Mackin R Scott, Nelson J Craig, Delucchi Kevin, Raue Patrick, Byers Amy, Barnes Deborah, Satre Derek D, Yaffe Kristine, Alexopoulos George S, Arean Patricia A
Department of Psychiatry, University of California, San Francisco, San Francisco, CA; Center for Imaging of Neurodegenerative Disease, San Francisco, CA; Veterans Administration Medical Center, San Francisco, CA.
Department of Psychiatry, University of California, San Francisco, San Francisco, CA.
Am J Geriatr Psychiatry. 2014 Dec;22(12):1496-503. doi: 10.1016/j.jagp.2013.11.002. Epub 2013 Nov 16.
The purpose of this study was to determine the impact of psychotherapy on cognitive functioning in older adults with late-life depression (LLD) and executive dysfunction.
Two hundred twenty-one adults aged 60 years and older participated in a randomized clinical trial comparing the efficacy of Problem Solving Therapy (PST) and Supportive Therapy (ST) for LLD. Cognitive performance on seven tests of executive functioning, verbal learning, and memory was evaluated at baseline, after 12 weeks of treatment, and at 24 weeks after the completion of treatment.
Performance on a measure of executive functioning with a significant information processing speed component (Stroop Color and Word Test) improved after treatment, F (1, 312) = 8.50, p = 0.002, and improved performance was associated with a reduction in depressive symptoms but not treatment type. Performance on other measures of executive functioning, verbal learning, and memory did not change significantly after 12 weeks of psychotherapy treatment.
Our results suggest that improvements in cognitive functioning after psychotherapy treatment for depression in older adults with executive dysfunction are likely focal and not distributed across all cognitive domains. Although previous analyses reported that PST was superior to ST in the treatment of depression, this analysis indicated no difference between the two treatments with regard to improvements in cognitive functioning.
本研究旨在确定心理治疗对患有老年期抑郁症（LLD）和执行功能障碍的老年人认知功能的影响。
221名60岁及以上的成年人参与了一项随机临床试验，比较解决问题疗法（PST）和支持性疗法（ST）对LLD的疗效。在基线、治疗12周后以及治疗完成后24周时，对执行功能、言语学习和记忆的七项测试的认知表现进行评估。
在一项具有显著信息处理速度成分的执行功能测量（斯特鲁普颜色和文字测试）中，治疗后的表现有所改善，F（1, 312） = 8.50，p = 0.002，表现的改善与抑郁症状的减轻相关，但与治疗类型无关。在心理治疗12周后，其他执行功能、言语学习和记忆测量的表现没有显著变化。
我们的结果表明，对患有执行功能障碍的老年人进行抑郁症心理治疗后，认知功能的改善可能是局部的，并非分布在所有认知领域。尽管先前的分析报告称PST在抑郁症治疗方面优于ST，但该分析表明，在认知功能改善方面，两种治疗方法没有差异。
