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(PSYCHIATRIC TIMES) - Subjective complaints of impaired concentration, memory, and attention are common in people with major depressive disorder (MDD), and research shows that a variety of structural brain abnormalities are associated with MDD.1 These findings have intensified the interest in quantitative assessment of cognitive and neuropsychological performance in patients with mood disorders. Many studies that used standardized cognitive tests have found that mild cognitive abnormalities are associated with MDD and that these abnormalities are more pronounced in persons who have MDD with melancholic or psychotic features.2,3 Older patients with MDD, especially those with onset of illness after age 55 years and patients who have signs of vascular injury to the brain, were also shown to have cognitive abnormalities.4-6

In this article, we review the scientific literature that addresses neuropsychological and cognitive impairments in patients who have MDD.

A few key conceptual issues need to be considered when evaluating research on MDD in general and on the association of cognitive dysfunction with MDD in particular. It is increasingly clear that MDD is a genetically complex syndrome with multiple causal pathways involving gene-environment interactions.7 In addition, pathology associated with co-occurring drug and alcohol abuse and some general medical disorders, such as diabetes, cardiovascular disease, and autoimmune disorders, may further contribute to the pathology of MDD or lead to mental states that share many of the same symptoms but arise from markedly different neurobiological origins.

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