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认知障碍在缓解期抑郁症的社会心理功能中的作用。

The role of cognitive impairment in psychosocial functioning in remitted depression.

机构信息

Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, 57 North Terrace, Adelaide, SA 5000, Australia.

出版信息

J Affect Disord. 2018 Aug 1;235:129-134. doi: 10.1016/j.jad.2018.04.051. Epub 2018 Apr 6.

Abstract

BACKGROUND

Cognitive dysfunction is a prevalent and disabling symptom of Major Depressive Disorder (MDD), and is often retained in the remitted stage of illness. Emerging evidence suggests that cognitive impairment may be associated with dysfunction in a number of psychosocial domains (e.g., workplace productivity, social relationships). The current study explored the relationship between cognition and psychosocial functioning in remitted MDD and in healthy controls.

METHODS

Data were obtained from 182 participants of the Cognitive Function and Mood Study (CoFaM-S), a cross-sectional study of cognition, mood, and social cognition in mood disorders. Participants' (Remitted MDD n = 72, Healthy n = 110) cognition was assessed with a battery of cognitive tests including the Repeatable Battery for the Assessment of Neuropsychological Function (RBANS) and other standard measures of cognition (e.g., The Tower of London task). Psychosocial functioning was clinically evaluated with the Functioning Assessment Short Test (FAST).

RESULTS

The results indicated that executive functioning was the strongest independent predictor of functioning in remitted MDD patients, whereas various cognitive domains predicted psychosocial functioning in healthy individuals.

LIMITATIONS

Psychosocial functioning was measured with a clinical interview, and was therefore reliant on clinicians' judgement of impairment, as opposed to more objective measures of functioning.

CONCLUSIONS

These findings suggest that executive cognition plays an important role in functional recovery in remitted depression, and may be a crucial target in adjunctive treatment.

摘要

背景

认知功能障碍是重度抑郁症(MDD)的一种普遍且致残的症状,且在疾病缓解期通常仍存在。新出现的证据表明,认知损伤可能与许多心理社会领域(例如,工作场所生产力、社交关系)的功能障碍有关。本研究探讨了缓解期 MDD 患者和健康对照组的认知功能与心理社会功能之间的关系。

方法

数据来自认知功能和情绪研究(CoFaM-S)的 182 名参与者,该研究是一项关于心境障碍的认知、情绪和社会认知的横断面研究。参与者(缓解期 MDD 组 n=72,健康对照组 n=110)的认知功能通过认知测试组合进行评估,包括重复性成套神经心理状态测验(RBANS)和其他认知标准测试(例如,伦敦塔任务)。心理社会功能通过功能评估简短测试(FAST)进行临床评估。

结果

结果表明,执行功能是缓解期 MDD 患者功能的最强独立预测因子,而各种认知领域则预测了健康个体的心理社会功能。

局限性

心理社会功能是通过临床访谈进行测量的,因此依赖于临床医生对损伤的判断,而不是更客观的功能测量。

结论

这些发现表明,执行认知在缓解期抑郁症的功能恢复中起着重要作用,并且可能是辅助治疗的关键目标。

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