Cited by 31Treatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychological Treatments and Disorders

Is cognitive dysfunction involved in difficult-to-treat depression? Characterizing resistance from a cognitive perspective

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López-Solà, Clara, Subirà, Marta, Serra-Blasco, Maria, Vicent-Gil, Muriel, Navarra-Ventura, Guillem, Aguilar, Eva, Acebillo, Siddarta, Palao, Diego J. +1 more·2020·European Psychiatry

Abstract

Background.: This study aimed to identify clinical and cognitive factors associated with increased risk for difficult-to-treat depression (DTD) or treatment-resistant depression (TRD). Methods.: A total of 229 adult outpatients with major depression were recruited from the mental health unit at a public hospital. Participants were subdivided into resistant and nonresistant groups according to their Maudsley Staging Model score. Sociodemographic, clinical, and cognitive (objective and subjective measures) variables were compared between groups, and a logistic regression model was used to identify the factors most associated with TRD risk. Results.: TRD group patients present higher verbal memory impairment than the nonresistant group irrespective of pharmacological treatment or depressive symptom severity. Logistic regression analysis showed that low verbal memory scores (odds ratio [OR]: 2.02; 95% confidence interval [CI]: 1.38–2.95) together with high depressive symptom severity (OR: 1.29; CI95%: 1.01–1.65) were associated with TRD risk. Conclusions.: Our findings align with neuroprogression models of depression, in which more severe patients, defined by greater verbal memory impairment and depressive symptoms, develop a more resistant profile as a result of increasingly detrimental neuronal changes. Moreover, our results support a more comprehensive approach in the evaluation and treatment of DTD in order to improve illness course. Longitudinal studies are warranted to confirm the predictive value of verbal memory and depression severity in the development of TRD.

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  • Executive function is especially impacted in TRD.

    “which has important treatment implications given that it is especially impacted in TRD (López-Solà et al., 2020;Rao et al., 2019)”

    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 López-Solà et al., 2020

    The Results report poorer executive-function performance in the TRD group than in the nonresistant group. However, they do not identify executive function as especially affected relative to other domains: verbal memory was the domain that remained significantly different after controlling for treatment and symptom severity and was associated with TRD risk (Results; Discussion, Cognitive variables). (LLM, conf=0.84)

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1 of the 66 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. [32]Lezak MD, Howieson DB, Loring DW, with Hannay HJ, Fischer JS. Neuropsychological assessment. 4th ed. Oxford, UK: Oxford University Press, 2004.
  2. [48]Romeo B, Choucha W, Fossati P, Rotge J-Y. Clinical and biological predictors of ketamine response in treatment-resistant major depression: review. Encephale. 2017; 43: 354– 362. 27623117

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Authors
López-Solà, C., Subirà, M., Serra-Blasco, M., Vicent-Gil, M., Navarra-Ventura, G., Aguilar, E., Acebillo, S., Palao, D. J., & Cardoner, N.
Affiliations
  • Instituto de Salud Carlos III (ES)
  • Corporació Sanitària Parc Taulí (ES)
  • Universitat Autònoma de Barcelona (ES)
Venue
European Psychiatry
Published
2020
Volume
63
Issue
1
Pages
e74-e74
ISSN
  • 0924-9338 (ISSN-L)
  • 1778-3585
OpenAlex
W3036644526
Cited by
31
References
66
Citations by year
2026: 9 · 2025: 7 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 2
FWCI
1.65
Type
journal article
Language
en
Open access
Locations
  • European Psychiatry (publishedVersion, cc-by-nc-sa)
  • PubMed Central (publishedVersion, cc-by-nc-sa)
  • PubMed (publishedVersion)
  • Dipòsit Digital de Documents de la UAB (Universitat Autònoma de Barcelona) (submittedVersion, cc-by-nc-sa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • Instituto de Salud Carlos III (PI17/01205, PI15/01478)
  • European Regional Development Fund (PI15/01478)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
Keywords
treatment-resistant depression, difficult-to-treat depression, cognitive impairment, verbal memory impairment, depression severity, major depressive disorder
MeSH terms
Adult, Cognition, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Memory, Middle Aged, Outpatients, Odds Ratio, Cognitive Dysfunction, Depressive Disorder, Treatment-Resistant

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