Executive function impairments in depression and bipolar disorder: association with functional impairment and quality of life
Abstract
Background The neuropsychological correlates of major depressive (MDD) and bipolar disorder (BD), and their association with quality of life (QOL) and functioning, have not been sufficiently studied in the literature. The present study aimed to compare executive functions, attention, processing speed, QOL and disability between patients with BD type I, BD type II, MDD and healthy controls.Method 205 participants (n=37 BDI, 81% female; n=35 BDII, 80% female; n=45 MDD, 69% female; n=89C, 46% female) aged between 18 and 67 years were administered an extensive neurocognitive battery consisting of widely used standardized measures such as the Trail Making Test, the Stroop Color-Word Test and a modified version of the Wisconsin Card Sorting Task. Z-scores were compared between groups by ANCOVA. The prevalence of impairments on each measure (Z-score<1.5) was compared between groups using chi-square tests. The associations between cognition, quality of life and functioning were evaluated through correlational analysis.Results Patients with MDD showed poor selective and sustained attention, and exhibited impairments in timed tasks, suggesting low efficiency of executive processing. Patients with BDI displayed more widespread cognitive impairment than the remaining groups, and performed worse than subjects with MDD on measures of sustained attention and inhibitory control. Decision-making ability and attentional control were able to distinguish between patients with BDI and BDII. QOL and disability were most impaired in patients with BDI, and more closely associated with cognitive impairment than in the remaining groups.Limitations No control of pharmacological variables, clinical or demographic characteristics.Conclusions Our results provide important information regarding the nature and severity of the cognitive alterations associated with different mood disorders, and may contribute to the diagnosis, rehabilitation and treatment of these conditions.
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Recurrently depressed individuals have impaired cognitive functioning and diminished cognitive resources.
“Recurrently depressed individuals’ vulnerability to depressogenic cognition is additionally exacerbated by impaired cognitive functioning and diminished cognitive resources.”
From Mindfulness-Based Interventions in Psychiatry (2018) · cites this paper as [67]
These individuals often show overgeneral autobiographical memory, impaired attention regulation, and difficulty suppressing competing or irrelevant thoughts and mental sets.
“These individuals often exhibit overgeneral autobiographical memory (i.e. a difficulty in retrieving specific personal events), impairments in attention regulation, and difficulties suppressing competing or currently-irrelevant thoughts and mental sets, among other cognitive deficits (62–68).”
From Mindfulness-Based Interventions in Psychiatry (2018) · cites this paper as [67]
Attention impairments in major depressive disorder negatively impact daily function and are associated with poorer clinical outcome.
“Attention impairments in particular are known to negatively impact daily function3,4 and are associated with poorer clinical outcome5.”
From Paying attention to attention in depression (2019) · cites this paper as [4]
Cites
Studies of interference in serial verbal reactions
Stroop, J. R. (1935) · Journal of Experimental Psychology · doi:10.1037/h0054651 · Cited by 18,622 · see citing works
Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000) · Cognitive Psychology · doi:10.1006/cogp.1999.0734 · Cited by 15,798 · see citing works
Insensitivity to future consequences following damage to human prefrontal cortex
Bechara, A., Damasio, A. R., Damasio, H., & Anderson, S. W. (1994) · Cognition · doi:10.1016/0010-0277(94)90018-3 · Cited by 6,128 · see citing works
Stern, Y. (2009) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2009.03.004 · Cited by 2,943 · see citing works
Cross-national epidemiology of DSM-IV major depressive episode
Bromet, E., Andrade, L. H., Hwang, I., Sampson, N. A., Alonso, J., de Girolamo, G., de Graaf, R., Demyttenaere, K., Hu, C., Iwata, N., et al. (2011) · BMC Medicine · doi:10.1186/1741-7015-9-90 · Cited by 2,221 · see citing works
