title: Cognition in major depressive disorder: a 'Systemically Important Functional Index' (SIFI).
abstract: OBJECTIVE
  Cognitive dysfunction in major depressive disorder (MDD) is common, pervasive across multiple subdomains of cognitive function, and is a principle determinant of health outcomes from patient, provider, and societal perspectives. The overarching aim herein is to provide rationale for the evaluation, measurement, and specific treatment of cognitive function in adults with MDD.
  
  
  RESULTS
  Evidence indicates that cognitive dysfunction in MDD is a critical mediator of workplace disability. Systematic evaluation and measurement of cognitive function is warranted. All individuals with MDD should be evaluated for both objective and subjective cognitive dysfunction. Although differences between antidepressants in overall antidepressant efficacy are not consistent, unequivocal differences in improving measures of cognitive function are noted with evidence indicating that vortioxetine has multidomain cognitive benefits, whereas duloxetine has replicated evidence of improving measures of acquisition and recall (i.e. memory).
  
  
  CONCLUSIONS
  The probability of functional recovery in MDD is likely to increase with interventions that specifically target and improve measures of cognitive function. Clinicians are encouraged to evaluate patients using a validated measure (e.g. the THINC-it tool); prevention of cognitive impairment in MDD is a critical therapeutic priority. Vortioxetine and duloxetine benefit measures of cognitive function in MDD. Preliminary evidence of beneficial effects on cognitive emotional processing are reported with ketamine.
authors.affiliation: aDepartment of PsychiatrybDepartment of Pharmacology, University of TorontocMood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.
authors.forename: Roger S
authors.initials: RS
authors.lastname: McIntyre
authors.forename: Yena
authors.initials: Y
authors.lastname: Lee
mesh_terms: D000928:Antidepressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D003072:Cognition Disorders / Q000188:drug therapy* / Q000523:psychology*; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000523:psychology*; D000068736:Duloxetine Hydrochloride / Q000627:therapeutic use; D006801:Humans; D007858:Learning / Q000187:drug effects; D011939:Mental Recall; D010879:Piperazines / Q000627:therapeutic use; D020127:Recovery of Function; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors / Q000627:therapeutic use; D013440:Sulfides / Q000627:therapeutic use; D000078784:Vortioxetine
chemical_list: D000928:Antidepressive Agents; D010879:Piperazines; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors; D013440:Sulfides; D000078784:Vortioxetine; D000068736:Duloxetine Hydrochloride