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Cognitive Dysfunction in the Workplace: Focus on Depression

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Book cover Mental Health in the Workplace

Part of the book series: Integrating Psychiatry and Primary Care ((IPPC))

Abstract

Major depressive disorder (MDD) is a common and burdensome mental health condition that is associated with significant occupational disability. Cognitive dysfunction, especially in neurocognitive domains of attention, memory, and executive functioning, is a well-recognized core feature of MDD that contributes to impairment in work functioning. Although there are many evidence-based treatments for MDD, neurocognitive deficits can persist even when other depressive symptoms are in remission after treatment. Despite the importance of cognition in mediating functional and occupational recovery, there has been little study of treatments that specifically address depression-associated cognitive dysfunction. In this chapter, we review the importance of cognitive dysfunction as it relates to workplace impairment in MDD, summarize the specific cognitive effects of evidence-based psychological and pharmacological treatments, and provide some principles to guide optimal treatment for working patients with MDD.

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References

  1. Jaeger J, Berns S, Uzelac S, Davis-Conway S. Neurocognitive deficits and disability in major depressive disorder. Psychiatry Res. 2006;145:39–48.

    Article  Google Scholar 

  2. Knight MJ, Baune BT. Cognitive dysfunction in major depressive disorder. Curr Opin Psychiatry. 2018;31:26–31.

    Article  Google Scholar 

  3. Rock PL, Roiser JP, Riedel WJ, Blackwell AD. Cognitive impairment in depression: a systematic review and meta-analysis. Psychol Med. 2014;44:2029–40.

    Article  CAS  Google Scholar 

  4. Gualtieri CT, Morgan DW. The frequency of cognitive impairment in patients with anxiety, depression, and bipolar disorder: an unaccounted source of variance in clinical trials. J Clin Psychiatry. 2008;69:1122–30.

    Article  Google Scholar 

  5. Douglas KM, Gallagher P, Robinson LJ, Carter JD, McIntosh VV, Frampton CM, Watson S, Young AH, Ferrier IN, Porter RJ. Prevalence of cognitive impairment in major depression and bipolar disorder. Bipolar Disord. 2018;20:260–74.

    Article  CAS  Google Scholar 

  6. Beblo T, Sinnamon G, Baune BT. Specifying the neuropsychology of affective disorders: clinical, demographic and neurobiological factors. Neuropsychol Rev. 2011;21:337–59.

    Article  Google Scholar 

  7. Clark M, DiBenedetti D, Perez V. Cognitive dysfunction and work productivity in major depressive disorder. Expert Rev Pharmacoecon Outcomes Res. 2016;16:455–63.

    Article  Google Scholar 

  8. Evans VC, Chan SS, Iverson GL, Bond DJ, Yatham LN, Lam RW. Systematic review of neurocognition and occupational functioning in major depressive disorder. Neuropsychiatry. 2013;3:97–105.

    Article  Google Scholar 

  9. Bearden CE, Glahn DC, Monkul ES, Barrett J, Najt P, Villarreal V, Soares JC. Patterns of memory impairment in bipolar disorder and unipolar major depression. Psychiatry Res. 2006;142:139–50.

    Article  Google Scholar 

  10. Cotrena C, Branco LD, Shansis FM, Fonseca RP. Executive function impairments in depression and bipolar disorder: association with functional impairment and quality of life. J Affect Disord. 2016;190:744–53.

    Article  Google Scholar 

  11. Zaninotto L, Solmi M, Veronese N, Guglielmo R, Ioime L, Camardese G, Serretti A. A meta-analysis of cognitive performance in melancholic versus non-melancholic unipolar depression. J Affect Disord. 2016;201:15–24.

    Article  Google Scholar 

  12. MacQueen GM, Memedovich KA. Cognitive dysfunction in major depression and bipolar disorder: assessment and treatment options. Psychiatry Clin Neurosci. 2017;71:18–27.

    Article  Google Scholar 

  13. Baune BT, Miller R, McAfoose J, Johnson M, Quirk F, Mitchell D. The role of cognitive impairment in general functioning in major depression. Psychiatry Res. 2010;176:183–9.

