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Neuropsychological Performance in Remitted Major Depressive Disorder Patients: A Case-Control Study

Ahmed Souhali Bannour, Mtiraoui A, Brahem A, Ben Romdhane A, Ben Nasr S, ElKissi Y and Ben Hadj Ali B

Background: Neurocognitive deficits in Major Depressive Disorder (MDD) might hamper social readjustment and impede full recovery. Their reversibilityafter remission remains controversial.Diverge results are mainly explained by methodological biases.The aim of the present study was to (1) examine the cognitive performance in a well-defined homogenous group of MDD patients in remitted state and to (2) determine clinical features associated with cognitive deficits.

Methods : We recruited thirty outpatients meeting the DSM-IV criteria of former MDD, 18 to 60 years-old, free from axis-I comorbid disorders and regularly consulting in the psychiatry department of Farhat Hached University Hospital, Sousse, Tunisia. Patients were in state of clinical remission for at least three months with HDRS score below 7 at the time of assessment. They were compared to thirty control subjects matched for age, sex, level of instruction and IQ. Participants were assessed for attention and processing-speed, working memory, verbal fluency, non-verbal memoryand executive functions.

Results: Remitted MDD patients displayed cognitive dysfunction in attention and processing-speed, non-verbal memory and executive functions. Patients with a single depressive episode showed a general intact cognitive performance. A positive correlation was found between number of previous depressive episodes and longer duration of the illness respectively with attention and processing-speed, mental flexibility and non-verbal memory performance.

Conclusions: Our results further reinforce the hypothesis of long-lasting cognitive impairment in remitted MDD patients.Findings suggest that cognitive dysfunction cannot be considered as trait marker but appears to be sensitive to depressive recurrence.