Cognitive dysfunction in major depressive disorder: effects on psychosocial functioning and implications for treatment.

M depressive disorder is a common condition with a high rate of recurrence, chronicity, and staggering economic burden, including disability in the workforce.1 In 2010, MDD was the second leading medical cause of burden globally, with highest estimates of disability in people of working age.2 In Canada, the annual prevalence of MDD is 3% to 4% overall, and 79% of people with MDD report some interference with work functioning, either decreased work productivity and (or) absenteeism.1 In addition to work impairment, the psychosocial impact of MDD often affects a person’s level of functioning in family and social relationships. While there is clearly an association between improvement in depressive symptoms and functioning, symptom improvement can also be dissociated from functional improvement and work loss.3,4 Hence there has been increasing recognition that symptomatic remission is an insufficient goal of treatment for MDD and that return to premorbid psychosocial functioning should be targeted.5