Longitudinal trajectories of subjective cognitive complaints in patients with major depressive disorder and similar objective cognitive trajectories

Abstract

Background

We examined the factors influencing various subtypes of subjective cognitive change in patients who shared similar objective cognitive trajectories within 6 months.

Method

We used data from an observational, prospective, cohort study, including 598 patients with major depressive disorder (MDD) in latent class mixed models based on the digit symbol substitution test performance. Participants were stratified into four distinct objective cognitive layers: “low cognitive performance,” “lower-middle cognitive performance,” “upper-middle cognitive performance,” and “high cognitive performance.” Within each of the four layers, the trajectories of subjective cognitive complaints were identified. Multinomial regression was employed, with cognitive complaint trajectories as the outcome, and depressive symptoms, clinical features, and other covariates as predictors.

Results

The factors influencing the subjective trajectories varied among the different objective layers. Patients with comorbid anxiety disorders or functional syndromes had more prominent self-reported cognitive symptoms and a slower rate of improvement. Younger age and lower education level were also influential factors for delayed remission of subjective cognitive function. Disease severity and antidepressant type did not contribute to dedifferentiating subjective cognitive trajectory subtypes within different subjective cognitive trajectories.

Conclusion

Despite similar objective cognitive trajectories, subjective perceptions of these cognitive changes are heterogeneous. These findings deepen our understanding of the multifaceted nature of cognitive change in individuals with MDD and underscore the importance of considering a range of factors when interpreting and treating cognitive impairment at an early stage.