    Article  Google Scholar 

  14. Biringer E, Mykletun A, Sundet K, Kroken R, Stordal KI, Lund A. A longitudinal analysis of neurocognitive function in unipolar depression. J Clin Exp Neuropsychol. 2007;29:879–91.

    Article  Google Scholar 

  15. Bora E, Harrison BJ, Yücel M, Pantelis C. Cognitive impairment in euthymic major depressive disorder: a meta-analysis. Psychol Med. 2013;43:2017–26.

    Article  CAS  Google Scholar 

  16. Knight MJ, Air T, Baune BT. The role of cognitive impairment in psychosocial functioning in remitted depression. J Affect Disord. 2018;235:129–34.

    Article  Google Scholar 

  17. Bubonya M, Cobb-Clark D, Wooden M. Mental health and productivity at work: does what you do matter? Labour Econ. 2017;46:150–65.

    Article  Google Scholar 

  18. Laing SS, Jones SM. Anxiety and depression mediate the relationship between perceived workplace health support and presenteeism: a cross-sectional analysis. J Occup Environ Med. 2016;58:1144–9.

    Article  Google Scholar 

  19. Lee SA, Ju YJ, Han KT, Choi JW, Yoon HJ, Park EC. The association between loss of work ability and depression: a focus on employment status. Int Arch Occup Environ Health. 2017;90:109–16.

    Article  Google Scholar 

  20. Lerner D, Henke RM. What does research tell us about depression, job performance, and work productivity? J Occup Environ Med. 2008;50:401–10.

    Article  Google Scholar 

  21. Kalechstein AD, Newton TF, van Gorp WG. Neurocognitive functioning is associated with employment status: a quantitative review. J Clin Exp Neuropsychol. 2003;25:1186–91.

    Article  CAS  Google Scholar 

  22. Adler DA, McLaughlin TJ, Rogers WH, Chang H, Lapitsky L, Lerner D. Job performance deficits due to depression. Am J Psychiatry. 2006;163:1569–76.

    Article  Google Scholar 

  23. Lerner D, Amick BC, Rogers WH, Malspeis S, Bungay K, Cynn D. The work limitations questionnaire. Med Care. 2001;39:72–85.

    Article  CAS  Google Scholar 

  24. Rosa AR, Sánchez-Moreno J, Martínez-Aran A, Salamero M, Torrent C, Reinares M, Comes M, Colom F, Van Riel W, Ayuso-Mateos JL, Kapczinski F, Vieta E. Validity and reliability of the Functioning Assessment Short Test (FAST) in bipolar disorder. Clin Pract Epidemiol Ment Health. 2007;3:5.

    Article  Google Scholar 

  25. Lam RW, Kennedy SH, Parikh SV, MacQueen GM, Milev RV, Ravindran AV. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: introduction and methods. Can J Psychiatr. 2016;61:506–9.

    Article  Google Scholar 

  26. Godard J, Baruch P, Grondin S, Lafleur MF. Psychosocial and neurocognitive functioning in unipolar and bipolar depression: a 12-month prospective study. Psychiatry Res. 2012;196:145–53.

    Article  Google Scholar 

  27. Leon AC, Solomon DA, Mueller TI, Turvey CL, Endicott J, Keller MB. The Range of Impaired Functioning Tool (LIFE-RIFT): a brief measure of functional impairment. Psychol Med. 1999;29:869–78.

    Article  CAS  Google Scholar 

  28. Godard J, Grondin S, Baruch P, Lafleur MF. Psychosocial and neurocognitive profiles in depressed patients with major depressive disorder and bipolar disorder. Psychiatry Res. 2011;190:244–52.

    Article  Google Scholar 

  29. Parikh SV, Quilty LC, Ravitz P, Rosenbluth M, Pavlova B, Grigoriadis S, Velyvis V, Kennedy SH, Lam RW, MacQueen GM, Milev RV, Ravindran AV, Uher R. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: Section 2. Psychological treatments. Can J Psychiatr. 2016;61:524–39.

    Article  Google Scholar 

  30. Kamenov K, Twomey C, Cabello M, Prina AM, Ayuso-Mateos JL. The efficacy of psychotherapy, pharmacotherapy and their combination on functioning and quality of life in depression: a meta-analysis. Psychol Med. 2017;47:414–25.

