Institut universitaire en santé mentale de Québec, Québec, Canada.
Psychiatry Res. 2011 Dec 30;190(2-3):244-52. doi: 10.1016/j.psychres.2011.06.014. Epub 2011 Jul 18.
Previous studies have revealed psychosocial and cognitive impairments in patients during depression. The primary aim of this study was to investigate whether patients with major depression (MDD) and bipolar disorder (BD) differ in psychosocial and neurocognitive profiles. A second aim was to examine whether cognitive impairments are homogeneous among depressed patients. Patients with MDD (n=16) and BD (n=14) were enrolled during a major depressive episode. About half of them had comorbidities, including personality, substance use, and anxiety disorders. Information was collected about symptomatology and psychosocial functioning, whereas an exhaustive neuropsychological battery was administered to assess cognition. During a depressive episode, MDD and BD patients had global psychosocial dysfunction, characterized by occupational and relational impairments. A cognitive slowing was also observed, as well as deficits related to alertness, spontaneous flexibility, sustained and divided attention. Moreover, severity of depression and cognitive functions were significantly associated with psychosocial functioning. In the case of severe mood disorders, psychosocial and neurocognitive functioning seem similar among MDD and BD patients during a depressive episode. In addition to an altered daily functioning, the neurocognitive profile was heterogeneous with regard to the nature and extent of cognitive deficits. Executive functions, as well as verbal learning and memory, were preserved better than attentional processes.
先前的研究揭示了抑郁症患者的心理社会和认知损伤。本研究的主要目的是调查重度抑郁症(MDD)和双相情感障碍(BD)患者在心理社会和神经认知特征上是否存在差异。第二个目的是检查认知损伤在抑郁患者中是否具有同质性。在重度抑郁发作期间,纳入了 16 名 MDD 患者和 14 名 BD 患者。他们中的近一半患有共病,包括人格障碍、物质使用障碍和焦虑障碍。收集了症状和心理社会功能的信息,同时还进行了详尽的神经心理学测试来评估认知。在抑郁发作期间,MDD 和 BD 患者存在整体心理社会功能障碍,表现为职业和人际关系受损。还观察到认知速度减慢,以及与警觉性、自发性灵活性、持续和分散注意力相关的缺陷。此外,抑郁严重程度和认知功能与心理社会功能显著相关。在严重情绪障碍的情况下,MDD 和 BD 患者在抑郁发作期间的心理社会和神经认知功能似乎相似。除了日常功能改变外,认知特征在认知缺陷的性质和程度上存在异质性。执行功能以及言语学习和记忆比注意力过程更好地保留。