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意大利精神病学家对重度抑郁症认知症状的看法。

Italian psychiatrists' perception on cognitive symptoms in major depressive disorder.

作者信息

Albert Umberto, Brugnoli Roberto, Caraci Filippo, Dell'Osso Bernardo, Di Sciascio Guido, Tortorella Alfonso, Vampini Claudio, Cataldo Nazarena, Pegoraro Valeria

机构信息

a Mood and Anxiety Disorders Unit, Rita Levi Montalcini Department of Neuroscience , University of Turin , Turin , Italy.

b Ne.S.M.O.S. Department , Sapienza University of Rome - Azienda Ospedaliera Sant'Andrea , Rome , Italy.

出版信息

Int J Psychiatry Clin Pract. 2016;20(1):2-9. doi: 10.3109/13651501.2015.1093147. Epub 2015 Nov 2.

Abstract

OBJECTIVE

Differently than Schizophrenia, the investigation of cognitive impairment in bipolar disorder and major depressive disorder (MDD) attracted the interest of research only recently. Therefore, it is worth understanding clinicians' perception about cognitive dysfunction in MDD and raising awareness about this issue.

METHODS

Between December 2014 and January 2015, 128 Italian psychiatrists participated in an on-line survey aiming at understanding psychiatrists' perception about cognitive symptoms in MDD. The questionnaire comprised three sections: the first investigating psychiatrists' socio-demographic profile, the second assessing cognitive symptoms relevance without mentioning that they represented the study focus and the third explicitly investigating cognitive symptoms.

RESULTS

Cognitive symptoms were considered as a relevant dimension of MDD and appeared among the most frequently cited residual symptoms influencing patients' work and relapse risk. About 70% of psychiatrists declared that cognitive symptoms significantly influence antidepressant choice. However, in the second questionnaire section cognitive symptoms appeared less frequently considered for antidepressant choice.

CONCLUSIONS

Results revealed a clear understanding of cognitive symptoms relevance in MDD. Nevertheless, the discrepancy between psychiatrists' perception and their therapeutical choices underlines the presence of an unmet-need that should be addressed increasing the awareness about the positive effects on cognitive symptoms of existing drugs, which could allow a more symptom-oriented therapeutical intervention. Key points Major depressive disorder (MDD) is a common mental disorder often associated with deficits in cognitive function. Psychiatrists considered cognitive symptoms among the most relevant residual symptoms in MDD patients that compromise patients working and influence the relapse risk. The importance given to residual cognitive symptoms seemed not to be reflected by psychiatrists' therapeutical choice. There is a gap between what psychiatrists know and what psychiatrists apply to their clinical practice reflecting the feeling of a therapeutical unmet need.

摘要

目的

与精神分裂症不同,双相情感障碍和重度抑郁症(MDD)中认知障碍的研究直到最近才引起研究兴趣。因此,了解临床医生对MDD中认知功能障碍的看法并提高对该问题的认识是值得的。

方法

2014年12月至2015年1月期间,128名意大利精神科医生参与了一项在线调查,旨在了解精神科医生对MDD中认知症状的看法。问卷包括三个部分:第一部分调查精神科医生的社会人口学特征,第二部分评估认知症状的相关性,但未提及它们是研究重点,第三部分明确调查认知症状。

结果

认知症状被认为是MDD的一个相关维度,并且是影响患者工作和复发风险的最常被提及的残留症状之一。约70%的精神科医生表示认知症状会显著影响抗抑郁药的选择。然而,在问卷的第二部分中,认知症状在抗抑郁药选择中出现的频率较低。

结论

结果显示对MDD中认知症状的相关性有清晰的认识。然而,精神科医生的认知与他们的治疗选择之间的差异凸显了存在未满足的需求,应通过提高对现有药物对认知症状的积极作用的认识来解决,这可以实现更以症状为导向的治疗干预。要点 重度抑郁症(MDD)是一种常见的精神障碍,常与认知功能缺陷相关。精神科医生认为认知症状是MDD患者中最相关的残留症状之一,会影响患者的工作并影响复发风险。精神科医生对残留认知症状的重视程度似乎未体现在他们的治疗选择中。精神科医生所知道的与他们在临床实践中应用的之间存在差距,这反映了治疗未满足需求的感觉。

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