Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Ground Floor, Office Block, Queen Elizabeth University Hospital, Glasgow, G51 4TF UK.
General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Eur Psychiatry. 2015 Nov;30(8):950-8. doi: 10.1016/j.eurpsy.2015.08.006. Epub 2015 Oct 21.
This study investigated differences in cognitive performance between middle-aged adults with and without a lifetime history of mood disorder features, adjusting for a range of potential confounders.
Cross-sectional analysis of baseline data from the UK Biobank cohort. Adults aged 40-69 (n=143,828) were assessed using measures of reasoning, reaction time and memory. Self-reported data on lifetime features of major depression and bipolar disorder were used to construct groups for comparison against controls. Regression models examined the association between mood disorder classification and cognitive performance, adjusting for sociodemographic, lifestyle and clinical confounders.
Inverse associations between lifetime history of bipolar or severe recurrent depression features and cognitive performance were attenuated or reversed after adjusting for confounders, including psychotropic medication use and current depressive symptoms. Participants with a lifetime history of single episode or moderate recurrent depression features outperformed controls to a small (but statistically significant) degree, independent of adjustment for confounders. There was a significant interaction between use of psychotropic medication and lifetime mood disorder features, with reduced cognitive performance observed in participants taking psychotropic medication.
In this general population sample of adults in middle age, lifetime features of recurrent depression or bipolar disorder were only associated with cognitive impairment within unadjusted analyses. These findings underscore the importance of adjusting for potential confounders when investigating mood disorder-related cognitive function.
本研究旨在调查有和无心境障碍特征的中年成年人之间认知表现的差异，并调整了一系列潜在的混杂因素。
使用英国生物库队列的基线数据进行横断面分析。评估了年龄在 40-69 岁的成年人的推理、反应时间和记忆能力。使用自评的重度抑郁症和双相情感障碍的终生特征数据来构建与对照组进行比较的组。回归模型检查了心境障碍分类与认知表现之间的关联，调整了混杂因素，包括精神药物的使用和当前的抑郁症状。
在调整了混杂因素（包括精神药物的使用和当前的抑郁症状）后，双相或严重复发性抑郁特征的终生史与认知表现之间的反比关系减弱或逆转。有单发性或中度复发性抑郁特征的终生史的参与者，在未调整混杂因素的情况下，表现出与对照组相比略有（但统计学上显著）的优势。精神药物的使用和心境障碍特征之间存在显著的交互作用，服用精神药物的参与者认知表现下降。
在这项针对中年普通人群的研究中，复发性抑郁或双相情感障碍的终生特征仅在未经调整的分析中与认知障碍相关。这些发现强调了在调查心境障碍相关认知功能时调整潜在混杂因素的重要性。
