Cognitive dysfunction in major depression and bipolar disorder: Assessment and treatment options.
Cognitive dysfunction is a recognized feature of mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD). Cognitive impairment is associated with poor overall functional outcome and is therefore an important feature of illness to optimize for patients' occupational and academic outcomes. While generally people with BD appear to have a greater degree of cognitive impairment than those with MDD, direct comparisons of both patient groups within a single study are lacking. There are a number of methods for the assessment of cognitive function, but few are currently used in clinical practice. Current symptoms, past course of illness, clinical features, such as the presence of psychosis and comorbid conditions, may all influence cognitive function in mood disorders. Despite the general lack of assessment of cognitive function in clinical practice, clinicians are increasingly targeting cognitive symptoms as part of comprehensive treatment strategies. Novel pharmacological agents may improve cognitive function, but most studies of standard mood stabilizers, such as lithium and the anticonvulsants, have focused on whether or not the medications impair cognition. Non-pharmacological strategies, such as cognitive remediation and exercise, are increasingly studied in patients with mood disorders. Despite the growing interest in strategies to manage cognitive function, there is a paucity of high-quality trials examining either pharmacological or non-pharmacological modes of intervention.
Cumming School of Medicine, Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.
Glenda M
http://orcid.org/0000-0003-3352-6781
GM
MacQueen
Bachelor's of Health Sciences Program, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Katherine A
KA
Memedovich
D001714:Bipolar Disorder / Q000150:complications*; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003865:Major Depressive Disorder / Q000150:complications*; D006801:Humans
bipolar; cognition; major depressive disorder; neuropsychological; treatment