Vitos Clinic for Psychiatry and Psychotherapy Giessen, Germany; Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany.
Vitos Clinic for Psychiatry and Psychotherapy Giessen, Germany.
Psychiatry Res. 2019 Nov;281:112533. doi: 10.1016/j.psychres.2019.112533. Epub 2019 Aug 26.
Cognitive impairments are well documented in major depressive disorder (MDD), however, they cannot be fully explained by depressive symptom severity. We investigated how diurnal preference and sleep quality affect cognitive function in MDD. In 34 inpatients with current MDD and 29 healthy controls (HC), we obtained diurnal preference (Morningness-Eveningness Questionnaire, MEQ) and subjective sleep quality (Pittsburgh Sleep Quality Index, PSQI). Further, current mood and neuropsychological performance (Trail Making Test, TMT, part A and B) were assessed in the evening and in the following morning. Patients with MDD performed worse than HC on the TMT-B (particularly requiring executive function), but not on the TMT-A (assessing foremost visuomotor processing speed). In general, participants with evening preference (MEQ-score median split) performed poorer on the TMT than participants with morning preference. Subgroup analyses within MDD confirmed the negative effect of evening preference on the TMT. In addition, patients with severely impaired sleep quality (PSQI > 10) performed cognitively worse than patients with normal to moderately impaired sleep quality (PSQI ≤ 10). The results were largely independent of current mood state. Our findings suggest that evening preference and severely impaired sleep quality independently contribute to cognitive impairment in MDD.
认知障碍在重度抑郁症（MDD）中得到了充分的记录，但它们不能完全由抑郁症状的严重程度来解释。我们研究了昼夜倾向和睡眠质量如何影响 MDD 患者的认知功能。在 34 名当前患有 MDD 的住院患者和 29 名健康对照者（HC）中，我们获得了昼夜倾向（Morningness-Eveningness Questionnaire，MEQ）和主观睡眠质量（Pittsburgh Sleep Quality Index，PSQI）。此外，在晚上和第二天早上评估了当前的情绪和神经心理表现（Trail Making Test，TMT，A 部分和 B 部分）。与 HC 相比，MDD 患者在 TMT-B 上表现较差（尤其是需要执行功能），但在 TMT-A 上表现较差（主要评估视觉运动处理速度）。一般来说，具有傍晚倾向（MEQ 得分中位数分割）的参与者在 TMT 上的表现不如具有早晨倾向的参与者。在 MDD 患者中进行的亚组分析证实了傍晚倾向对 TMT 的负面影响。此外，睡眠质量严重受损（PSQI>10）的患者的认知表现明显差于睡眠质量正常或中度受损（PSQI≤10）的患者。结果在很大程度上独立于当前的情绪状态。我们的研究结果表明，傍晚倾向和睡眠质量严重受损独立导致 MDD 患者的认知障碍。
