Bridging the Gap From a Clinician's Perspective to Patient-Oriented Remission: Focusing on Cognitive Dysfunction in Depression

Cognitive problems in depression are a major factor affecting functional recovery, improvement of quality of life, therapeutic response, and overall prognosis. Cognitive dysfunction tends to be persistently observed during the active episode of depression and after remission. To achieve functional recovery, cognitive dysfunction is an essential target for depression treatment. To improve cognitive function in treatment of depression, early recognition and assessment with personalized management are necessary. In this review, the importance of cognitive dysfunction in the treatment of depression and potential pathophysiological mechanisms are summarized. The monoamine system, systematic inflammation, and hypothalamic-pituitary-adrenal axis are all related to the pathogenesis of cognitive dysfunction in depression. Clinicians should consider individualized factors that can affect cognitive problem, including age, duration of illness, the number of episodes, previous treatment response, baseline cognitive reservoir, subtype of depression, and presence of childhood trauma. Comorbid physical and psychiatric conditions also need to be evaluated. [Psychiatr Ann. 2022;52(3):95-99.]