    Article  CAS  Google Scholar 

  31. Joyce S, Modini M, Christensen H, Mykletun A, Bryant R, Mitchell PB, Harvey SB. Workplace interventions for common mental disorders: a systematic meta-review. Psychol Med. 2016;46:683–97.

    Article  CAS  Google Scholar 

  32. Porter RJ, Bourke C, Carter JD, Douglas KM, McIntosh VV, Jordan J, Joyce PR, Frampton CM. No change in neuropsychological dysfunction or emotional processing during treatment of major depression with cognitive-behaviour therapy or schema therapy. Psychol Med. 2016;46:393–404.

    Article  CAS  Google Scholar 

  33. Roiser JP, Sahakian BJ. Hot and cold cognition in depression. CNS Spectr. 2013;18:139–49.

    Article  Google Scholar 

  34. Katsumi A, Hoshino H, Fujimoto S, Yabe H, Ikebuchi E, Nakagome K, Niwa SI. Effects of cognitive remediation on cognitive and social functions in individuals with schizophrenia. Neuropsychol Rehabil. 2017;1–13.

    Google Scholar 

  35. Ikebuchi E, Sato S, Yamaguchi S, Shimodaira M, Taneda A, Hatsuse N, Watanabe Y, Sakata M, Satake N, Nishio M, Ito JI. Does improvement of cognitive functioning by cognitive remediation therapy effect work outcomes in severe mental illness? A secondary analysis of a randomized controlled trial. Psychiatry Clin Neurosci. 2017;71:301–8.

    Article  Google Scholar 

  36. Hill NT, Mowszowski L, Naismith SL, Chadwick VL, Valenzuela M, Lampit A. Computerized cognitive training in older adults with mild cognitive impairment or dementia: a systematic review and meta-analysis. Am J Psychiatry. 2017;174:329–40.

    Article  Google Scholar 

  37. Bowie CR, Gupta M, Holshausen K. Cognitive remediation therapy for mood disorders: rationale, early evidence, and future directions. Can J Psychiatr. 2013;58:319–25.

    Article  Google Scholar 

  38. Motter JN, Pimontel MA, Rindskopf D, Devanand DP, Doraiswamy PM, Sneed JR. Computerized cognitive training and functional recovery in major depressive disorder: a meta-analysis. J Affect Disord. 2016;189:184–91.

    Article  Google Scholar 

  39. Kennedy SH, Lam RW, McIntyre RS, Tourjman SV, Bhat V, Blier P, Hasnain M, Jollant F, Levitt AJ, MacQueen GM, McInerney SJ, McIntosh D, Milev RV, Müller DJ, Parikh SV, Pearson NL, Ravindran AV, Uher R. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: Section 3. Pharmacological treatments. Can J Psychiatr. 2016;61:540–60.

    Article  Google Scholar 

  40. Baune BT, Renger L. Pharmacological and non-pharmacological interventions to improve cognitive dysfunction and functional ability in clinical depression--a systematic review. Psychiatry Res. 2014;219:25–50.

    Article  Google Scholar 

  41. Prado CE, Watt S, Crowe SF. A meta-analysis of the effects of antidepressants on cognitive functioning in depressed and non-depressed samples. Neuropsychol Rev. 2018;28:32–72.

    Article  Google Scholar 

  42. Baune BT, Brignone M, Larsen KG. A network meta-analysis comparing effects of various antidepressant classes on the Digit Symbol Substitution Test (DSST) as a measure of cognitive dysfunction in patients with major depressive disorder. Int J Neuropsychopharmacol. 2018;21:97–107.

    Article  Google Scholar 

  43. Rosenblat JD, Kakar R, McIntyre RS. The cognitive effects of antidepressants in major depressive disorder: a systematic review and meta-analysis of randomized clinical trials. Int J Neuropsychopharmacol. 2015;19, pii: pyv082.

    Google Scholar 

  44. Mahableshwarkar AR, Zajecka J, Jacobson W, Chen Y, Keefe RS. A randomized, placebo-controlled, active-reference, double-blind, flexible-dose study of the efficacy of vortioxetine on cognitive function in major depressive disorder. Neuropsychopharmacology. 2015;40:2025–37.

