, H. Lundbeck A/S, Ottiliavej 9, 2500, Valby, Denmark.
Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, København Ø, Denmark.
BMC Psychiatry. 2017 Nov 21;17(1):370. doi: 10.1186/s12888-017-1523-8.
The manifestation of major depressive disorder (MDD) may include cognitive symptoms that can precede the onset of MDD and persist beyond the resolution of acute depressive episodes. However, little is known about how cognitive symptoms are experienced by MDD patients and the people around them.
In this international (Brazil, Canada, China, France, and Germany) ethnographic study, we conducted semi-structured interviews and observations of remitted as well as symptomatic MDD patients (all patients self-reported being diagnosed by an HCP and self-reported being on an antidepressant) aged 18-60 years with self-reported cognitive symptoms (N = 34). In addition, participating depressed patients' close family or friends (N = 31) were interviewed. Separately recruited from depressed participants, work colleagues (N = 21) and healthcare providers (HCPs; N = 13) of depressed individuals were interviewed.
Key insights were that: (1) patients were generally unaware that their cognitive symptoms were linked to their depression and, instead, attributed these symptoms to negative aspects of their person (e.g., age, separate disease, laziness, exhaustion); (2) cognitive symptoms in MDD appeared to negatively impact patients' social relationships and patients' ability to handle daily tasks at work and at home; (3) patients' cognitive symptoms also impacted relationships with family members and coworkers; (4) patients' cognitive symptoms increased stress and feelings of failure, which in turn seemed to worsen the cognitive symptoms, thereby creating a destructive cycle; and (5) although HCPs recommended that patients re-engage in everyday activities to help overcome their depression, cognitive symptoms seemed to impede such functional recovery.
Taken together, these findings highlight a negative impact of patients' cognitive symptoms on their social functioning, work performance, and quality of life on the people close to them, and consequently on the degree of functional recovery after depression.
重度抑郁症（MDD）的表现可能包括认知症状，这些症状可能先于 MDD 发作，并在急性抑郁发作缓解后持续存在。然而，人们对 MDD 患者及其周围人的认知症状体验知之甚少。
在这项国际（巴西、加拿大、中国、法国和德国）民族志研究中，我们对缓解期和有症状的 MDD 患者（所有患者均自我报告由 HCP 诊断并正在服用抗抑郁药）进行了半结构化访谈和观察，年龄在 18-60 岁之间，自述有认知症状（N=34）。此外，还采访了参与研究的抑郁患者的亲密家人或朋友（N=31）。另外，还分别采访了抑郁患者的同事（N=21）和医疗保健提供者（HCP；N=13）。
主要发现包括：（1）患者通常没有意识到他们的认知症状与他们的抑郁有关，而是将这些症状归因于他们自身的负面方面（例如，年龄、单独的疾病、懒惰、疲惫）；（2）MDD 中的认知症状似乎对患者的社会关系和他们在工作和家庭中处理日常任务的能力产生负面影响；（3）患者的认知症状也影响了他们与家庭成员和同事的关系；（4）患者的认知症状增加了他们的压力和失败感，这反过来又似乎使认知症状恶化，从而形成了一个破坏性循环；（5）尽管 HCP 建议患者重新参与日常活动以帮助克服抑郁，但认知症状似乎阻碍了这种功能恢复。
综上所述，这些发现强调了患者认知症状对他们的社交功能、工作表现和生活质量以及他们在抑郁后的功能恢复程度对其周围人的负面影响。
