Ask depressed patients about brain fog to ensure melancholia is not mist

Abstract

Objective This study aims to highlight cognitive ‘brain fog’ as a key depression sub-typing symptom, being weighted to melancholic (as against non-melancholic) depression and note its common persistence after episode remission. Method This paper weights clinical observation but considers several salient overview papers and research findings. Results While ‘brain fog’ is intrinsically non-specific in that it has multiple causes, when assessed as a second-order depressive sub-typing symptom, it has seemingly distinctive specificity to the melancholic sub-type, with many patients with melancholia resonating with such a descriptor question. As it may persist (albeit attenuated) after episode remission, psychostimulant medication may be of benefit in some patients. Conclusion In the clinical assessment and differential diagnosis of those with a depressive disorder, inquiring into ‘brain fog’ can have distinct diagnostic benefit in differentiating melancholic and non-melancholic depression.