Cognitive impairment as measured by the THINC-integrated tool (THINC-it): Association with psychosocial function in major depressive disorder

Danielle S. Cha, Nicole E. Carmona, Mehala Subramaniapillai, Rodrigo B. Mansur, Yena Lee, Jae Hon Lee, Jung Goo Lee, Joshua D. Rosenblat, Margarita Shekotikhina, Caroline Park, Carola Rong, Tracy L. Greer, Raymond Lam, Bernhard T. Baune, John Harrison, Roger S. McIntyre

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background Psychosocial impairment represents an important treatment target in major depressive disorder (MDD). The majority of patients with MDD do not regain premorbid levels of psychosocial functioning despite the resolution of core depressive symptoms. This study aimed to investigate the respective effects of cognitive function and depression severity on impaired psychosocial function in MDD. Methods Adults aged 18–65 with moderate-to-severe MDD (n = 100) and age-, sex-, and education-matched healthy controls participated in a cross-sectional study validating the THINC-integrated tool (THINC-it), a cognitive screening tool comprised of objective and subjective measures of cognitive function. Depression severity was assessed using the Montgomery-Åsberg Depression Rating Scale and psychosocial function was assessed using the Sheehan Disability Scale (SDS). Results Subjects with MDD reported greater impairment in psychosocial function than healthy controls, with significant differences in SDS total and domain scores (ps <.01) after controlling for age, sex, and education. Generalized linear models indicated that subjective cognitive function was most strongly associated with SDS total score (RR =.14, p =.01) and SDS domains of work/school (RR =.15, p =.03), family and home responsibilities (RR =.15, p =.02), and economic days lost (RR =.18, p =.03). Depression severity was most strongly associated with SDS social life (RR =.08, p <.01) and economic days underproductive (RR =.07, p <.01). Objective cognitive function was not significantly associated with any SDS outcomes. Limitations The cross-sectional, observational study design limits temporal inferences. The self-report nature of measures included may have influenced associations observed. Potential medication effects are not noted. Conclusions Cognitive deficits, as measured by the THINC-it, are associated with significant psychosocial impairment in MDD. These results provide empirical support for the assessment of both subjective and objective measures of cognition, as they are not associated with each other and have differential effects on functional trajectory.

Original languageEnglish
Pages (from-to)14-20
Number of pages7
JournalJournal of Affective Disorders
Volume222
DOIs
Publication statusPublished - 1 Nov 2017

Cite this

Cha, Danielle S. ; Carmona, Nicole E. ; Subramaniapillai, Mehala ; Mansur, Rodrigo B. ; Lee, Yena ; Hon Lee, Jae ; Lee, Jung Goo ; Rosenblat, Joshua D. ; Shekotikhina, Margarita ; Park, Caroline ; Rong, Carola ; Greer, Tracy L. ; Lam, Raymond ; Baune, Bernhard T. ; Harrison, John ; McIntyre, Roger S. / Cognitive impairment as measured by the THINC-integrated tool (THINC-it) : Association with psychosocial function in major depressive disorder. In: Journal of Affective Disorders. 2017 ; Vol. 222. pp. 14-20.
@article{5dd4faa1c5124deeb73ac0130f4c34e8,
title = "Cognitive impairment as measured by the THINC-integrated tool (THINC-it): Association with psychosocial function in major depressive disorder",
abstract = "Background Psychosocial impairment represents an important treatment target in major depressive disorder (MDD). The majority of patients with MDD do not regain premorbid levels of psychosocial functioning despite the resolution of core depressive symptoms. This study aimed to investigate the respective effects of cognitive function and depression severity on impaired psychosocial function in MDD. Methods Adults aged 18–65 with moderate-to-severe MDD (n = 100) and age-, sex-, and education-matched healthy controls participated in a cross-sectional study validating the THINC-integrated tool (THINC-it), a cognitive screening tool comprised of objective and subjective measures of cognitive function. Depression severity was assessed using the Montgomery-{\AA}sberg Depression Rating Scale and psychosocial function was assessed using the Sheehan Disability Scale (SDS). Results Subjects with MDD reported greater impairment in psychosocial function than healthy controls, with significant differences in SDS total and domain scores (ps <.01) after controlling for age, sex, and education. Generalized linear models indicated that subjective cognitive function was most strongly associated with SDS total score (RR =.14, p =.01) and SDS domains of work/school (RR =.15, p =.03), family and home responsibilities (RR =.15, p =.02), and economic days lost (RR =.18, p =.03). Depression severity was most strongly associated with SDS social life (RR =.08, p <.01) and economic days underproductive (RR =.07, p <.01). Objective cognitive function was not significantly associated with any SDS outcomes. Limitations The cross-sectional, observational study design limits temporal inferences. The self-report nature of measures included may have influenced associations observed. Potential medication effects are not noted. Conclusions Cognitive deficits, as measured by the THINC-it, are associated with significant psychosocial impairment in MDD. These results provide empirical support for the assessment of both subjective and objective measures of cognition, as they are not associated with each other and have differential effects on functional trajectory.",
keywords = "Cognition, Major depressive disorder, Measurement-based care, Psychosocial impairment",
author = "Cha, {Danielle S.} and Carmona, {Nicole E.} and Mehala Subramaniapillai and Mansur, {Rodrigo B.} and Yena Lee and {Hon Lee}, Jae and Lee, {Jung Goo} and Rosenblat, {Joshua D.} and Margarita Shekotikhina and Caroline Park and Carola Rong and Greer, {Tracy L.} and Raymond Lam and Baune, {Bernhard T.} and John Harrison and McIntyre, {Roger S.}",
year = "2017",
month = "11",
day = "1",
doi = "10.1016/j.jad.2017.06.036",
language = "English",
volume = "222",
pages = "14--20",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
publisher = "Elsevier",

