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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald


CiteScore 2018: 0.85

SCImago Journal Rank (SJR) 2018: 0.494
Source Normalized Impact per Paper (SNIP) 2018: 0.427

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1877-8879
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Volume 15, Issue 1

Issues

Pain and major depressive disorder: Associations with cognitive impairment as measured by the THINC-integrated tool (THINC-it)

Danielle S. Cha / Nicole E. Carmona / Rodrigo B. Mansur / Yena Lee
  • Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
  • Institute of Medical Science, University of Toronto, Toronto, ON, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Hyun Jung Park / Nelson B. Rodrigues / Mehala Subramaniapillai / Joshua D. Rosenblat
  • Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
  • Institute of Medical Science, University of Toronto, Toronto, ON, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Zihang Pan
  • Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
  • Institute of Medical Science, University of Toronto, Toronto, ON, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Jae Hon Lee
  • Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
  • Department of Psychiatry, Samsung Seoul Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ JungGoo Lee
  • Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
  • Paik Institute for Clinical Research, Inje University, Busan, Republic of Korea
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Fahad Almatham / Asem Alageel
  • Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
  • Department of Psychiatry, College of Medicine, Imam University, Riyadh, Saudi Arabia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Margarita Shekotikhina / Aileen J. Zhou / Carola Rong
  • Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
  • American University of Integrative Sciences School of Medicine, Sint Maarten, The Netherlands
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/ John Harrison
  • Alzheimer Center, VU Medical Center, Amsterdam, The Netherlands
  • Metis Cognition Ltd, Warminster, UK
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/ Roger S. McIntyre
  • Corresponding author
  • Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
  • Institute of Medical Science, University of Toronto, Toronto, ON, Canada
  • Department of Psychiatry, University of Toronto, Toronto, ON, Canada
  • Department of Pharmacology, University of Toronto, Toronto, ON, Canada
  • Email
  • Other articles by this author:
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Published Online: 2017-04-01 | DOI: https://doi.org/10.1016/j.sjpain.2016.12.004

Abstract

Objectives

To examine the role of pain on cognitive function in adults with major depressive disorder (MDD).

Methods

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.

Results

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.

Conclusions

Results indicated that pain is associated with increased self-rated and objective cognitive deficits in adults with MDD.

Implications

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.

Keywords: Major depressive disorder; Pain; Cognition; Cognitive impairment; Measurement based care

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About the article

Brain and Cognition Discovery Foundation, 399 Bathurst Street, Toronto, ON, Canada M5T 2S8. Fax: +1 416 603 5368.


Received: 2016-12-10

Accepted: 2016-12-17

Published Online: 2017-04-01

Published in Print: 2017-04-01


Funding: No funding was obtained in the production of the present study.

Ethical Issues: No ethical issues were reported in the present study.

Conflict of interest: Dr. Roger S. McIntyre has received Research Grants from: Stanley Medical Research Institute, Lundbeck, Janssen Ortho, Purdue, AstraZeneca, Shire, Pfizer, Otsuka, and Allergan. He is on the Advisory Board for: Lundbeck, Pfizer, AstraZeneca, Eli Lilly, Janssen Ortho, Purdue, Johnson & Johnson, Moksha8, Sunovion, Mitsubishi, Takeda, Forest, Otsuka, Bristol-Myers Squibb, and Shire. He has also been a Speaker for: Lundbeck, Pfizer, AstraZeneca, Eli Lilly, Janssen Ortho, Purdue, Johnson & Johnson, Moksha8, Sunovion, Mitsubishi, Takeda, Forest, Otsuka, Bristol-Myers Squibb, and Shire. All other authors have nothing to disclose. All authors declare no conflict of interest.


Citation Information: Scandinavian Journal of Pain, Volume 15, Issue 1, Pages 62–67, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1016/j.sjpain.2016.12.004.

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