Department of Psychiatry, University Hospital of Copenhagen, Rigshospitalet, Denmark.
J Affect Disord. 2011 Nov;134(1-3):20-31. doi: 10.1016/j.jad.2010.11.011. Epub 2010 Dec 15.
It is unclear whether cognitive impairment is prevalent in the remitted state of unipolar disorder.
To evaluate whether cognitive function is impaired in the remitted state in patients with unipolar depression compared with healthy control individuals, and to investigate the association to prior course of illness, i.e. the number, duration and severity of prior depressive episodes.
Systematic search on existing on-line databases and hand-search of original published papers.
A total of 11 studies fulfilled the selection criteria and were included in the review, including a total of 500 patients remitted from unipolar depression and 471 healthy control individuals. In nine of the eleven studies performance on neuropsychological tests was found to be decreased in patients compared to healthy control individuals in at least one of the tests. Methodological drawbacks were prevalent including non-stringent definition of remission and non-correction for multiple testing. Only few studies investigated the association between cognition and prior course of illness and the results were divergent.
Stringent criteria were used in the assessment of eligibility of studies. The studies were first and foremost selected according to the criteria for remission used.
Cognitive dysfunction seems to be present in individuals suffering from unipolar disorder in the remitted state. We recommend that future studies should focus on disentangling the state and trait characteristics of cognitive dysfunction in unipolar disorder and further clarify the associations with clinical phenotype, course of illness and subsyndromal psychopathology. Furthermore, there is a need to identify the cognitive difficulties in individuals suffering from unipolar disorder in relation to psychosocial function, quality of life and risk of recurrence and to assess the effect of treatment intervention on cognitive function.
单相障碍缓解期是否普遍存在认知障碍尚不清楚。
评估单相抑郁患者在缓解期的认知功能是否受损，并探讨与既往疾病病程的关系，即既往抑郁发作的次数、持续时间和严重程度。
系统检索现有在线数据库和原始已发表论文的手工检索。
共有 11 项研究符合入选标准并纳入综述，共纳入 500 例单相抑郁缓解患者和 471 例健康对照者。在 11 项研究中的 9 项中，与健康对照组相比，患者在至少一项神经心理学测试中表现出认知功能下降。方法学缺陷普遍存在，包括缓解期定义不严格和未对多次测试进行校正。只有少数研究调查了认知功能与既往疾病病程之间的关系，结果存在差异。
在评估研究纳入标准时使用了严格的标准。这些研究首先根据所使用的缓解标准进行选择。
认知功能障碍似乎存在于单相障碍缓解期的个体中。我们建议未来的研究应重点阐明单相障碍认知功能障碍的状态和特质特征，并进一步阐明与临床表型、病程和亚综合征精神病理学的关系。此外，需要确定单相障碍患者的认知困难与社会心理功能、生活质量和复发风险的关系，并评估治疗干预对认知功能的影响。
