Introduction
Cognitive deficits are common in individuals with stress-related disorders and may represent an important barrier to successfully return to work after treatment. The THINC-it tool is a cognitive assessment tool designed to assess key domains of cognitive function. Evidence regarding the association between cognitive function, assessed with the THINC-it tool, and depression severity remains inconsistent. In this analysis, which is part of a larger project (HARMODI study), we examined the association between cognitive function and depression severity, as well as changes in cognitive performance and depression severity from baseline to discharge from inpatient treatment.
Methods
The HARMODI study is an observational study performed in a psychiatric clinic for stress-related disorders. A total of 153 inpatients (27-64 years, 88 women) diagnosed with burnout syndrome and either a depressive episode or an adjustment disorder, undergoing a multimodal psychiatric treatment, were included. At baseline and before the end of a 6-8 week-long treatment, depression severity was rated using the Beck Depression Inventory-II, while cognitive function was tested with the THINC-it tool. The THINC-it tool consists of a self-rated questionnaire, the Perceived Deficits Questionnaire, and variants of four cognitive tests: the Choice Reaction Time Identification Task (Spotter), the One-Back Test (Symbol Check), the Digit Symbol Substitution Test (Codebreaker), and the Trail Making Test-Part B (Trails).
Results
Multiple regression analyses indicate little evidence for associations between baseline depression score and cognitive function tests. Cognitive function, i.e., the Symbolcheck (mean difference = 5 points, 95%CI [3,6 ], p < .001), Codebreaker (mean difference = 6 points, 95%CI [4,8 ], p < .001), Trails (mean difference = -5 seconds, 95%CI [-6,-3 ], p < .001), and Spotter (mean difference = -36 milliseconds, 95%CI [-55.-18 ], p < .001), as well as depression severity (mean difference = -12 points, 95%CI [-13,-11 ], p < .001) improved from baseline to discharge. Analyses provide little evidence for associations between change in depression severity and discharge cognitive function test scores.
Conclusion
Depressive symptoms and cognitive function scores improved from baseline to discharge, reflecting meaningful gains in domains critical for daily functioning in patients with stress-related disorders. Our findings indicate that improvements in depression and cognitive function may occur in parallel rather than being directly interdependent. At discharge, cognitive function remained below normative levels, emphasizing the importance of routine cognitive screenings, the need for continuous treatment, and a gradual return to work.