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使用《情感障碍认知简短评估量表》定义抑郁症患者的认知特征。

Defining cognitive profiles of depressive patients using the Brief Assessment of Cognition in Affective Disorders.

作者信息

Chen Ruei-An, Lee Chun-Yi, Lee Yu, Hung Chi-Fa, Huang Yu-Chi, Lin Pao-Yen, Lee Sheng-Yu, Wang Liang-Jen

机构信息

Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

出版信息

PeerJ. 2019 Aug 1;7:e7432. doi: 10.7717/peerj.7432. eCollection 2019.

Abstract

BACKGROUND

Cognitive impairments in patients with depressive disorders have a negative impact on their daily skill functioning and quality of life. In this study, we evaluated the cognitive profiles and associated factors of patients with depressive disorders with the Brief Assessment of Cognition in Affective Disorders (BAC-A).

METHODS

This cross-sectional study consisted of 75 patients with depressive disorders (56 patients with major depressive disorder (MDD) and 19 patients with depressive disorder NOS or dysthymic disorder (non-MDD)). We evaluated the participants' cognitive functions at euthymic status using the BAC-A. The BAC-A includes six subtests derived from the Brief Assessment of Cognition in Schizophrenia (BAC-S) and Affective Processing Tests. The current severity of depressive symptoms was assessed with the 17-item Hamilton Depression Rating Scale (HAMD-17), and we recorded any psychotropic drugs being used by the patients.

RESULTS

We observed no differences in cognitive profiles in the MDD group and non-MDD group after adjusting for educational levels, severity of depression, and psychotropic drugs. Instead, the HAMD-17 scores were negatively correlated to cognitive performance in working memory, motor speed, verbal fluency, attention and processing speed, executive function, composite score, and the six indexes of the Affective Processing Test measured by the BAC-A. A longer illness duration was associated with worse performance of four indexes of the Affective Processing Test. Furthermore, benzodiazepine use was associated with a worse performance of verbal memory, and antidepressant use was associated with better motor speed performance.

CONCLUSION

The current severity of depressive symptoms and psychotropic drugs being taken, not the diagnosis category, are associated with cognitive impairments in patients with depressive disorders. Clinicians should pay particular attention to managing residual depressive symptoms and prescribing adequate psychotropic drugs in order to eliminate depressive patients' cognitive deficits.

摘要

背景

抑郁症患者的认知障碍对其日常技能功能和生活质量有负面影响。在本研究中,我们使用情感障碍认知简短评估量表(BAC - A)评估了抑郁症患者的认知概况及相关因素。

方法

这项横断面研究包括75名抑郁症患者(56名重度抑郁症(MDD)患者和19名未特定的抑郁症或心境恶劣障碍(非MDD)患者)。我们使用BAC - A在患者心境正常状态下评估其认知功能。BAC - A包括从精神分裂症认知简短评估量表(BAC - S)和情感加工测试中衍生出的六个子测试。使用17项汉密尔顿抑郁量表(HAMD - 17)评估当前抑郁症状的严重程度,并记录患者正在使用的任何精神药物。

结果

在调整教育水平、抑郁严重程度和精神药物后,我们观察到MDD组和非MDD组在认知概况上没有差异。相反,HAMD - 17评分与工作记忆、运动速度、语言流畅性、注意力和加工速度、执行功能、综合评分以及BAC - A测量的情感加工测试的六个指标的认知表现呈负相关。病程较长与情感加工测试的四个指标表现较差有关。此外,使用苯二氮䓬类药物与言语记忆表现较差有关,使用抗抑郁药与运动速度表现较好有关。

结论

抑郁症患者的认知障碍与当前抑郁症状的严重程度和正在服用的精神药物有关,而非诊断类别。临床医生应特别注意管理残留的抑郁症状并开具适当的精神药物,以消除抑郁症患者的认知缺陷。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/692c/6679906/a7fbffcb1494/peerj-07-7432-g001.jpg

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