Persistent Cognitive Dysfunction Following Remission from Depression: An Explanatory Model

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Abstract

Cognitive deficits during a depressive episode are a well-established feature of major depression. Whether these dysfunctions are reversible with mood normalisation was contentious until recently. Current research aims to disentangle their specific nature and stability over the disorder’s course, with the distinction between cold (emotionally independent) and hot (emotionally laden) cognitions providing useful for this purpose.
Existing evidence points toward a normal neurocognitive functioning prior to the first depressive episode, with no cold cognitive deficits preexisting the diagnosis. Higher (pre-)adolescent IQ increases the future likelihood of developing depression, while a trait-like vulnerability is conferred by the hot cognitive tendency to attribute stressful life events to global, stable, and internal causes. A depressive episode is characterised by psychomotor speed and memory deficits, which worsen with each consecutive depressive episode and do not normalise in remission.
Depression presents as a dysregulation of hot cognition where the individual’s focus on analysing the environment's negative aspects leads to depleted cognitive resources. The latter expresses through a state-related cold deficit in psychomotor speed, whereas cold memory deficits progressively install with multiple episodes. Depression has a scarring effect on cognition in remission.
Original languageEnglish
Title of host publication23rd World Congress of Psychiatry
Publication date29. Sept 2023
Publication statusPublished - 29. Sept 2023
EventProceedings of the 23rd World Congress of Psychiatry - Vienna, Austria
Duration: 27. Sept 20232. Oct 2023

Conference

ConferenceProceedings of the 23rd World Congress of Psychiatry
Country/TerritoryAustria
CityVienna
Period27/09/202302/10/2023

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