Salagre E, Solé B, Tomioka Y, Fernandes B S, Hidalgo-Mazzei D, Garriga M, Jimenez E, Sanchez-Moreno J, Vieta E, Grande I
Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia; Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
J Affect Disord. 2017 Oct 15;221:205-221. doi: 10.1016/j.jad.2017.06.034. Epub 2017 Jun 19.
Cognitive symptoms in Major Depressive Disorder (MDD) are persistent and commonly entail neurocognitive impairment and a decline in quality of life. This systematic review gathers the current scientific evidence on therapeutic strategies for neuropsychological impairment in MDD.
A systematic search on PubMed, PsycINFO and Clinicaltrials.gov was carried out on December 2016 according to PRISMA using Boolean terms to identify interventions for the treatment of cognitive dysfunction in MDD. Only English-written articles providing original data and focusing in adults with MDD were included with no time restrictions.
A total of 95 studies reporting data on 40 pharmacological and non-pharmacological interventions were included. Interventions were grouped into the following categories: 1) Pharmacological Therapies (antidepressants, stimulants, compounds acting on NMDA receptors, compounds acting on the cholinergic system, compounds showing anti-inflammatory or antioxidant properties, other mechanisms of action), 2) Physical Therapies and 3) Psychological Therapies, 4) Exercise. There are some promising compounds showing a positive impact on cognitive symptoms including vortioxetine, lisdexamfetamine or erythropoietin.
The studies included showed significant methodological differences in heterogeneous samples. The lack of a standardized neuropsychological battery makes comparisons between studies difficult.
Current evidence is not sufficient to widely recommend the use of procognitive treatments in MDD although promising results are coming to light.
重度抑郁症（MDD）中的认知症状持续存在，通常伴有神经认知障碍和生活质量下降。本系统评价收集了有关MDD神经心理障碍治疗策略的当前科学证据。
2016年12月，根据PRISMA在PubMed、PsycINFO和Clinicaltrials.gov上进行了系统检索，使用布尔逻辑词识别治疗MDD认知功能障碍的干预措施。仅纳入提供原始数据且关注成年MDD患者的英文撰写文章，无时间限制。
共纳入95项报告40种药物和非药物干预数据的研究。干预措施分为以下几类：1）药物治疗（抗抑郁药、兴奋剂、作用于NMDA受体的化合物、作用于胆碱能系统的化合物、具有抗炎或抗氧化特性的化合物、其他作用机制），2）物理治疗，3）心理治疗，4）运动。有一些有前景的化合物对认知症状有积极影响，包括伏硫西汀、赖氨酸右旋苯丙胺或促红细胞生成素。
纳入的研究在异质性样本中显示出显著的方法学差异。缺乏标准化的神经心理测验组合使得研究之间难以进行比较。
尽管有一些有前景的结果，但目前的证据不足以广泛推荐在MDD中使用促认知治疗。
