2026 ECNP Congress

PS03-3181

Clinical and cognitive factors associated with psychosocial functioning in patients with major depressive disorder

Júlia Carrasco Hernández — M. Vicent-Gil, G. Vall, T. Legido, J. Vera, L. Gawron, C. del Mar Bonnin, C. Alemany, N. Cardoner, J. de Diego-Adeliño, J. Trujols, M.J. Portella · IR Sant Pau, Mental Health Research Group- Department of Psychiatry, Barcelona, Spain

2026 ECNP Congress

Background

Major Depressive Disorder (MDD) is associated with significant psychosocial impairment, which often persists beyond improvement in core affective symptoms. In this context, cognitive dysfunction has been identified as a key contributor to disability in MDD [1]. In addition, subjective cognitive complaints have emerged as a particularly relevant factor influencing psychosocial functioning [2]. However, the clinical and functional profile of these patients and the factors associated with their psychosocial functioning, remain insufficiently characterized.

Aims

The aim to characterize the clinical and sociodemographic profile of patients with Major Depressive Disorder (MDD) referred to cognitive rehabilitation and to identify clinical, subjective cognitive, and sociodemographic factors associated with psychosocial functioning.

Methods

This is a cross-sectional study of patients with MDD (DSM-5-TR) referred to a cognitive rehabilitation program. Subjective cognitive difficulties were assessed using the Perceived Deficits Questionnaire (PDQ), and depressive symptom severity was measured using the 17-item Hamilton Depression Rating Scale (HDRS-17). Descriptive analyses were first performed. Pearson bivariate correlations were then conducted to explore the association between sociodemographic and clinical variables and psychosocial functioning. Variables with statistical significance (p < 0.1) were included in multiple linear regression models using a backward stepwise procedure. Two models were constructed: one including the total score of the Functioning Assessment Short Test (FAST) as the dependent variable, and another for the cognitive domain of the FAST.

Results

The sample included 112 patients, with a mean age of 49.75 years (SD = 9.6) and a mean HDRS-17 score of 11.59 (SD = 4.55), indicating mild depressive symptoms. The final model for the FAST total score explained a substantial proportion of the variance (adjusted R² = 0.338) and was statistically significant (F[3, 84] = 15.82, p < 0.001). Depressive symptom severity (p < 0.001) and subjective cognitive complaints (p = 0.02) emerged as significant factors, while sex showed a trend toward significance (p = 0.058). For the cognitive domain of the FAST, age (p = 0.006) and subjective cognitive complaints (p < 0.001) were significant predictors, and the model showed moderate explanatory capacity (R² = 0.232), reaching overall statistical significance (F[2, 90] = 13.56, p < 0.001).

Conclusions

These findings suggest that, even in the presence of mild or subsyndromal depressive symptoms, psychosocial functioning is influenced by subjective cognitive complaints and sociodemographic factors such as age and sex, pointing to the existence of distinct clinical profiles. Considering these factors may be particularly relevant for optimizing patient selection for cognitive rehabilitation programs and for tailoring interventions to those most likely to benefit. Moreover, recognizing the combined impact of affective, cognitive, and demographic variables may help clarify their impact on functional impairment in MDD, supporting the development of personalized treatment strategies aimed at improving psychosocial functioning.

Keywords:depression, psychosocial functioning, cognition, subjective cognition

References

  1. Lam, R. W., Kennedy, S. H., McIntyre, R. S., & Khullar, A. (2014). Cognitive dysfunction in major depressive disorder: Effects on psychosocial functioning and implications for treatment. The Canadian Journal of Psychiatry, 59(12), 649–654. https://doi.org/10.1177/070674371405901206
  2. Sumiyoshi, T., Watanabe, K., Noto, S., Sakamoto, S., Moriguchi, Y., Hammer-Helmich, L., & Fernandez, J. (2021). Relationship of subjective cognitive impairment with psychosocial function and relapse of depressive symptoms in patients with major depressive disorder: Analysis of longitudinal data from PERFORM-J. Neuropsychiatric Disease and Treatment, 17, 945–955. https://doi.org/10.2147/NDT.S288108