Introduction
cognitive impairment, depressive disorder, MDD, depression, Cognitive impairment
STAGGERING
Major depressive disorder (MDD) is a serious, often chronic condition with a staggering burden that disrupts psychosocial, interpersonal, and workplace function. Cognitive impairment is recognized as a major contributor to both poor functional outcomes and lack of symptom relief from antidepressant treatments.A growing pool of studies document cognitive impairment in MDD across the adult lifespan and assess treatments for it.Our previous work has shown that patients with MDD, in young to mid-adulthood, are distinguished from healthy patients by a group mean reduction in cognitive performance, which persists despite ADTsWe used a machine learning method of cluster analysis to identify the cognitive biotype within the broader MDD diagnosis. Our primary research goal was to validate the cognitive biotype of depression by assessing whether it is distinguished by baseline symptom and function profiles, by baseline neural dysfunctions in the cognitive control circuit, and by poorer response to standard antidepressants. We also sought to determine whether lack of amelioration of cognitive impairment mediates poorer symptom and function outcomes during the treatment period (but not the reverse).