Cognitive Impairments in Depressive Disorders: Relevance of Research and Therapeutic Perspectives

Abstract

Problem. To date, there is no consensus among researchers and clinicians regarding the pathogenetic mechanisms of cognitive impairments in depression. Despite its significant impact on patients' quality of life and ability to achieve premorbid levels of functioning, the correction of cognitive deficits is rarely considered a priority in the treatment of depressive disorders. Although cognitive dysfunction can occur in various diseases, there is reason to believe that major depressive disorder (MDD) is associated with a specific pattern of impairments that distinguishes it from other conditions. Therefore, the aim of this review was to identify and systematize the features of cognitive deficits associated with depressive disorders, which would improve diagnostics and therapeutic strategies for this patient group. As a result, a specific cognitive profile characteristic of MDD patients was proposed: (1) deficits in executive functions (working memory, cognitive flexibility, inhibitory control), (2) atypical attentional distribution with negative cognitive bias and rigid self-focus, (3) autobiographical memory impairments (overgeneralization, reduced positivity). This pattern reflects neurocognitive dysregulation affecting both basic cognitive processes and higher integrative functions, necessitating a comprehensive approach to diagnosis and treatment.Conclusion. Further validation of the proposed cognitive profile is required to establish objective diagnostic criteria and personalized therapeutic approaches for depressive disorders.