Impact of Cognitive Dysfunction in the Middle East Depressed Patients: The ICMED Study

Abdulqader Al Jarad1, Ahmad Al Hadi1, Ali Al Garatli2, Aly Akram3, Dakhil Alsaeidi4, Fahad Al Mansour5, Hany El Amin3, Mohamed Khaled6, Nawaf Alharthi7, *, Rafat Al Owesie8, Samia Abdullah9, Talaat Matar10, Tarek Darwish11
1 Psychiatric Department, King Saud University, King Khalid University Hospital, Riyadh, KSA
2 Psychiatric Department in King Fahd Medical City, Riyadh, KSA
3 Psychiatric Department, Cairo University, Egypt and Psychiatric Department at Dr Erfan Hospital, Jeddah, KSA
4 Psychiatric Departments, King Faisal Specialist Hospital and Research Centre, Jeddah, KSA
5 Psychiatric Departments, Edrak Medical Center, Riyadh, KSA
6 Psychiatric Departments, Saudi German Hospital, Jeddah, KSA
7 Jeddah Mental Health Hospital, Jeddah, KSA
8 Prince Sultan Military Hospital, Riyadh, KSA
9 Psychiatric Departments, Rashid Hospital, Dubai Health Authority, UAE
10 Psychiatric Departments, Saif Hospital, Ras Al-Khaimah, UAE
11 Psychiatric Departments, Sheikh Khalifa Medical City, Abu Dhabi, UAE

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© 2018 Al Jarad et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Jeddah Mental Hospital, 1276 Jeddah, 21431, Tel: 00966505697004; E-mail:



Major depressive disorder is a common condition with a high rate of recurrence, chronicity, and affecting economic burden, including disability in the workplace, which leads to negative consequences on both individuals and society.


This study aimed to estimate the impact of cognitive dysfunction, as declared by the patient, on performing daily tasks/activities among patients with major depression disorder (MDD).


This investigation is based on multinational cross-sectional survey of 499 workers recruited from the Kingdom of Saudi Arabia (KSA) and United Arab Emirates (UAE). We assessed the severity of depression by Hamilton Depression Rating Scale (HDRS). Impact of Depression in the Workplace in Europe Audit (IDEA) survey and trial making test (TMT) parts A and B were used to assess the impact of cognitive dysfunction on performing daily tasks/activities in adult patients presented with MDD.


A total of 499 persons were included in this study, aged 18–66 years, current workers and managers. Of them, 17.8% were normal (remitted), 22.4% were mildly depressed, 23.4% were moderately depressed, 8.6% were severely depressed, and 27.7% were very severely depressed at the time of the study according to HDRS. Common symptoms attributable to depression were low mode or sadness (89.8%), followed by insomnia (75.2%) and crying (70.9%). Of them, low mode or sadness was the most common factor affecting the work performance (90.2%). About 66.3% of participants diagnosed with depression by a doctor/medical professional. Awareness of the disease was recognizable by patients’ managers in only 31.9% of the cases. Furthermore, 45.3% of cases had taken off work due to depression with mean duration of 38.7 (95% CI 37.7 to 39.7) days. The mean TMT parts A and B score were 69.2 (95% CI 66.3 to 72.2) and 126.6 (95% CI 121 to 132), respectively. Lastly, a significant positive correlation between the mean score for HDRS and TMT-A and B scores was observed.


Depression affects work productivity and work environment with negative consequences to countries’ economy. Awareness of depression in the workplace in KSA and UAE is still suboptimal. The personal and societal burden of this issue cannot be neglected when we become aware of the proportion of affected people.

Keywords: Depression, Hamilton Depression Rating Scale, IDEA questionnaire, Trail Making Test (TMT)-A and B, Workplace, Cognitive dysfunction.