Relationship of cognitive impairment with depressive symptoms and psychosocial function in patients with major depressive disorder: Cross–sectional analysis of baseline data from PERFORM-J
Open accessAbstract
BACKGROUND: Evidence is accumulating for the presence of cognitive impairment in patients with major depressive disorder (MDD). The Prospective Epidemiological Research on Functioning Outcomes Related to Major Depressive Disorder in Japan (PERFORM-J) study is a 6-month, non-interventional, prospective, multicenter, epidemiological study. Using baseline data, the relationship between cognitive symptoms and psychosocial function was analyzed in Japanese patients with MDD. METHODS: A total of 518 Japanese outpatients (aged 18-65 years) with MDD initiating new antidepressant monotherapy (first-line or switch from a previous drug) participated. Assessment measures were: physician-rated Montgomery-Asberg Depression Rating Scale (MADRS) (depression severity); Digit Symbol Substitution Test (DSST) (objective cognition); and patient-rated Perceived Deficits Questionnaire - Depression (PDQ-D) (subjective cognition); Sheehan Disability Scale (SDS); Work Productivity and Activity Impairment questionnaire (WPAI) (psychosocial function); and EuroQol-5 Dimension-5 Level (quality of life). RESULTS: Over half of patients exhibited a greater than 1 standard deviation decline below norm in objective cognition, as measured by the DSST. Severity of depressive symptoms correlated positively with subjective (PDQ-D), but not objective (DSST) cognition. Depression severity and subjective cognition were significantly associated with psychosocial function, as measured by the SDS and WPAI (except the absenteeism items). Conversely, the association between objective cognition and psychosocial function was not significant. LIMITATIONS: Only outpatients were recruited. Occupations and job-related stress levels were not taken into account. CONCLUSIONS: Japanese patients with MDD presented a high incidence of cognitive impairment. The relationships between cognitive and psychosocial function in these patients suggest a need for therapeutics targeting cognitive impairment of MDD.
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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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Zhou, T., Zhao, J., Ma, Y., He, L., Ren, Z., Yang, K., Tang, J., Liu, J., Luo, J., & Zhang, H. (2024) · Figshare · doi:10.6084/m9.figshare.25687385
Dong, C.-H., Gao, C.-N., An, X.-H., Li, N., Yang, L., Li, D.-C., & Tan, Q. (2021) · Figshare · doi:10.6084/m9.figshare.17127267
Dong, C.-H., Gao, C.-N., An, X.-H., Li, N., Yang, L., Li, D.-C., & Tan, Q. (2021) · Figshare · doi:10.6084/m9.figshare.17127285
Dong, C.-H., Gao, C.-N., An, X.-H., Li, N., Yang, L., Li, D.-C., & Tan, Q. (2021) · Figshare · doi:10.6084/m9.figshare.17127273
Dong, C.-H., Gao, C.-N., An, X.-H., Li, N., Yang, L., Li, D.-C., & Tan, Q. (2021) · Figshare · doi:10.6084/m9.figshare.17127264
Dong, C.-H., Gao, C.-N., An, X.-H., Li, N., Yang, L., Li, D.-C., & Tan, Q. (2021) · Figshare · doi:10.6084/m9.figshare.17127282
Dong, C.-H., Gao, C.-N., An, X.-H., Li, N., Yang, L., Li, D.-C., & Tan, Q. (2021) · Figshare · doi:10.6084/m9.figshare.17127279
Mild motor signs in major depressive disorder: prevalence and clinical profile
Luca, A., Serretti, A., Barlati, S., Buson, L., Menesello, V., Magistrali, A., Silva, R. C., Perusi, G., Nibbio, G., Bignotti, S., et al. (2026) · The European Journal of Psychiatry · doi:10.1016/j.ejpsy.2026.100342
Gibbons, M. B. C., Kodkany, N., Liow, Y., & Crits-Christoph, P. F. (2026) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70254
“…baseline depressive severity predicted persistence of suicidal ideation trajectories among those with MDD. Higher levels of depressive symptoms among those with MDD have also been found to be associated with overall work impairment and relatively poor cognitive functioning (Sumiyoshi et al. 2019).”
- Authors
- Sumiyoshi, T., Watanabe, K., Noto, S., Sakamoto, S., Moriguchi, Y., Tan, K. H. X., Hammer-Helmich, L., & Fernandez, J.
- Affiliations
- National Center of Neurology and Psychiatry (JP)
- Kyorin University (JP)
- Niigata University of Health and Welfare (JP)
- Takeda (Japan) (JP)
- Lundbeck (Denmark) (DK)
- Corresponding author
- Sumiyoshi, Tomiki
- ORCID
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2019-11
- Volume
- 258
- Pages
- 172-178
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2964831565
- Cited by
- 70
- References
- 28
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 7 · 2023: 8 · 2022: 16 · 2021: 21 · 2020: 5 · 2019: 2
- FWCI
- 6.82
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Takeda Pharmaceutical Company
- 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
- major depressive disorder, cognitive impairment, depressive symptoms, psychosocial functioning, objective cognition, subjective cognition, depression severity, labor productivity, disability, quality of life, Japanese patients, antidepressant monotherapy
- MeSH terms
- Adolescent, Adult, Aged, Antidepressive Agents, Cognition, Cross-Sectional Studies, Major Depressive Disorder, Depressive Disorder, Major, Disability Evaluation, Efficiency, Female, Humans, Japan, Male, Middle Aged, Outpatients, Prospective Studies, Quality of Life, Surveys and Questionnaires, Social Behavior, Asian People, Young Adult, Cognitive Dysfunction
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