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抑郁认知:我们能否想得更清楚?

Cognition in depression: Can we THINC-it better?

机构信息

Mood Assessment and Classification (MAC) Committee, Australia; Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia.

Mood Assessment and Classification (MAC) Committee, Australia; Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia; Sydney Medical School Northern, University of Sydney, Sydney, NSW, Australia; CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia.

出版信息

J Affect Disord. 2018 Jan 1;225:559-562. doi: 10.1016/j.jad.2017.08.080. Epub 2017 Aug 30.

Abstract

BACKGROUND

Cognitive compromise is a common experience for patients with depression and other mood disorders. Depressed patients sustain deficits in working memory and attentional distortions in emotional processing and negative attention biases, which may contribute to maintaining their depressive state.

METHODS

The Mood Assessment and Classification (MAC) Committee comprised academic psychiatrists with clinical expertise in the management of mood disorders. The independently convened committee met to discuss contentious aspects of mood disorders diagnosis and assessment with the express aim of informing clinical practice and future research.

RESULTS

The Committee specifically identified cognition as an important aspect for clinicians to consider in the context of depression and mood disorders. This article highlights some of the barriers to assessment and proposes tools that have the potential to be implemented in clinical practice.

LIMITATIONS

The conclusions drawn within this article are based on expert opinion. We have noted the limitations of the literature that informs this opinion.

CONCLUSIONS

As cognitive ability has been closely linked to patients' ability to achieve functional recovery, it is imperative that clinicians are able to identify patients with cognitive deficits and are equipped with tools to conduct effective cognitive assessments. Examining cognitive factors may generate a deeper understanding of the pathogenesis of depression and mood disorders which can ultimately be used to inform treatment.

摘要

背景

认知功能障碍是抑郁症和其他心境障碍患者的常见体验。抑郁患者的工作记忆和情绪处理中的注意力扭曲以及负性注意偏向持续存在缺陷,这可能导致其抑郁状态持续存在。

方法

心境评估与分类(MAC)委员会由具有心境障碍管理临床专业知识的学术精神病学家组成。该独立召集的委员会开会讨论心境障碍诊断和评估方面有争议的问题,明确旨在为临床实践和未来研究提供信息。

结果

委员会特别确定认知是临床医生在评估抑郁症和心境障碍时需要考虑的一个重要方面。本文重点介绍了评估中的一些障碍,并提出了一些有可能在临床实践中实施的工具。

局限性

本文得出的结论是基于专家意见。我们已经注意到了为这一观点提供信息的文献的局限性。

结论

由于认知能力与患者实现功能恢复的能力密切相关,因此临床医生必须能够识别有认知缺陷的患者,并配备有效的认知评估工具。检查认知因素可能会更深入地了解抑郁症和心境障碍的发病机制,最终可以用于指导治疗。

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