Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia.
Department of Psychiatry, School of Medicine, University of Occupational and Environmental Health, Kitakyushu City, Japan.
J Clin Psychiatry. 2018 Nov 20;80(1):18m12472. doi: 10.4088/JCP.18m12472.
To evaluate the extent to which cognitive measures in the recently developed THINC-integrated tool (THINC-it) are associated with global and domain specific psychosocial disability in patients with current and remitted major depressive disorder (MDD).
Cross-sectional data (N = 127) were obtained from participants with current (n = 105) or remitted (n = 22) MDD who completed the THINC-it between July 2014 and June 2018. Major depressive disorder was diagnostically assessed with DSM-IV and DSM-5 criteria. The THINC-it includes 4 objective cognitive tests: the Spotter (ie, Choice Reaction Time), Symbol Check (ie, n-back), CodeBreaker (ie, Digit Symbol Substitution), and Trails (ie, Trail Making Test part B), as well as a measure of self-perceived cognitive deficits, the Perceived Deficits Questionnaire for Depression-5-item (PDQ-5-D). Psychosocial dysfunction was assessed with the Functioning Assessment Short Test.
The whole group analysis (ie, lifetime MDD) indicated that poor objective cognitive performance on the CodeBreaker (β = 0.346, P = .002) and Trails tasks (β = 0.232, P = .017) and greater self-reported cognitive deficits on the PDQ-5-D (β = 0.596, P < .001) were associated with more severe global psychosocial disability. In addition, performance on the CodeBreaker and Trails tasks showed dissociable relationships with specific psychosocial deficits (eg, occupational functioning, daily autonomy). The relationship between cognitive and psychosocial deficits was stronger in participants with current compared to remitted MDD.
Cognitive deficits identified by the THINC-it are associated with global and specific psychosocial deficits, highlighting the clinical value and utility of the THINC-it as a cognitive screening instrument in patients with MDD.
评估新开发的 THINC 综合工具（THINC-it）中的认知测量与当前和缓解期重度抑郁症（MDD）患者的整体和特定领域心理社会功能障碍的关联程度。
本研究纳入了 2014 年 7 月至 2018 年 6 月期间完成 THINC-it 的 127 名参与者，其中包括当前患有 MDD（n=105）或缓解期 MDD（n=22）的患者。MDD 的诊断评估采用 DSM-IV 和 DSM-5 标准。THINC-it 包括 4 项客观认知测试：“Spotter”（即选择反应时）、“Symbol Check”（即 n-back）、“CodeBreaker”（即数字符号替换）和“Trails”（即 Trail Making Test 部分 B），以及一项自我感知认知缺陷测量工具“抑郁 5 项认知缺陷问卷（PDQ-5-D）”。心理社会功能障碍采用功能评估简短测试进行评估。
全组分析（即终生 MDD）表明，CodeBreaker（β=0.346，P=0.002）和 Trails 任务（β=0.232，P=0.017）的客观认知表现较差，以及 PDQ-5-D 自我报告的认知缺陷较多（β=0.596，P<0.001）与更严重的整体心理社会功能障碍相关。此外，CodeBreaker 和 Trails 任务的表现与特定的心理社会缺陷（例如职业功能、日常自主性）存在可分离的关系。在当前患有 MDD 的参与者中，认知和心理社会缺陷之间的关系强于缓解期 MDD 的参与者。
THINC-it 识别的认知缺陷与整体和特定的心理社会缺陷相关，突出了 THINC-it 作为 MDD 患者认知筛查工具的临床价值和实用性。
