Psychiatry and Psychiatric Neuroscience, School of Medicine and Dentistry, James Cook University, Townsville 4811, Australia.
Psychiatry Res. 2010 Apr 30;176(2-3):183-9. doi: 10.1016/j.psychres.2008.12.001.
The association between cognitive performance and general functioning in depression is controversial. The present study evaluated the association between cognitive dysfunction and major depressive disorder (MDD, N=70) as compared with age- and gender-matched healthy controls (n=206) and its relationship to general functioning (physical and mental health quality of life, activities of daily living, and employment status) in participants with current MDD (n=26) and those with previous MDD only (n=44). Participants were assessed clinically using the Mini International Neuropsychiatric Interview (M.I.N.I.) for the depression groups and the Diagnostic Interview for Psychoses (DIP-DM) for the control group. Measures to evaluate cognition and quality of lifes comprised the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Short Form-36 Health Survey Questionnaire, and the Activities/Instrumental Activities of Daily Living (ADL/IADL); employment status was also assessed in MDD. The results showed that a) while individuals with current depression had worse cognitive performance in all domains than healthy controls, those individuals with previous depression had lasting cognitive impairments in the domains of immediate memory and attention as compared with healthy controls; b) individuals with current depression had lower scores in the visuospatial/constructional and attention domains and the total score than individuals with previous depression; c) individuals in the depression group as a whole who were currently unemployed had significantly lower scores in all domains (except attention) of cognitive function; d) cognitive function was not related to either physical or mental quality of life or impairments of activities of daily living (ADL, IADL); e) that unemployment in previous depression was related to poor cognitive function similar to those with current depression. The results indicate that MDD may have detrimental and lasting effects on cognitive performance partly related to poorer general functioning.
抑郁患者的认知表现与一般功能之间的关系存在争议。本研究评估了认知功能障碍与重度抑郁症（MDD，N=70）的关系，并与当前 MDD 患者（n=26）和仅患有既往 MDD 的患者（n=44）的一般功能（身体和心理健康生活质量、日常生活活动和就业状况）进行了比较。参与者使用 Mini International Neuropsychiatric Interview（MINI）对抑郁组进行临床评估，使用诊断性访谈精神疾病（DIP-DM）对对照组进行评估。评估认知和生活质量的措施包括重复神经心理状态评估量表（RBANS）、36 项简短健康调查量表（SF-36）和日常生活活动/工具性日常生活活动（ADL/IADL）；MDD 还评估了就业状况。结果表明：a）尽管当前患有抑郁症的个体在所有领域的认知表现均差于健康对照组，但与健康对照组相比，既往患有抑郁症的个体在即时记忆和注意力领域仍存在持久的认知障碍；b）当前患有抑郁症的个体在视空间/结构和注意力领域以及总分方面的得分均低于既往患有抑郁症的个体；c）抑郁症组中当前失业的个体在认知功能的所有领域（注意力除外）的得分均显著较低；d）认知功能与身体或心理健康或日常生活活动（ADL、IADL）的损害无关；e）既往抑郁症的失业与当前抑郁症患者相似，与较差的认知功能有关。结果表明，MDD 可能对认知表现产生有害且持久的影响，部分原因与一般功能较差有关。
