Jaeger Judith, Berns Stefanie, Uzelac Sarah, Davis-Conway Sara
Center for Neuropsychiatric Outcome and Rehabilitation Research, Zucker Hillside Hospital, North Shore Long Island Jewish Health System, 75-59 263rd St., Glen Oaks, NY 11004, USA.
Psychiatry Res. 2006 Nov 29;145(1):39-48. doi: 10.1016/j.psychres.2005.11.011. Epub 2006 Oct 11.
Disability in life functioning is an important and poorly understood consequence of major depressive disorder (MDD). Mood symptoms do not account for the magnitude of disability resulting from MDD. Impairments in several domains of neurocognitive (NC) functioning have been shown to interfere with functionality in other psychiatric populations. These deficits, also present in MDD, may play a significant role in disability experienced by many with this disorder. The aim of this study was to examine the degree to which NC deficits, independent of affective and psychotic symptoms, explain functional outcome 6 months following hospitalization for a major depressive episode. Participants with an MDD diagnosis (N=48) received NC testing and symptom ratings while in the hospital. These procedures were repeated, along with functionality ratings, 6 months later. Six-month NC performance was strongly associated with functionality ratings after covariation for residual depression. Selected NC domains tested at baseline were predictive of functionality at 6 months. These data indicate that NC deficits, at least for some MDD sufferers, play an important role in functional recovery. New treatments, whether pharmacologic or rehabilitative, may be required to help affected patients accommodate neurocognitively based performance deficits at work, at home and in the community.
生活功能障碍是重度抑郁症（MDD）的一个重要但却鲜为人知的后果。情绪症状并不能解释MDD所导致的功能障碍的严重程度。在其他精神疾病群体中，神经认知（NC）功能的几个领域的损害已被证明会干扰功能。这些缺陷在MDD中也存在，可能在许多患有这种疾病的人的功能障碍中起重要作用。本研究的目的是检验NC缺陷（独立于情感和精神病性症状）在重度抑郁发作住院6个月后对功能结局的解释程度。患有MDD诊断的参与者（N = 48）在住院期间接受了NC测试和症状评分。6个月后重复这些程序，同时进行功能评分。在对残余抑郁进行协变量调整后，6个月的NC表现与功能评分密切相关。在基线时测试的选定NC领域可预测6个月时的功能。这些数据表明，至少对一些MDD患者来说，NC缺陷在功能恢复中起重要作用。可能需要新的治疗方法，无论是药物治疗还是康复治疗，来帮助受影响的患者在工作、家庭和社区中适应基于神经认知的表现缺陷。
