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Cognitive deficits in depression

Possible implications for functional neuropathology

Mood Disorders Unit and Department of Liaison Psychiatry, Prince of Wales Hospital, Sydney, Lecturer, School of Psychiatry, University of New South Wales

PHILIP MITCHELL, MD, Director

Mood Disorders Unit, Prince of Wales Hospital, Sydney, Professor, School of Psychiatry, University of New South Wales

GUY M. GOODWIN, FRCPsych, W. A. Handley Professor of Psychiatry

Oxford University

Correspondence: Dr Marie-Paule Austin, Department of Liaison Psychiatry, Prince of Wales Hospital, Randwick 2031, Australia. Tel: +61 2 93822796; fax: +61 2 93822177; e-mail: m.austin{at}unsw.edu.au

Declaration of interest This paper was supported by an Australian National Health and Medical Research Council Program Grant (993208).

Background While depression is known to involve a disturbance of mood, movement and cognition, its associated cognitive deficits are frequently viewed as simple epiphenomena of the disorder.

Aims To review the status of cognitive deficits in depression and their putative neurobiological underpinnings.

Method Selective computerised review of the literature examining cognitive deficits in depression and their brain correlates.

Results Recent studies report both mnemonic deficits and the presence of executive impairment — possibly selective for set-shifting tasks — in depression. Many studies suggest that these occur independent of age, depression severity and subtype, task ‘difficulty’, motivation and response bias: some persist upon clinical ‘recovery’.

Conclusions Mnemonic and executive deficits do no appear to be epiphenomena of depressive disorder. A focus on the interactions between motivation, affect and cognitive function may allow greater understanding of the interplay between key aspects of the dorsal and ventral aspects of the prefrontal cortex in depression.

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