TY - JOUR
T1 - Analysing UK clinicians’ understanding of cognitive symptoms in major depression
T2 - A survey of primary care physicians and psychiatrists
AU - McAllister-Williams, R. Hamish
AU - Bones, Kate
AU - Goodwin, Guy M.
AU - Harrison, John
AU - Katona, Cornelius
AU - Rasmussen, Jill
AU - Strong, Sarah
AU - Young, Allan H.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background Cognitive dysfunction occurs in depression and can persist into remission. It impacts on patient functioning but remains largely unrecognised, unmonitored and untreated. We explored understanding of cognitive dysfunction in depression among UK clinicians. Methods A multi-step consultation process. Step 1: a multi-stakeholder steering committee identified key themes of burden, detection and management of cognitive dysfunction in depression, and developed statements on each to explore understanding and degree of agreement among clinicians. Step 2: 100 general practitioners (GPs) and 100 psychiatrists indicated their level of agreement with these statements. Step 3: the steering committee reviewed responses and highlighted priority areas for future education and research. Results There was agreement that clinicians are not fully aware of cognitive dysfunction in depression. Views of the relationship between cognitive dysfunction and other depressive symptom severities was not consistent with the literature. In particular, there was a lack of recognition that some cognitive dysfunction can persist into remission. There was understandable uncertainty around treatment options, given the current limited evidence base. However, it was recognised that cognitive dysfunction is an area of unmet need and that there is a lack of objective tests of cognition appropriate for depressed patients that can be easily implemented in the clinic. Limitations Respondents are likely to be ‘led’ by the direction of the statements they reviewed. The study did not involve patients and carers. Conclusions UK clinicians should undergo training regarding cognitive dysfunction in depression, and further research is needed into its assessment, treatment and monitoring.
AB - Background Cognitive dysfunction occurs in depression and can persist into remission. It impacts on patient functioning but remains largely unrecognised, unmonitored and untreated. We explored understanding of cognitive dysfunction in depression among UK clinicians. Methods A multi-step consultation process. Step 1: a multi-stakeholder steering committee identified key themes of burden, detection and management of cognitive dysfunction in depression, and developed statements on each to explore understanding and degree of agreement among clinicians. Step 2: 100 general practitioners (GPs) and 100 psychiatrists indicated their level of agreement with these statements. Step 3: the steering committee reviewed responses and highlighted priority areas for future education and research. Results There was agreement that clinicians are not fully aware of cognitive dysfunction in depression. Views of the relationship between cognitive dysfunction and other depressive symptom severities was not consistent with the literature. In particular, there was a lack of recognition that some cognitive dysfunction can persist into remission. There was understandable uncertainty around treatment options, given the current limited evidence base. However, it was recognised that cognitive dysfunction is an area of unmet need and that there is a lack of objective tests of cognition appropriate for depressed patients that can be easily implemented in the clinic. Limitations Respondents are likely to be ‘led’ by the direction of the statements they reviewed. The study did not involve patients and carers. Conclusions UK clinicians should undergo training regarding cognitive dysfunction in depression, and further research is needed into its assessment, treatment and monitoring.
KW - Clinician awareness
KW - Cognitive dysfunction
KW - Depression
UR - http://www.scopus.com/inward/record.url?scp=84991666779&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2016.09.036
DO - 10.1016/j.jad.2016.09.036
M3 - Article
C2 - 27743537
AN - SCOPUS:84991666779
VL - 207
SP - 346
EP - 352
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
ER -