Cognitive disturbance in outpatient depressed younger adults: Evidence of modest impairment

Background: Investigations of cognitive disturbances among patients with mo od disorders have yielded inconsistent results. Although marked neuropsycho logic deficits have been reported in elderly patients and in midlife patien ts with severe depression, the severity of cognitive impairments in medical ly healthy younger ambulatory adults with depression has not been well char acterized. Methods: A comprehensive battery of standard neuropsychologic tests and exp erimental computerized measures of cognitive functioning were administered to unmedicated ambulatory younger adults with mild to moderate nonbipolar d epression and to a group of age- and gender-equated healthy subjects. Results: Patients demonstrated a notable absence of widespread cognitive im pairment. Deficits in executive functions were observed on the Wisconsin Ca rd Sort Test but not on several other tests. Despite the absence of signifi cant impairment on tests of attention, memory, and motor performance in the total sample, symptom severity and age of illness onset were correlated wi th poorer performance on some tests of cognitive functioning evert after co rrection for age. Conclusions: These findings, derived from a large sample of unmedicated dep ressed outpatients, indicate that major depressive disorder in healthy youn ger ambulatory adults does not cause appreciable impairment in cognitive fu nctioning in the absence of clinical and course-of-illness features. Biol P sychiatry 2001;50:35-43 (C) 2001 Society of Biological Psychiatry.