Oxford University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK.
Eur Neuropsychopharmacol. 2011 Sep;21 Suppl 4:S710-5. doi: 10.1016/j.euroneuro.2011.07.016. Epub 2011 Aug 23.
Symptoms and observable signs offer an important way of measuring the severity of depression and estimating recovery. However, a shift to understanding the cognitive neuroscience underlying the clinical picture has been fruitful and could change the approach in meaningful ways. Cognition as defined by attention, memory and executive function is impaired in depression and offers a way of identifying abnormal brain states or structure. Moreover, such changes may limit functional recovery and explain why recurrent depression in particular is so impairing. More subtle aspects of cognition can be revealed by studies of emotional processing. Patients with depression have negative emotional biases but the measurement of such effects is confounded by the global impairments already described and may be secondary to a primary change in mood. Nevertheless, there are early effects of antidepressants treatments in healthy volunteers and depressed patients on such mechanisms specifically. It remains to be established how far the properties of antidepressants are defined by such effects both in relation to successful treatment and in their potential for emotional side effects, or blunting of experience, after recovery from depressive symptoms.
症状和可观察到的体征为衡量抑郁严重程度和评估康复提供了重要方法。然而，对临床症状背后的认知神经科学的理解的转变已经产生了丰硕的成果，并可能以有意义的方式改变治疗方法。抑郁时注意力、记忆和执行功能等认知会受损，为识别异常大脑状态或结构提供了一种方法。此外，这种变化可能会限制功能恢复，并解释为什么特别是复发性抑郁症如此具有破坏性。通过情绪处理的研究可以揭示认知的更细微方面。抑郁症患者存在负性情绪偏见，但对这些影响的测量受到已经描述的全面损伤的干扰，可能是情绪变化的次要因素。然而，抗抑郁药物治疗在健康志愿者和抑郁症患者中确实对这些机制具有早期影响。在与成功治疗相关的范围内以及在抗抑郁症状缓解后对情绪副作用或体验钝化的潜在影响方面，抗抑郁药物的特性在多大程度上由这些作用来定义，这仍有待确定。