}

Cha, DS, Carmona, NE, Subramaniapillai, M, Mansur, RB, Lee, Y, Hon Lee, J, Lee, JG, Rosenblat, JD, Shekotikhina, M, Park, C, Rong, C, Greer, TL, Lam, R, Baune, BT, Harrison, J & McIntyre, RS 2017, 'Cognitive impairment as measured by the THINC-integrated tool (THINC-it): Association with psychosocial function in major depressive disorder' Journal of Affective Disorders, vol. 222, pp. 14-20. https://doi.org/10.1016/j.jad.2017.06.036

Cognitive impairment as measured by the THINC-integrated tool (THINC-it) : Association with psychosocial function in major depressive disorder. / Cha, Danielle S.; Carmona, Nicole E.; Subramaniapillai, Mehala; Mansur, Rodrigo B.; Lee, Yena; Hon Lee, Jae; Lee, Jung Goo; Rosenblat, Joshua D.; Shekotikhina, Margarita; Park, Caroline; Rong, Carola; Greer, Tracy L.; Lam, Raymond; Baune, Bernhard T.; Harrison, John; McIntyre, Roger S.

In: Journal of Affective Disorders, Vol. 222, 01.11.2017, p. 14-20.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Cognitive impairment as measured by the THINC-integrated tool (THINC-it)

T2 - Association with psychosocial function in major depressive disorder

AU - Cha, Danielle S.

AU - Carmona, Nicole E.

AU - Subramaniapillai, Mehala

AU - Mansur, Rodrigo B.

AU - Lee, Yena

AU - Hon Lee, Jae

AU - Lee, Jung Goo

AU - Rosenblat, Joshua D.

AU - Shekotikhina, Margarita

AU - Park, Caroline

AU - Rong, Carola

AU - Greer, Tracy L.

AU - Lam, Raymond

AU - Baune, Bernhard T.

AU - Harrison, John

AU - McIntyre, Roger S.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Background Psychosocial impairment represents an important treatment target in major depressive disorder (MDD). The majority of patients with MDD do not regain premorbid levels of psychosocial functioning despite the resolution of core depressive symptoms. This study aimed to investigate the respective effects of cognitive function and depression severity on impaired psychosocial function in MDD. Methods Adults aged 18–65 with moderate-to-severe MDD (n = 100) and age-, sex-, and education-matched healthy controls participated in a cross-sectional study validating the THINC-integrated tool (THINC-it), a cognitive screening tool comprised of objective and subjective measures of cognitive function. Depression severity was assessed using the Montgomery-Åsberg Depression Rating Scale and psychosocial function was assessed using the Sheehan Disability Scale (SDS). Results Subjects with MDD reported greater impairment in psychosocial function than healthy controls, with significant differences in SDS total and domain scores (ps <.01) after controlling for age, sex, and education. Generalized linear models indicated that subjective cognitive function was most strongly associated with SDS total score (RR =.14, p =.01) and SDS domains of work/school (RR =.15, p =.03), family and home responsibilities (RR =.15, p =.02), and economic days lost (RR =.18, p =.03). Depression severity was most strongly associated with SDS social life (RR =.08, p <.01) and economic days underproductive (RR =.07, p <.01). Objective cognitive function was not significantly associated with any SDS outcomes. Limitations The cross-sectional, observational study design limits temporal inferences. The self-report nature of measures included may have influenced associations observed. Potential medication effects are not noted. Conclusions Cognitive deficits, as measured by the THINC-it, are associated with significant psychosocial impairment in MDD. These results provide empirical support for the assessment of both subjective and objective measures of cognition, as they are not associated with each other and have differential effects on functional trajectory.

AB - Background Psychosocial impairment represents an important treatment target in major depressive disorder (MDD). The majority of patients with MDD do not regain premorbid levels of psychosocial functioning despite the resolution of core depressive symptoms. This study aimed to investigate the respective effects of cognitive function and depression severity on impaired psychosocial function in MDD. Methods Adults aged 18–65 with moderate-to-severe MDD (n = 100) and age-, sex-, and education-matched healthy controls participated in a cross-sectional study validating the THINC-integrated tool (THINC-it), a cognitive screening tool comprised of objective and subjective measures of cognitive function. Depression severity was assessed using the Montgomery-Åsberg Depression Rating Scale and psychosocial function was assessed using the Sheehan Disability Scale (SDS). Results Subjects with MDD reported greater impairment in psychosocial function than healthy controls, with significant differences in SDS total and domain scores (ps <.01) after controlling for age, sex, and education. Generalized linear models indicated that subjective cognitive function was most strongly associated with SDS total score (RR =.14, p =.01) and SDS domains of work/school (RR =.15, p =.03), family and home responsibilities (RR =.15, p =.02), and economic days lost (RR =.18, p =.03). Depression severity was most strongly associated with SDS social life (RR =.08, p <.01) and economic days underproductive (RR =.07, p <.01). Objective cognitive function was not significantly associated with any SDS outcomes. Limitations The cross-sectional, observational study design limits temporal inferences. The self-report nature of measures included may have influenced associations observed. Potential medication effects are not noted. Conclusions Cognitive deficits, as measured by the THINC-it, are associated with significant psychosocial impairment in MDD. These results provide empirical support for the assessment of both subjective and objective measures of cognition, as they are not associated with each other and have differential effects on functional trajectory.

KW - Cognition

KW - Major depressive disorder

KW - Measurement-based care

KW - Psychosocial impairment

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U2 - 10.1016/j.jad.2017.06.036

DO - 10.1016/j.jad.2017.06.036

M3 - Article

VL - 222

SP - 14

EP - 20

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -