Self-evaluation and objective assessment of cognition in major depression and attention deficit disorder: Implications for clinical practice

One of the major challenges associated with the assessment of cognitive functioning in psychiatric populations is the choice of an evaluation tool. Access to cognitive assessment is often limited by issues of expense and by the lengthiness of the testing procedure. As a result, an interest emerged in the development of self-administered questionnaires to assess an individual's perception of their own cognitive functioning. These questionnaires could be more easily used for screening as part of a routine psychiatric consultation. However, few studies have compared the results of the novel subjective measures with established objective tests of cognitive skills, and most have focused on psychopathologies marked by major and apparent cognitive impairments. The main goal of this study was to investigate the relationship between objective and subjective cognition in patients with major depression (MDD) and attention-deficit/hyperactivity disorder (ADHD) both associated with subtle cognitive impairments on neuropsychological testing. First, we compared the performance of patients with MDD and ADHD to that of healthy controls (HC) on objective and subjective measures of cognition. Then, we evaluated the association between objective and subjective measures of cognitive functioning in the three groups of participants. Patients with MDD and ADHD performed worse than HC on neuropsychological tests and reported more cognitive difficulties in their daily life. Only a moderate correlation was observed between objective and subjective measures of cognition in individuals with MDD and ADHD. Subjective cognitive measures were more closely correlated with functioning than objective measures. These findings suggest that neuropsychological testing and self-reported scales of cognition are not interchangeable but rather give information about different constructs. The evaluation of cognitive functioning should ideally include both objective and subjective measures of cognition.