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Cited by 98Treatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesDementia and Cognitive Impairment Research

Clinical characteristics associated with the discrepancy between subjective and objective cognitive impairment in depression

Petersen, J.Z., Porter, R.J., Miskowiak, K.W.·2019·Journal of Affective Disorders
DOI 10.1016/j.jad.2018.12.105
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Abstract

Background Patients with unipolar disorder (UD) commonly experience cognitive dysfunction during symptomatic and remitted phases. However, it is not necessarily the patients with the greatest subjective complaints, who display the largest objectively-measured deficits on neuropsychological tests.Objective This report investigated the demographic and clinical factors associated with the discrepancy between subjective and objective measures of cognition in two separate depressed patient populations in Denmark and New Zealand, respectively, using a new methodology.Methods Data from 137 depressed patients and 103 healthy controls including neuropsychological test scores, self-reported cognitive difficulties, and ratings of mood were pooled from two studies conducted in Copenhagen, Denmark, and Christchurch, New Zealand, respectively. Cognitive discrepancy scores were calculated using a novel methodology, with positive values indicating disproportionately more subjective than objective difficulties (i.e., "sensitivity") and negative values indicating more objective than subjective impairments (i.e., "stoicism").Results In the Danish partially remitted patient sample, greater 'sensitivity' was associated with more subsyndromal depression severity (standardized Beta (std. β )= 0.4, p < 0.01)), illness duration (std. β = 0.4, p < 0.01), and younger age (std. β = 0.6, p < 0.001). This association was replicated in the New Zealand sample of more symptomatic patients (p-values ≤ 0.05).Limitations The cross-sectional design hampered causal inferences. We had obtained different measures of objective and subjective cognition from the two studies.Conclusions Patients with more depressive symptoms and younger age overreported cognitive impairments across all illness states. The use of an objective cognition screener thus seems particularly relevant for these patients to assess whether subjective complaints are accompanied by measurable cognitive deficits.

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Authors
Petersen, J. Z., Porter, R. J., & Miskowiak, K. W.
Affiliations
  • University of Copenhagen (DK)
  • University of Otago (NZ)
Corresponding author
Miskowiak, K.W.
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2019-03
Volume
246
Pages
763-774
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2018.12.105
OpenAlex
W2907938785
Cited by
98
References
69
Citations by year
2026: 6 · 2025: 13 · 2024: 8 · 2023: 14 · 2022: 19 · 2021: 14 · 2020: 21 · 2019: 3
FWCI
6.16
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Funders
Health Research Council of New Zealand
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 › Dementia and Cognitive Impairment Research
Keywords
depression, cognitive impairment, neuropsychological assessment, subthreshold depression, disease duration, age, cognitive screening, major depressive disorder
MeSH terms
Adult, Affect, Cognition, Cross-Sectional Studies, Denmark, Depressive Disorder, Female, Humans, Male, Mass Screening, Middle Aged, Neuropsychological Tests, New Zealand, Self Concept, Sensitivity and Specificity, Reproducibility of Results, Young Adult, Diagnostic Self Evaluation, Cognitive Dysfunction

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