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Alterations in cognitive performance have been described in patients with major depressive disorder (MDD). However, the specific risk factors of these changes are not yet known. This study aimed to explore whether inmunometabolic parameters are related to cognitive performance in MDD in comparison to healthy controls (HC) Methods: Sample consisted of 84 MDD patients and 78 HC. Both groups were compared on the results of cognitive performance measured with the Cambridge Neuropsychological Test Automated Battery (CANTAB), the presence of metabolic syndrome (MetS) and an inflammatory/oxidative index calculated by a principal component analysis of peripheral biomarkers (tumor necrosis factor, C-reactive protein and 4-hydroxynonenal). A multiple linear regression was carried out, to study the relationship between inmunometabolic variables and the global cognitive performance, being the latter the dependent variable. Results: Significant differences were obtained in the inflammatory/oxidative index between both groups (F(1157)= 12.93; p < .001), also in cognitive performance (F(1157)= 56.75; p < .001). The inmunometabolic covariate regression model (i.e., condition (HC/MDD), sex, age and medication loading, MetS, inflammatory/oxidative index and the interaction between MetS and inflammatory/oxidative index) was statistically significant (F(7157)= 11.24; p < .01) and explained 31% of variance. The condition, being either MDD or HD, (B=˗0.97; p < .001), age (B=˗0.28; p < .001) and the interaction between inflammatory/oxidative index and MetS (B=˗0.38; p = .02) were factors associated to cognitive performance. Limitations: Sample size was relatively small. The cross-sectional design of the study limits the possibilities of analysis. Conclusions: Our results provide evidence on the conjoint influence of metabolic and inflammatory dysregulation on cognitive dysfunction in MDD patients. In this way, our study opens a line of research in immunometabolic agents to deal with cognitive decline associated with MDD, This study was supported in part by grants from the Carlos III Health Institute through the Ministry of Science, Innovation and Universities (PI15/00662, PI15/0039, PI15/00204, PI19/01040), co-funded by the European Regional Development Fund (ERDF) “A way to build Europe”, CIBERSAM, and the Catalan Agency for the Management of University and Research Grants (AGAUR 2017 SGR 1247). We also thank CERCA Programme/ Generalitat de Catalunya for institutional support. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. MJP was funded with a Miguel Servet II contract until 2020 (CP16/00020) from the Carlos III Health Institute through the Spanish Ministry of Health. YSC work is supported by the FPI predoctoral grant (FPI 2016/17) from Universidad Autonoma de Madrid. The authors would like to acknowledge the support of the research participants, who helped to make this work possible. We thank Tamara Oliva and Marta Martín for technical assistance

Mindfulness-based cognitive therapy (MBCT), an intervention that integrates mindfulness with cognitive-behavioral therapy, is an 8-week program originally developed to prevent relapses in patients with depression. Previous studies have demonstrated the efficacy of MBCT for preventing relapse, but few studies have evaluated MBCT in naturalistic conditions with real-world samples. Therefore, we sought to explore the characteristics and experiences of individuals receiving MBCT in primary care. Mixed-methods approach combining descriptive and qualitative data. Quantitative data were obtained from 269 individuals from different socioeconomic backgrounds who participated in an MBCT program in our healthcare area during the years 2017 and 2018. Qualitative data were obtained from a subsample of participants who agree to participate in semi-structured individual interviews. An interpretative phenomenological analysis (IPA) approach was used to analyze the qualitative data. In the whole sample (n = 269), the most commonly diagnosed disorders were adjustment (41.6%), mood (22.7%), and anxiety (14.1%). Most participants (60%) were taking psychotropic medications (mainly antidepressants). Overall, mindfulness training improved depressive and anxiety symptoms, regardless of the specific diagnosis. A subsample of 14 individuals participated in the qualitative study. Four overarching themes emerged from the IPA analysis in this subsample: (1) effects of mindfulness practice, (2) learning process, (3) group experience, and (4) mindfulness in the healthcare system. The findings of this naturalistic, mixed-methods study suggest that MBCT could be an effective approach to treating the symptoms of common mental disorders in the primary care setting.

BackgroundVerb fluency (VF) is the less commonly used fluency test, despite several studies suggesting its potential as a neuropsychological assessment tool. Objective: To investigate the presence of VF deficits in mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) dementia; to assess the usefulness of VF in the detection of cognitively healthy (CH) people who will convert to MCI, and from MCI to dementia; and to establish the VF cut-offs useful in the cognitive assessment of Spanish population.Methods568 CH, 885 MCI, and 367 mild AD dementia individuals were administered the VF test and a complete neuropsychological battery. Longitudinal analyses were performed in 231 CH and 667 MCI subjects to search for VF predictors of diagnosis conversion.ResultsA worsening on VF performance from CH, MCI to AD dementia groups was found. Lower performances on VF were significantly related to conversion from CH to MCI/MCI to dementia. When the effect of time to conversion was analyzed, a significant effect of VF was found on the faster conversion from CH to MCI, but not from MCI to dementia. Moreover, VF cut-off scores and sensitivity/specificity values were calculated for 6 conditions (3 age ranges by 2 educational levels). ConclusionThe VF test may be a useful tool for the differential diagnosis of cognitive failure in the elderly. Since VF deficits seem to take place in early stages of the disease, it is a suitable neuropsychological tool for the detection not only of CH people who will convert to MCI, but also from MCI to dementia.