Stordal Kirsten I, Lundervold Astri J, Egeland Jens, Mykletun Arnstein, Asbjørnsen Arve, Landrø Nils Inge, Roness Atle, Rund Bjørn Rishovd, Sundet Kjetil, Oedegaard Ketil J, Lund Anders
Department of Psychiatry, University of Bergen, Bergen, Norway.
Nord J Psychiatry. 2004;58(1):41-7. doi: 10.1080/08039480310000789.
Depression is associated with impairment of cognitive functions, and especially executive functions (EFs). Despite the fact that most depressed patients experience recurrence of episodes, the pattern and the severity of executive impairment have not been well characterized in this group of depressed patients. We asked if and to what extent these patients were impaired on a range of neuropsychological tests measuring EFs, and also when confounding factors were adjusted for. Forty-five patients (aged 19-51 years) with moderate to severe (Hamilton score >18) recurrent major depressive disorder (DSM-IV) were compared to 50 healthy controls matched on age, education, gender and intellectual abilities. The subjects were administered a set of neuropsychological tests that assesses sub-components of EFs. The depressed patients were impaired compared to the control group on all selected tests, with a severity of impairment within -1 standard deviation from the control group mean. The group difference was statistically significant for eight of the 10 EFs that were assessed. These were measures of verbal fluency, inhibition, working memory, set-maintenance and set-shifting. The group difference was still significant for all sub-components except for set-shifting (Wisconsin Card Sorting Test) and planning (Tower of London), when additional medication and retarded psychomotor speed was adjusted for. In conclusion, the depressed subjects were mildly impaired across a wide range of EFs. This may have a negative impact on everyday functioning for this group of patients.
抑郁症与认知功能损害相关，尤其是执行功能（EFs）。尽管大多数抑郁症患者会经历发作复发，但在这组抑郁症患者中，执行功能损害的模式和严重程度尚未得到很好的描述。我们询问了这些患者在一系列测量执行功能的神经心理学测试中是否受损以及受损程度如何，同时也考虑了混杂因素的调整。将45名年龄在19 - 51岁之间、患有中度至重度（汉密尔顿评分>18）复发性重度抑郁症（DSM - IV）的患者与50名在年龄、教育程度、性别和智力能力方面匹配的健康对照者进行比较。对受试者进行了一组评估执行功能子成分的神经心理学测试。与对照组相比，抑郁症患者在所有选定测试中均表现出受损，受损严重程度在对照组均值的 - 1个标准差范围内。在评估的10项执行功能中有8项的组间差异具有统计学意义。这些测试包括言语流畅性、抑制、工作记忆、定势维持和定势转换。在调整了额外用药和精神运动速度迟缓因素后，除定势转换（威斯康星卡片分类测试）和计划（伦敦塔测试）外，所有子成分的组间差异仍然显著。总之，抑郁症患者在广泛的执行功能方面存在轻度受损。这可能会对该组患者的日常功能产生负面影响。
