Massachusetts General Hospital, One Bowdoin Sq, 6th Floor, Boston, MA 02114
J Clin Psychiatry. 2014 Jan;75(1):8-14. doi: 10.4088/JCP.13r08710.
The literature regarding cognitive symptoms in major depressive disorder (MDD) is vast and often contradictory. To provide clinicians with a concise understanding of these prevalent and disabling symptoms, this overview describes what is known regarding cognitive symptoms in patients with MDD, the limitations of the current literature, and the implications of these data for current and future clinical practice.
PubMed searches were conducted to identify studies, meta-analyses, and systematic reviews evaluating cognitive function (not cognitive bias) in patients with MDD. Search terms used in combination with MDD were cognition, cognitive dysfunction, memory, psychomotor processing, and executive function. Searches were limited to articles available in the English language and those published between April 2007 and March 2012. Additional studies and those describing screening tools were identified using reference lists and PubMed "related citations." Ongoing trials were identified by searching for cognitive dysfunction and MDD at www.ClinicalTrials.gov. Relevant articles were obtained and reviewed by the author.
Small sample size and inconsistent assessment tools were identified as major limitations of studies assessing clinical characteristics and risk factors for cognitive symptoms. Meta-analyses and systematic reviews were used to mitigate this limitation.
Cognitive symptoms of depression are prevalent and associated with earlier illness onset and longer episode duration. They can have an adverse impact on the treatment course of MDD as well as on functional recovery in depression. Further studies are needed to help determine whether certain treatments can be more effective than others at targeting these symptoms.
关于重性抑郁障碍（MDD）认知症状的文献十分丰富，但往往相互矛盾。为了让临床医生能够简明地了解这些普遍存在且使人丧失能力的症状，本篇综述描述了 MDD 患者认知症状的已知情况、当前文献的局限性，以及这些数据对当前和未来临床实践的意义。
通过 PubMed 检索，以识别评估 MDD 患者认知功能（非认知偏差）的研究、荟萃分析和系统综述。检索词与 MDD 相结合，使用了认知、认知功能障碍、记忆、精神运动处理和执行功能。检索限于英文文献，以及 2007 年 4 月至 2012 年 3 月发表的文献。使用参考文献列表和 PubMed“相关引文”查找其他研究和描述筛选工具。通过在 www.ClinicalTrials.gov 上搜索认知功能障碍和 MDD，可识别正在进行的试验。作者获取并审查了相关文章。
研究评估认知症状的临床特征和危险因素时，样本量小和评估工具不一致被确定为主要局限性。荟萃分析和系统综述被用来减轻这一局限性。
抑郁的认知症状普遍存在，与疾病更早发作和更长的发作持续时间有关。它们会对 MDD 的治疗过程以及抑郁的功能恢复产生不利影响。需要进一步的研究来帮助确定某些治疗方法是否比其他方法更能有效地针对这些症状。
