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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by SLS on November 19, 2009, at 7:29:18
One of the most reliable indicators of depression severity is the degree of cognitive impairment. Although this is not news, I found the parsing of the various cognitive functions in this study interesting. For me, the results reported are accurate.
* Another major indicator of depression severity is psychomotor retardation.
- Scott------------------------------------------------
A meta-analysis of depression severity and cognitive functionLisa M. McDermotta and Klaus P. EbmeierCorresponding Author Contact Information, a, E-mail The Corresponding Author
aDepartment of Psychiatry, University of Oxford, UK
Received 26 January 2009;
revised 16 April 2009;
accepted 16 April 2009.
Available online 9 May 2009.Abstract
Background
Studies examining the way in which cognitive impairment is associated with depression have produced inconsistent findings. Different severity of depressed mood across studies may account for such conflicting reports. However, inconsistent results have also been reported in relation to the specific association of depression severity with cognitive performance.
Methods
A meta-analysis was conducted to examine the relationship between severity of depression and cognitive function, using the correlation (Pearson's r) between depression severity scores and neuropsychological test performance. Individual meta-analyses were conducted for composite measures of cognitive functional domains (episodic memory, executive function, processing speed, semantic memory, and visuo-spatial memory). Analyses were also done across functional domains for timed and un-timed tests.
Results
Significant correlations between depression severity and cognitive performance were found in the domains of episodic memory, executive function, and processing speed, but not for semantic memory or visuo-spatial memory. For both timed and un-timed cognitive measures there were equally significant correlations with depression severity.
Limitations
There were few studies meeting inclusion criteria in some cognitive domains, papers had to be excluded due to insufficient data reporting, and there are limitations associated with the cross-sectional design.
Conclusions
The results suggest that previous inconsistent findings of the relationship between the severity of depression and cognitive function may be attributed to random variations and lack of power within studies.
Keywords: Depression; Severity of depression; Cognitive function
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Posted by Maxime on November 19, 2009, at 10:47:51
In reply to Severity of depression = cognitive impairment, posted by SLS on November 19, 2009, at 7:29:18
I agree.
It's hard for me because, not to sound vain, I am an intelligent person to begin with. When I start having cognitive disfunctions from the depression people think I am still intelligent. As a result I have had pdocs not believe me when I say that I am depressed. "You don't seem depressed. You seem intelligent blah, blah, blah". Sigh. It's really frustrating. *Yes*, intelligent people suffer from depression. There are so many people here on PB who are highly intelligent and still suffering.
Good article though.
Posted by Phillipa on November 19, 2009, at 12:24:28
In reply to Re: Severity of depression = cognitive impairment » SLS, posted by Maxime on November 19, 2009, at 10:47:51
I see so many more than intelligent people on the boards scientists, doctors, nurses, therapists, People getting masters degrees, doctorates. I could never in my best days see myself ever attaining this high an intelligence. Did you ever wonder if less intelligent just don't even recognizie depression? Phillipa
Posted by Meltingpot on November 19, 2009, at 16:23:18
In reply to Severity of depression = cognitive impairment, posted by SLS on November 19, 2009, at 7:29:18
Hi,
I know that I can't concentrate so well when I'm feeling really low and if I leave it too long (without taking a Zyprexa) I can come across as a total incompetant imbecile when working as I just can't seem to take in what people are saying to me properly.
I can still articulate my feelings well when I go to see the psychiatrist no matter how bad I'm feeling.
I guess what the trials are saying are that if you are severely depressed then you can't even talk properly.
I don't know though, if I can feel really suicidal when I'm off all meds and yet still function to a certain level then how the hell must a "Severely" depressed person be feeling. I dread to think.
I have to say that I agree with Maxime, it's just really difficult to get psychiatrists to take you seriously when you can express yourself ok.
The last NHS psychiatrist I saw, said in the report that I presented as Euthymic (meaning neither up or down) and that was after I'd been telling him how suicidal I'd been feeling.
Denise
Posted by bleauberry on November 20, 2009, at 4:52:36
In reply to Severity of depression = cognitive impairment, posted by SLS on November 19, 2009, at 7:29:18
Since cognitive impairment...brain fog I call it...is extremely common in CFS, FM, Lyme, candida, hypoadrenalism, heavy metal burden,and other mysterious conditions, and it is almost always teamed up with depression, it does not surprise me that the two go together. They are both extremely common in other diseases besides the cluster of symptoms we call depression.
Absolutely no scientific basis for my comments here, but I think where there is depression without marked cognitive issues, that directs the diagnosis away from a physical disease and toward a brain disease. Where there is marked cognitive impairment, physical causes of both the depression and the impairment must be investigated deeply and creatively at the same time symptomatic treatment is attempted.
Posted by SLS on November 20, 2009, at 6:29:40
In reply to Re: Severity of depression = cognitive impairment, posted by bleauberry on November 20, 2009, at 4:52:36
> Since cognitive impairment...brain fog I call it...is extremely common in CFS, FM, Lyme, candida, hypoadrenalism, heavy metal burden,and other mysterious conditions, and it is almost always teamed up with depression, it does not surprise me that the two go together. They are both extremely common in other diseases besides the cluster of symptoms we call depression.
>
> Absolutely no scientific basis for my comments here, but I think where there is depression without marked cognitive issues, that directs the diagnosis away from a physical disease and toward a brain disease. Where there is marked cognitive impairment, physical causes of both the depression and the impairment must be investigated deeply and creatively at the same time symptomatic treatment is attempted.
Conjecture can be a good thing.I agree with you that psychiatrists generally do not employ a battery of tests in order to rule out conditions other than the described mental illnesses. It is probably a good idea to go to a general practitioner early to screen for other conditions.
Regarding the "brain-fog" and "zombie" complaints of people with depression, I am quite confident that these are a common symptom of major depressive disorder and bipolar disorder.
Think of someone who is in a drunken stupor. The biology behind this condition is entirely neurochemical and occurs in the brain. Why should an imbalance in depression be thought of as being any different from the neurochemical imbalance created by the presence of alcohol in brain tissues?
- Scott
Posted by bleauberry on November 21, 2009, at 15:06:21
In reply to Re: Severity of depression = cognitive impairment, posted by SLS on November 20, 2009, at 6:29:40
>>
>
> Think of someone who is in a drunken stupor. The biology behind this condition is entirely neurochemical and occurs in the brain. Why should an imbalance in depression be thought of as being any different from the neurochemical imbalance created by the presence of alcohol in brain tissues?If we remove the alcohol, the symptoms resolve.
If we reset the neurotransmitters, the symptoms resolve.
If we remove the "other" neurotoxin that is causing similar effect as alcohol, and is actually a cousin derivative of alcohol (candida and bacterial waste products), symptoms resolve.
The problem is, we don't know which is which, except the alcohol of course.
My point was that a not uncommon story with patients with long protracted refractory psych and cognitive issues is that they saw their depression and brain fog symptoms resolve when "other" diseases were treated instead, sometimes blindly on just a hunch.
Not unlike every psych prescription we fill...a hunch.
>
>
> - Scott
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