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老年未治疗抑郁症患者的精神运动迟缓

Psychomotor retardation in elderly untreated depressed patients.

作者信息

Beheydt Lieve Lia, Schrijvers Didier, Docx Lise, Bouckaert Filip, Hulstijn Wouter, Sabbe Bernard

机构信息

Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University , Antwerp , Belgium.

University Psychiatric Center KU Leuven , Kortenberg , Belgium.

出版信息

Front Psychiatry. 2015 Jan 26;5:196. doi: 10.3389/fpsyt.2014.00196. eCollection 2014.

Abstract

BACKGROUND

Psychomotor retardation (PR) is one of the core features in depression according to DSM V (1), but also aging in itself causes cognitive and psychomotor slowing. This is the first study investigating PR in relation to cognitive functioning and to the concomitant effect of depression and aging in a geriatric population ruling out contending effects of psychotropic medication.

METHODS

A group of 28 non-demented depressed elderly is compared to a matched control group of 20 healthy elderly. All participants underwent a test battery containing clinical depression measures, cognitive measures of processing speed, executive function and memory, clinical ratings of PR, and objective computerized fine motor skill-tests. Statistical analysis consisted of a General Linear Method multivariate analysis of variance to compare the clinical, cognitive, and psychomotor outcomes of the two groups.

RESULTS

Patients performed worse on all clinical, cognitive, and PR measures. Both groups showed an effect of cognitive load on fine motor function but the influence was significantly larger for patients than for healthy elderly except for the initiation time.

LIMITATIONS

Due to the restrictive inclusion criteria, only a relatively limited sample size could be obtained.

CONCLUSION

With a medication free sample, an additive effect of depression and aging on cognition and PR in geriatric patients was found. As this effect was independent of demand of effort (by varying the cognitive load), it was apparently not a motivational slowing effect of depression.

摘要

背景

根据《精神疾病诊断与统计手册》第五版(DSM V),精神运动迟缓(PR)是抑郁症的核心特征之一,但衰老本身也会导致认知和精神运动速度减慢。这是第一项研究,在老年人群中调查PR与认知功能的关系,以及抑郁症和衰老的协同效应,同时排除精神药物的干扰作用。

方法

将一组28名无痴呆的老年抑郁症患者与一组匹配的20名健康老年人进行比较。所有参与者都接受了一系列测试,包括临床抑郁症测量、处理速度、执行功能和记忆的认知测量、PR的临床评分以及客观的计算机化精细运动技能测试。统计分析采用一般线性方法进行多变量方差分析,以比较两组的临床、认知和精神运动结果。

结果

患者在所有临床、认知和PR测量中表现更差。两组在认知负荷对精细运动功能的影响上均有体现,但除启动时间外,患者受到的影响明显大于健康老年人。

局限性

由于纳入标准严格,只能获得相对有限的样本量。

结论

在无药物样本中,发现抑郁症和衰老对老年患者认知和PR有累加效应。由于这种效应与努力需求无关(通过改变认知负荷),显然不是抑郁症的动机性减慢效应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6840/4306283/131ea03e4465/fpsyt-05-00196-g001.jpg

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