Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Department of Mood and Anxiety, Institute of Mental Health, Singapore.
J Affect Disord. 2018 May;232:237-242. doi: 10.1016/j.jad.2018.02.014. Epub 2018 Feb 16.
Several studies have described the presence of perceived cognitive dysfunction amongst Asian patients with major depressive disorder (MDD). To date, no study has been conducted investigating the predictors of perceived cognitive dysfunction amongst Asian MDD patients.
This was a post-hoc analysis of the Cognitive Dysfunction in Asian patients with Depression (CogDAD) study. Descriptive statistics were used to describe the most common cognitive complaints by patients. Univariate and multivariate analyses were performed to determine variables associated with perceived cognitive dysfunction (Perceived Deficit Questionnaire-Depression, PDQ-D).
The CogDAD study population is comprised of MDD patients with mild-to-moderate depression (Patient Health Questionnaire 9-item [PHQ-9]: 11.3 ± 6.9) who reported perceived cognitive dysfunction (PDQ-D = 22.6 ± 16.2). The most common cognitive complaints were: mind drifting (42.3%), trouble making decision (39.6%) and trouble concentrating (38.0%). Predictors of perceived cognitive dysfunction were: being Southeast Asians (vs. Taiwanese) (p < 0.001), current episode longer than 8 weeks (vs. 1-8 weeks) (p < 0.05), the presence of disability (vs. no disability) (p < 0.05), younger age (p < 0.01), and higher PHQ-9 total scores (p < 0.001).
The causal relationship between predictive variables and PDQ-D could not be tested due to the cross-sectional nature of the study. Furthermore, a neuropsychological test was not included in the CogDAD study and use of concomitant medications, including anti-depressants, could have impacted patient's perceived cognitive ability.
The present study results suggest a potential role for subjective cognitive assessment in patients with MDD who are young, with long durations of depression or severe depression.
几项研究描述了亚洲重度抑郁症(MDD)患者存在认知功能障碍。迄今为止,尚无研究调查亚洲 MDD 患者认知功能障碍的预测因素。
这是对亚洲抑郁症患者认知障碍(CogDAD)研究的事后分析。采用描述性统计方法描述患者最常见的认知主诉。进行单变量和多变量分析,以确定与感知认知障碍相关的变量(感知缺陷问卷-抑郁,PDQ-D)。
CogDAD 研究人群由轻度至中度抑郁(PHQ-9:11.3±6.9)且报告存在感知认知障碍(PDQ-D=22.6±16.2)的 MDD 患者组成。最常见的认知主诉是:注意力不集中(42.3%)、决策困难(39.6%)和注意力不集中(38.0%)。感知认知障碍的预测因素为:东南亚人(与台湾人相比)(p<0.001)、当前发作时间超过 8 周(与 1-8 周相比)(p<0.05)、存在残疾(与无残疾相比)(p<0.05)、年龄较小(p<0.01)和 PHQ-9 总分较高(p<0.001)。
由于研究的横断面性质,无法检验预测变量与 PDQ-D 之间的因果关系。此外,CogDAD 研究中未包含神经心理测试,并且使用抗抑郁药等伴随药物可能会影响患者的感知认知能力。
本研究结果表明,主观认知评估可能对年轻、抑郁时间长或抑郁严重的 MDD 患者有一定作用。