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抑郁症患者皮质醇水平与认知特征分析:现症与既往抑郁患者的比较。

Cortisol levels and cognitive profile in major depression: A comparison of currently and previously depressed patients.

机构信息

Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Division of Mental Health and Addiction, University Hospital of North Norway, Tromsø, Norway.

Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Neurology, University Hospital of North Norway, Tromsø, Norway.

出版信息

Psychoneuroendocrinology. 2019 Jan;99:57-65. doi: 10.1016/j.psyneuen.2018.08.024. Epub 2018 Aug 22.

Abstract

The association between depressive symptoms and elevated cortisol levels, and depression and cognitive functioning, has been less robust in outpatients with symptoms in the mild to moderate range. Furthermore, the association between elevated cortisol levels and cognitive functioning is unclear. In the present study, currently depressed (n = 37), previously depressed (n = 81) and never depressed controls (n = 50) were assessed on a range of neuropsychological measures. Salivary cortisol was measured in the morning and evening. Participants with current depression were non-hospitalized and had symptoms predominately in the mild to moderate range. Elevated salivary evening cortisol, but not morning cortisol, was significantly related to depressive symptoms. The difference in cortisol levels between the previously depressed group and the never depressed controls was not significant. The groups had significantly different cognitive profiles, with the currently depressed performing poorer on tasks related to working memory compared to the never depressed controls. Both the currently and previously depressed performed worse on attentional tasks. The findings indicate that outpatients with mild to moderate depression have elevated cortisol levels and limited mild cognitive impairments. Furthermore, mild impairments in attention may persist after remission, indicating that this could be a trait-marker in depression. The present study did not find support for a significant relationship between cortisol and cognitive functioning.

摘要

抑郁症状与皮质醇水平升高之间的关联,以及抑郁与认知功能之间的关联,在症状处于轻度至中度的门诊患者中不太明显。此外,皮质醇水平升高与认知功能之间的关联尚不清楚。在本研究中,目前患有抑郁症的患者(n=37)、以前患有抑郁症的患者(n=81)和从未患过抑郁症的对照组(n=50)接受了一系列神经心理学测试。在早晨和晚上测量唾液皮质醇。目前患有抑郁症的患者未住院,且症状主要处于轻度至中度。傍晚唾液皮质醇升高,而早晨皮质醇升高不明显,与抑郁症状显著相关。与从未患过抑郁症的对照组相比,以前患有抑郁症的患者的皮质醇水平差异无统计学意义。三组的认知特征明显不同,目前患有抑郁症的患者在与工作记忆相关的任务中表现较差,而从未患过抑郁症的对照组表现较好。目前患有抑郁症的患者和以前患有抑郁症的患者在注意力任务上的表现均较差。研究结果表明,轻度至中度抑郁症的门诊患者皮质醇水平升高,轻度认知障碍有限。此外,缓解后注意力轻度损伤可能持续存在,表明这可能是抑郁症的特征标志物。本研究未发现皮质醇与认知功能之间存在显著关系的证据。

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