    Article  CAS  Google Scholar 

  45. Bang-Andersen B, Ruhland T, Jorgensen M, Smith G, Frederiksen K, Jensen KG, Zhong H, Nielsen SM, Hogg S, Mork A, Stensbol TB. Discovery of 1-[2-(2,4-dimethylphenylsulfanyl)phenyl]piperazine (Lu AA21004): a novel multimodal compound for the treatment of major depressive disorder. J Med Chem. 2011;54:3206–21.

    Article  CAS  Google Scholar 

  46. Evans VC, Alamian G, McLeod J, Woo C, Yatham LN, Lam RW. The effects of newer antidepressants on occupational impairment in major depressive disorder: a systematic review and meta-analysis of randomized controlled trials. CNS Drugs. 2016;30:405–17.

    Article  CAS  Google Scholar 

  47. Leon AC, Olfson M, Portera L, Farber L, Sheehan DV. Assessing psychiatric impairment in primary care with the Sheehan Disability Scale. Int J Psychiatry Med. 1997;27:93–105.

    Article  CAS  Google Scholar 

  48. Dunlop BW, Reddy S, Yang L, Lubaczewski S, Focht K, Guico-Pabia CJ. Symptomatic and functional improvement in employed depressed patients: a double-blind clinical trial of desvenlafaxine versus placebo. J Clin Psychopharmacol. 2011;31:569–76.

    Article  CAS  Google Scholar 

  49. Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a work productivity and activity impairment instrument. PharmacoEconomics. 1993;4:353–65.

    Article  CAS  Google Scholar 

  50. McIntyre RS, Florea I, Tonnoir B, Loft H, Lam RW, Christensen MC. Efficacy of vortioxetine on cognitive functioning in working patients with major depressive disorder. J Clin Psychiatry. 2017;78:115–21.

    Article  Google Scholar 

  51. Bilsker D, Wiseman S, Gilbert M. Managing depression-related occupational disability: a pragmatic approach. Can J Psychiatr. 2006;51:76–83.

    Article  Google Scholar 

  52. Chokka P, Bougie J, Rampakakis E, Proulx J. Assessment in Work Productivity and the Relationship with Cognitive Symptoms (AtWoRC): primary analysis from a Canadian open-label study of vortioxetine in patients with major depressive disorder (MDD). CNS Spectr. 2018;1–10.

    Google Scholar 

  53. Lam RW, Iverson GL, Evans VC, Yatham LN, Stewart K, Tam EM, Axler A, Woo C. The effects of desvenlafaxine on neurocognitive and work functioning in employed outpatients with major depressive disorder. J Affect Disord. 2016;203:55–61.

    Article  CAS  Google Scholar 

  54. Sarfati D, Evans VC, Tam EM, Woo C, Iverson GL, Yatham LN, Lam RW. The impact of fatigue and energy on work functioning and impairment in patients with major depressive disorder treated with desvenlafaxine. Int Clin Psychopharmacol. 2017;32:343–9.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada

    Raymond W. Lam

  2. Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, Canada

    Raymond W. Lam

  3. Department of Psychiatry, University of Michigan, Ann Arbour, MI, USA

    Carol Persad

Authors
  1. Raymond W. Lam
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  2. Carol Persad
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Correspondence to Raymond W. Lam .

Editor information

Editors and Affiliations

  1. Department of Psychiatry, University of Michigan Rogel Cancer Center, Ann Arbor, MI, USA

    Michelle B. Riba

  2. Comprehensive Depression Center, University of Michigan–Ann Arbor, Ann Arbor, MI, USA

    Sagar V. Parikh

  3. Comprehensive Depression Center, University of Michigan–Ann Arbor, Ann Arbor, MI, USA

    John F. Greden

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Lam, R.W., Persad, C. (2019). Cognitive Dysfunction in the Workplace: Focus on Depression. In: Riba, M., Parikh, S., Greden, J. (eds) Mental Health in the Workplace. Integrating Psychiatry and Primary Care. Springer, Cham. https://doi.org/10.1007/978-3-030-04266-0_7

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  • DOI: https://doi.org/10.1007/978-3-030-04266-0_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-04265-3

  • Online ISBN: 978-3-030-04266-0

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