisov, R., Hjorthøj, C., & Arnfred, S. (2024) · Trials · doi:10.1186/s13063-024-08517-8
“The Danish version of the instrument has, in research, been found to have good validity for detecting cognitive impairment [54].”
Method
- Authors
- Ott, C. V., Bjertrup, A. J., Jensen, J. H., Ullum, H., Sjælland, R., Purdon, S. E., Vieta, E., Kessing, L. V., & Miskowiak, K. W.
- Affiliations
- Copenhagen University Hospital (DK)
- Hvidovre Hospital (DK)
- University of Alberta (CA)
- Centro de Investigación Biomédica en Red de Salud Mental (ES)
- Corresponding author
- Miskowiak, Kamilla W.
- ORCID
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2016-01
- Volume
- 190
- Pages
- 607-615
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2170999507
- Cited by
- 128
- References
- 10
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 13 · 2023: 13 · 2022: 14 · 2021: 15 · 2020: 20 · 2019: 10 · 2018: 14 · 2017: 9 · 2016: 7
- FWCI
- 7.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Lundbeck Foundation
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- major depressive disorder, cognitive impairment, cognitive screening, COBRA, subjective cognitive complaints, objective cognitive impairment, socio-occupational functioning, executive function, screening tool validation, remitted depression
- MeSH terms
- Adult, Cognition Disorders, Depressive Disorder, Female, Humans, Male, Neuropsychological Tests, Self-Assessment, Sensitivity and Specificity, Reproducibility of Results, Case-Control Studies
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