Shehab Al Amira Safa, Brent David, Maalouf Fadi T
1 The Graduate Center, Queens College, City University of New York , New York, New York.
2 Western Psychiatric Institute and Clinic, University of Pittsburgh , Pittsburgh, Pennsylvania.
J Child Adolesc Psychopharmacol. 2016 Oct;26(8):713-720. doi: 10.1089/cap.2015.0190. Epub 2016 Mar 14.
Adolescents with major depressive disorder (MDD) were found to have deficits in executive function, attention, and memory. Despite the fact that some neurocognitive functions have been shown to be present in acute stage of the illness, but not in remission, longitudinal studies are lacking. The current study aimed to investigate the changes in neurocognitive functioning in adolescents with depression during an acute treatment course with selective serotonin reuptake inhibitor.
Twenty-four adolescents with current MDD and 24 healthy controls (HCs) were administered subtests of the Cambridge Neuropsychological Test Automated Battery as well as clinical scales at baseline and were retested at weeks 6 and 12. Those with MDD were started on fluoxetine after the baseline assessment.
Despite considerable improvement in depressive symptoms in the MDD group, there was a persistent deficit in visual memory in the MDD group over time compared with HCs (p = 0.001). On a task of sustained attention and inhibition, HCs became better at detecting target sequences at week 12 while there were residual sustained attention deficits in MDD (p = 0.01). On an executive function (planning) task, while HCs learned the task and improved substantially in performance over 12 weeks, MDD performance did not significantly change (p = 0.04).
When treating depressed adolescents, clinicians need to also monitor cognitive symptoms as they appear to lag behind mood symptoms in improvement.
研究发现，患有重度抑郁症（MDD）的青少年在执行功能、注意力和记忆力方面存在缺陷。尽管已经证明某些神经认知功能在疾病急性期存在，但在缓解期不存在，然而缺乏纵向研究。本研究旨在调查患有抑郁症的青少年在接受选择性5-羟色胺再摄取抑制剂急性治疗过程中神经认知功能的变化。
24名患有当前MDD的青少年和24名健康对照者（HCs）在基线时接受了剑桥神经心理测试自动成套测验的子测验以及临床量表测试，并在第6周和第12周进行了重新测试。患有MDD的青少年在基线评估后开始服用氟西汀。
尽管MDD组的抑郁症状有显著改善，但与HCs相比，MDD组的视觉记忆随着时间的推移仍持续存在缺陷（p = 0.001）。在一项持续注意力和抑制任务中，HCs在第12周时在检测目标序列方面变得更好，而MDD组仍存在持续注意力缺陷（p = 0.01）。在一项执行功能（计划）任务中，虽然HCs学会了该任务并在12周内表现有显著改善，但MDD组的表现没有显著变化（p = 0.04）。
在治疗抑郁青少年时，临床医生还需要监测认知症状，因为它们在改善方面似乎落后于情绪症状。
