Symptoms of depression: “hot” and “cold” cognition

Evidence-based Psychiatric Care 2015;1;48-58 Abstract Objectives: The central role of cognitive deficits in depression is well established and represents a primary mediator of the negative consequences of this disorder in both human and economic terms. The aim of the present review is to provide an up-to-date overview of current knowledge on the cognitive aspects of depression with particular focus on their clinical-therapeutic role. Materials and methods: English language and peer-reviewed publications were obtained by searching PubMed/Medline database using the keywords “depression” or “depressive” paired with “cognition”, “cognitive”, “cold”, “hot”, “deficit”, and “executive function”. Results: Recent studies have identified different cognitive systems that, when dysfunctional, play a crucial role in the onset and maintenance of depression: cognitive functions that are independent of emotional state (“cold” cognition) and cognitive regulation of emotional states (“hot” cognition). These systems develop an interaction between cognition and affectivity termed “affective cognition”, which is frequently dysfunctional in individuals with depression. Conclusions: Cognitive symptoms are increasingly the focus of clinical and scientific debate on depression, not only for their diagnostic utility, but also for their importance in the prognosis, therapy and rehabilitation of this disorder.