McIntyre Roger S, Soczynska Joanna Z, Woldeyohannes Hanna O, Alsuwaidan Mohammad T, Cha Danielle S, Carvalho André F, Jerrell Jeanette M, Dale Roman M, Gallaugher Laura A, Muzina David J, Kennedy Sidney H
Psychiatry and Pharmacology, University of Toronto, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
Psychiatry and Pharmacology, University of Toronto, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
Compr Psychiatry. 2015 Jan;56:279-82. doi: 10.1016/j.comppsych.2014.08.051. Epub 2014 Aug 23.
Cognitive dysfunction and depression severity are key mediators of workplace adjustment in adults with major depressive disorder (MDD). Herein, we sought to determine the extent to which measures of depression severity and cognitive dysfunction were associated with perceived global disability, workplace performance and quality of life.
A post hoc analysis was conducted using data from 260 participants with a diagnosis of DSM-IV-TR-defined MDD who were enrolled in the International Mood Disorders Collaborative Project (IMDCP) between January 2008 and July 2013. Measures of workplace function, global disability, depression severity, cognitive function, and quality of life were employed. These data were analyzed using a multiple variable linear regression equations.
Perceived global disability was significantly predicted by clinical ratings of depression severity (β=0.54), and perceived inattention (β=0.24), accounting for 37% of the variance. In addition, perceived inattention (β=0.58) and clinical ratings of depression severity (β=0.18), were also significant predictors of perceived workplace productivity/performance, accounting for 38% of the variance. Finally, both clinical ratings of depression severity (β=-0.54), and perceived inattention (β=-0.18) were significant inverse predictors of perceived quality of life, accounting for 34% of the variance.
The overarching finding in the analysis herein is that workplace performance variability is explained by subjective measures of cognitive dysfunction to a greater extent than total depression symptom severity. Conversely, total depression symptom severity accounts for a greater degree of variability in global measures of disability relative to cognitive measures. Treatment strategies for adults with major depressive disorder should address issues of cognitive dysfunction to improve workforce participation and performance.
认知功能障碍和抑郁严重程度是重度抑郁症(MDD)成年患者工作场所适应的关键调节因素。在此,我们试图确定抑郁严重程度和认知功能障碍的测量指标与感知到的整体残疾、工作场所表现和生活质量之间的关联程度。
使用2008年1月至2013年7月期间纳入国际情绪障碍协作项目(IMDCP)的260名诊断为DSM-IV-TR定义的MDD患者的数据进行事后分析。采用了工作场所功能、整体残疾、抑郁严重程度、认知功能和生活质量的测量指标。这些数据使用多元线性回归方程进行分析。
抑郁严重程度的临床评分(β=0.54)和注意力不集中感(β=0.24)可显著预测感知到的整体残疾,解释了37%的方差。此外,注意力不集中感(β=0.58)和抑郁严重程度的临床评分(β=0.18)也是感知到的工作场所生产力/表现的显著预测因素,解释了38%的方差。最后,抑郁严重程度的临床评分(β=-0.54)和注意力不集中感(β=-0.18)都是感知到的生活质量的显著反向预测因素,解释了34%的方差。
本分析的总体发现是,与总的抑郁症状严重程度相比,认知功能障碍的主观测量指标在更大程度上解释了工作场所表现的变异性。相反,相对于认知测量指标,总的抑郁症状严重程度在整体残疾测量指标的变异性中占更大比例。重度抑郁症成年患者的治疗策略应解决认知功能障碍问题,以提高劳动力参与度和表现。