Castaneda A E, Suvisaari J, Marttunen M, Perälä J, Saarni S I, Aalto-Setälä T, Aro H, Koskinen S, Lönnqvist J, Tuulio-Henriksson A
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.
J Affect Disord. 2008 Sep;110(1-2):36-45. doi: 10.1016/j.jad.2007.12.239. Epub 2008 Feb 14.
There is evidence for cognitive dysfunction in unipolar depression among middle-aged and elderly patients, but cognitive functioning among depressed young adults has scarcely been systematically investigated. The aims of the present study were to examine cognitive functioning among depressed young adults identified from the general population and to determine whether cognitive deficits vary as a function of different disorder characteristics, such as severity and age at onset.
Performance in verbal and visual short-term memory, verbal long-term memory and learning, attention, processing speed, and executive functioning was compared between a population-based sample of 21-35-year-olds with a lifetime history of non-psychotic unipolar depressive disorders without psychiatric comorbidity (n=68) and healthy controls derived from the same population (n=70).
Depressed young adults were not found to be impaired in any of the assessed cognitive functions, except for some suggestion of mildly compromised verbal learning. Nevertheless, younger age at depression onset was associated with more impaired executive functioning.
The results may slightly underestimate of the true association between depression and cognitive impairments in the young adult population due to possible dropout of participants. Additionally, the problem of multiple testing was not entirely corrected.
The findings from this study indicate that a lifetime history of non-psychotic unipolar depressive disorders among young adults without psychiatric comorbidity may be associated only with minimal cognitive deficits, even when some residual depressive symptoms are prevalent. However, early-onset depression may represent a more severe form of the disorder, associated with more cognitive dysfunction.
有证据表明中年和老年单相抑郁症患者存在认知功能障碍,但抑郁青年成人的认知功能几乎未得到系统研究。本研究的目的是检查从普通人群中识别出的抑郁青年成人的认知功能,并确定认知缺陷是否因不同的疾病特征(如严重程度和发病年龄)而有所不同。
比较了基于人群的21至35岁样本中终生患有无精神病性共病的单相抑郁障碍患者(n = 68)和来自同一人群的健康对照者(n = 70)在言语和视觉短期记忆、言语长期记忆和学习、注意力、处理速度以及执行功能方面的表现。
除了有一些轻度言语学习受损的迹象外,未发现抑郁青年成人在任何评估的认知功能上存在损害。然而,抑郁发病年龄较小与执行功能受损程度较高有关。
由于可能存在参与者退出情况,结果可能会略微低估青年成人中抑郁症与认知障碍之间的真实关联。此外,多重检验问题没有得到完全纠正。
本研究结果表明,在无精神病性共病的青年成人中,终生患有非精神病性单相抑郁障碍可能仅与最小程度的认知缺陷相关,即使存在一些残留的抑郁症状。然而,早发性抑郁症可能代表该疾病更严重的形式,与更多的认知功能障碍相关。