Division of Clinical Psychology and Psychotherapy, Philipps University, Marburg, Germany.
Division of Clinical Psychology and Psychotherapy, Philipps University, Marburg, Germany.
Child Abuse Negl. 2017 Aug;70:247-254. doi: 10.1016/j.chiabu.2017.06.013. Epub 2017 Jul 3.
Major depression is often accompanied by deficits in cognitive functioning and lowered executive functions. However, not all depressed patients show impairments in these domains. The aim of this study was to examine whether different kinds of childhood adversity might account for cognitive deficits in patients with major depression.
Ninety-one patients with major depression (DSM-IV) and 40 healthy controls completed a neuropsychological test battery assessing memory, processing speed and executive functions. The Childhood Trauma Questionnaire (CTQ) was used to measure the severity and number of incidences of sexual, physical and emotional abuse and physical and emotional neglect.
Patients with major depression had a significantly higher number of traumas and reported more severe emotional abuse, emotional neglect and physical neglect than healthy controls. Patients performed less well in memory tasks, general knowledge and processing speed than healthy controls. Hierarchical regression analyses indicated that the overall number of traumas was significantly associated with poorer general knowledge, lower processing speed and impaired executive functions in patients with major depression. A second model including all CTQ-subscales simultaneously demonstrated an association between physical neglect and poorer verbal learning, and physical abuse and diminished executive functions.
A higher number of childhood adversities may influence general knowledge, processing speed and executive functions in patients with major depression. In addition, physical abuse and neglect seemed to be associated with verbal learning deficits and poorer executive functions.
重度抑郁症常伴有认知功能障碍和执行功能下降。然而，并非所有抑郁患者在这些领域都存在损伤。本研究旨在探讨不同类型的童年逆境是否可以解释重度抑郁症患者的认知缺陷。
91 名符合 DSM-IV 诊断标准的重度抑郁症患者和 40 名健康对照者完成了一个神经心理学测试组合，评估记忆、加工速度和执行功能。采用儿童期创伤问卷（CTQ）来评估性虐待、躯体虐待、情感忽视和躯体忽视的严重程度和发生次数。
重度抑郁症患者的创伤次数明显多于健康对照组，且报告的情感虐待、情感忽视和躯体忽视更为严重。与健康对照组相比，患者在记忆任务、一般知识和加工速度方面的表现更差。分层回归分析表明，总体创伤次数与重度抑郁症患者的一般知识较差、加工速度较低和执行功能受损显著相关。纳入 CTQ 所有分量表的第二个模型表明，躯体忽视与言语学习能力下降有关，躯体虐待与执行功能减退有关。
更多的童年逆境可能会影响重度抑郁症患者的一般知识、加工速度和执行功能。此外，躯体虐待和忽视似乎与言语学习能力缺陷和执行功能较差有关。