Snyder, H. R. (2013) · Psychological Bulletin · doi:10.1037/a0028727 · Cited by 1,667 · see citing works
Executive dysfunction predicts nonresponse to fluoxetine in major depression
Dunkin, J. J., Leuchter, A. F., Cook, I. A., Kasl-Godley, J. E., Abrams, M., & Rosenberg-Thompson, S. (2000) · Journal of Affective Disorders · doi:10.1016/s0165-0327(99)00157-3 · Cited by 221 · see citing works
Savitz, J. B., Price, J. L., & Drevets, W. C. (2014) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2014.02.008 · Cited by 145 · see citing works
ELGAMAL, S., McKINNON, M. C., RAMAKRISHNAN, K., JOFFE, R. T., & MacQUEEN, G. (2007) · Psychological Medicine · doi:10.1017/s0033291707001110 · Cited by 141 · see citing works
Bowie, C. R., Gupta, M., Holshausen, K., Jokic, R., Best, M., & Milev, R. (2013) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0b013e31829c5030 · Cited by 136 · see citing works
Systematic review of neurocognition and occupational functioning in major depressive disorder
Evans, V. C., Chan, S. S., Iverson, G. L., Bond, D. J., Yatham, L. N., & Lam, R. W. (2013) · Neuropsychiatry · doi:10.2217/npy.13.3 · Cited by 42 · see citing works
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Paying attention to attention in depression
Keller, A. S., Leikauf, J. E., Holt-Gosselin, B., Staveland, B. R., & Williams, L. M. (2019) · Translational Psychiatry · doi:10.1038/s41398-019-0616-1 · Cited by 329 · see citing works
MacQueen, G. M., & Memedovich, K. A. (2017) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.12463 · Cited by 172 · see citing works
Mindfulness-Based Interventions in Psychiatry
Shapero, B. G., Greenberg, J., Pedrelli, P., de Jong, M., & Desbordes, G. (2018) · Focus · doi:10.1176/appi.focus.20170039 · Cited by 172 · see citing works
Vasavada, M. M., Leaver, A. M., Njau, S., Joshi, S. H., Ercoli, L., Hellemann, G., Narr, K. L., & Espinoza, R. (2017) · The Journal of ECT · doi:10.1097/yct.0000000000000426 · Cited by 73 · see citing works
Gao, Q., Jia, G., Zhao, J., & Zhang, D. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.01810 · Cited by 71 · see citing works
Lai, S., Zhong, S., Wang, Y., Zhang, Y., Xue, Y., Zhao, H., Ran, H., Yan, S., Luo, Y., He, J., et al. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.04.153 · Cited by 55 · see citing works
Afshari, B., Omidi, A., & Ahmadvand, A. (2020) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-019-09442-7 · Cited by 38 · see citing works
RetractedSong, R., Bai, Y., Li, X., Zhu, J., Zhang, H., Shi, Y., Li, K., Wang, B., Zhang, H., Yang, Y., et al. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.05.109 · Cited by 37 · see citing works
Greenberg, J., Shapero, B. G., Mischoulon, D., & Lazar, S. W. (2017) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-016-0746-x · Cited by 17 · see citing works
Le Chevanton, T., Fouques, D., Julien‐Sweerts, S., Petot, D., & Polosan, M. (2020) · Journal of Clinical Psychology · doi:10.1002/jclp.22912 · Cited by 4 · see citing works
- Authors
- Cotrena, C., Branco, L. D., Shansis, F. M., & Fonseca, R. P.
- Affiliations
- Pontifícia Universidade Católica do Rio Grande do Sul (BR)
- Corresponding author
- Cotrena, Charles
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2016-01
- Volume
- 190
- Pages
- 744-753
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2177357938
- Cited by
- 227
- References
- 11
- Citations by year
- 2026: 16 · 2025: 20 · 2024: 13 · 2023: 22 · 2022: 20 · 2021: 22 · 2020: 28 · 2019: 27 · 2018: 26 · 2017: 19 · 2016: 14
- FWCI
- 15.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- executive function, major depressive disorder, bipolar I disorder, bipolar II disorder, quality of life, functional disability, cognitive impairment, attention, processing speed, inhibitory control, decision-making, Wisconsin Card Sorting Test, Stroop task, Trail Making Test
- MeSH terms
- Adolescent, Adult, Aged, Attention, Bipolar Disorder, Major Depressive Disorder, Female, Persons with Disabilities, Humans, Male, Middle Aged, Neuropsychological Tests, Quality of Life, Case-Control Studies, Young Adult, Executive Function
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