Department of Psychology, Pontifical Catholic University of Rio Grande do Sul, Brazil.
Department of Psychology, Pontifical Catholic University of Rio Grande do Sul, Brazil.
Psychiatry Res. 2016 Jul 30;241:289-96. doi: 10.1016/j.psychres.2016.04.102. Epub 2016 May 4.
This study aimed to identify profiles of functioning and quality of life (QOL) in depression (MDD), bipolar disorder (BD) and healthy adults, as well as the clinical, demographic and cognitive variables associated with each of these profiles. Participants completed the WHODAS 2.0 and WHOQOL-BREF, which were submitted to latent profile analysis. The four cluster solution provided the best fit for our data. Cluster 1 consisted mostly of healthy adults, and had the highest functioning and QOL. Clusters 2 contained older patients with subclinical depressive symptoms and psychiatric comorbidities, whose impairments in QOL and functioning were associated with mood symptoms and several cognitive abilities. Patients with MDD, BDI or BDII with mild to moderate depression, such as those in cluster 3, may benefit more significantly from interventions in cognitive flexibility, inhibition, planning, and sustained attention. Lastly, patients with mood disorders and clinically significant levels of depression, as well as a history of suicide attempts, like those in cluster 4, may benefit from interventions aimed at working memory, inhibitory control, and cognitive flexibility; that is, the three core executive functions. These findings should be further investigated, and used to guide treatments for patients with mood disorders and different patterns of functional impairment.
本研究旨在确定抑郁症（MDD）、双相情感障碍（BD）和健康成年人的功能和生活质量（QOL）特征，并确定与这些特征相关的临床、人口统计学和认知变量。参与者完成了 WHODAS 2.0 和 WHOQOL-BREF 量表，这些量表都提交给潜在剖面分析。四聚类解决方案为我们的数据提供了最佳拟合。聚类 1 主要由健康成年人组成，具有最高的功能和 QOL。聚类 2 包含有亚临床抑郁症状和精神共病的老年患者，他们的 QOL 和功能障碍与情绪症状和几种认知能力有关。患有 MDD、BDI 或 BDII 且抑郁程度较轻至中度的患者，如聚类 3 中的患者，可能会从认知灵活性、抑制、计划和持续注意力等方面的干预中获益更多。最后，那些患有心境障碍且抑郁程度达到临床显著水平、以及有自杀企图史的患者，如聚类 4 中的患者，可能会从针对工作记忆、抑制控制和认知灵活性的干预中受益；也就是说，这三种核心执行功能。这些发现应进一步研究，并用于指导针对不同功能障碍模式的心境障碍患者的治疗。
