Dealing with heterogeneity of cognitive dysfunction in acute depression: A clustering approach
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Abstract Background Heterogeneity in cognitive functioning among major depressive disorder (MDD) patients could have been the reason for the small-to-moderate differences reported so far when it is compared to other psychiatric conditions or to healthy controls. Additionally, most of these studies did not take into account clinical and sociodemographic characteristics that could have played a relevant role in cognitive variability. This study aims to identify empirical clusters based on cognitive, clinical and sociodemographic variables in a sample of acute MDD patients. Methods In a sample of 174 patients with an acute depressive episode, a two-step clustering analysis was applied considering potentially relevant cognitive, clinical and sociodemographic variables as indicators for grouping. Results Treatment resistance was the most important factor for clustering, closely followed by cognitive performance. Three empirical subgroups were obtained: cluster 1 was characterized by a sample of non-resistant patients with preserved cognitive functioning (n = 68, 39%); cluster 2 was formed by treatment-resistant patients with selective cognitive deficits (n = 66, 38%) and cluster 3 consisted of resistant (n = 23, 58%) and non-resistant (n = 17, 42%) acute patients with significant deficits in all neurocognitive domains (n = 40, 23%). Conclusions The findings provide evidence upon the existence of cognitive heterogeneity across patients in an acute depressive episode. Therefore, assessing cognition becomes an evident necessity for all patients diagnosed with MDD, and although treatment resistant is associated with greater cognitive dysfunction, non-resistant patients can also show significant cognitive deficits. By targeting not only mood but also cognition, patients are more likely to achieve full recovery and prevent new relapses.
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Some evidence suggests heterogenous profiles of neurocognitive dysfunction among individuals experiencing depression and that treatment resistance may drive the existence of subgroups with particularly high levels of dysfunction.
“Some evidence suggests that there are heterogenous profiles of neurocognitive dysfunction among individuals experiencing depression (Martin et al., 2020) and that treatment resistance may drive the existence of subgroups with particularly high levels of dysfunction (Vicent-Gil et al., 2021).”
From Neurocognitive effects of theta burst stimulation for treatment-resistant depression in adults: A systematic review and recommendations for future research (2025) · cites this paper as Vicent-Gil et al., 2021
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- Authors
- Vicent-Gil, M., Portella, M. J., Serra-Blasco, M., Navarra-Ventura, G., Crivillés, S., Aguilar, E., Palao, D., & Cardoner, N.
- Affiliations
- Universitat Autònoma de Barcelona (ES)
- Corresponding author
- Serra-Blasco, Maria
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2020-06-01
- Volume
- 51
- Issue
- 16
- Pages
- 2886-2894
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC8640365
- OpenAlex
- W3029279116
- Cited by
- 28
- References
- 51
- Citations by year
- 2026: 8 · 2025: 4 · 2024: 3 · 2023: 5 · 2022: 6 · 2021: 2
- FWCI
- 1.95
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Psychological Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Dipòsit Digital de Documents de la UAB (Universitat Autònoma de Barcelona) (submittedVersion, cc-by)
- Funders
- Pfizer
- Ministerio de Ciencia e Innovación (CP16/00020)
- Universitat Autònoma de Barcelona
- Servier (2016-2020)
- H. Lundbeck A/S
- Cilag
- 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, acute depression, cognitive impairment, cognitive heterogeneity, treatment resistance, neurocognitive impairment, patient subgroups, sociodemographic factors, cognitive assessment
- MeSH terms
- Cognition, Cognition Disorders, Depression, Depressive Disorder, Major, Major Depressive Disorder, Humans, Neuropsychological Tests, Cluster Analysis, Cognitive Dysfunction
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Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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