Abstract
•Pain and major depressive disorder have independent and overlapping effects on cognitive function.•Few studies have primarily aimed to evaluate the combinatorial effect of comorbid pain and major depressive disorder on cognitive function.•The THINC-integrated tool (THINC-it) is a recently validated cognitive assessment battery that evaluates both objective and subjective aspects of cognitive function in individuals with major depressive disorders.•Results from the study herein demonstrated that on the THINC-it, subjective ratings of cognitive function were more highly correlated with objective cognitive measures in adults with major depressive disorder and concurrent pain.
To examine the role of pain on cognitive function in adults with major depressive disorder (MDD).
Adults (18–65) with a Diagnostic and Statistical Manual – Fifth Edition (DSM-5)-defined diagnosis of MDD experiencing a current major depressive episode (MDE) were enrolled (nMDD=100). All subjects with MDD were matched in age, sex, and years of education to healthy controls (HC) (nHC=100) for comparison. Cognitive function was assessed using the recently validated THINC-integrated tool (THINC-it), which comprises variants of the choice reaction time (i.e., THINC-it: Spotter), One-Back (i.e., THINC-it: Symbol Check), Digit Symbol Substitution Test (i.e., THINC-it: Codebreaker), Trail Making Test – Part B (i.e., THINC-it: Trails), as well as the Perceived Deficits Questionnaire for Depression – 5-item (i.e., THINC-it: PDQ-5-D). A global index of objective cognitive function was computed using objective measures from the THINC-it, while self-rated cognitive deficits were measured using the PDQ-5-D. Pain was measured using a Visual Analogue Scale (VAS). Regression analyses evaluated the role of pain in predicting objective and subjective cognitive function.
A significant between-group differences on the VAS was observed (p<0.001), with individuals with MDD reporting higher pain severity as evidenced by higher scores on the VAS than HC. Significant interaction effects were observed between self -rated cognitive deficits and pain ratings (p<0.001) on objective cognitive performance (after adjusting for MADRS total score), suggesting that pain moderates the association between self-rated and objective cognitive function.
Results indicated that pain is associated with increased self-rated and objective cognitive deficits in adults with MDD.
The study herein provides preliminary evidence demonstrating that adults with MDD reporting pain symptomatology and poorer subjective cognitive function is predictive of poorer objective cognitive performance. THINC-it is capable of detecting cognitive dysfunction amongst adults with MDD and pain.