Department of Psychiatry, University of Pittsburgh School of Medicine, 3801 O'Hara Street E-1124, Pittsburgh 15213, PA, United States.
Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA, United States.
J Affect Disord. 2020 Mar 15;265:216-223. doi: 10.1016/j.jad.2020.01.003. Epub 2020 Jan 3.
Executive function and psychomotor speed are consistently impaired in patients with major depressive disorder (MDD). Persistent cognitive impairments after depression remission are thought to reflect "scarring" from the neurotoxic effects of hypothalamic-pituitary-adrenal axis activity during a depressive episode. As sleep also deteriorates with depression and restores daytime executive functions, we examined whether adequate sleep could be protective against task-switching and psychomotor impairments associated with a history of MDD.
This cross-sectional study tested task-switching associations with MDD history, sleep, and their interaction to determine whether sleep continuity and sleep duration moderate the relationship between MDD history and task-switching performance.
After adjusting for age, sex, education, current depressive symptoms, and use of anti-depressants, a history of MDD, particularly recurrent MDD, was associated with slower response speed and disproportionately lower accuracy on repetition trials compared to switch trials, reflecting impaired adoption of a task-set. Regardless of MDD history, higher wake after sleep onset and shorter total sleep time were associated with slower response times, but neither sleep measure moderated the association between depression history and task-switching performance.
This cross-sectional study cannot assess the causal direction of associations. One night of sleep in the laboratory was used to assess sleep and a single task-switching paradigm was used to assess executive function.
These results suggest that longer, more continuous sleep is associated with greater psychomotor speed across healthy controls and those with a history of MDD, but MDD-task-switching associations are not mitigated by longer or more continuous sleep.
执行功能和心理运动速度在重度抑郁症（MDD）患者中始终受损。人们认为，抑郁缓解后持续存在的认知障碍反映了下丘脑-垂体-肾上腺轴活动的神经毒性作用在抑郁发作期间造成的“疤痕”。由于睡眠也会随着抑郁而恶化，并恢复白天的执行功能，我们研究了充足的睡眠是否可以预防与 MDD 病史相关的任务转换和心理运动障碍。
这项横断面研究测试了任务转换与 MDD 病史、睡眠及其相互作用的关联，以确定睡眠连续性和睡眠时间是否可以调节 MDD 病史与任务转换表现之间的关系。
在调整年龄、性别、教育程度、当前抑郁症状和抗抑郁药物使用后，MDD 病史，特别是复发性 MDD，与反应速度较慢和重复试验的准确性明显低于转换试验有关，反映出任务设定的适应性受损。无论 MDD 病史如何，睡眠后觉醒时间增加和总睡眠时间缩短与反应时间较慢有关，但这两种睡眠测量都不能调节抑郁病史与任务转换表现之间的关联。
这项横断面研究不能评估关联的因果方向。仅使用一夜的实验室睡眠来评估睡眠，并且仅使用单一的任务转换范式来评估执行功能。
这些结果表明，更长、更连续的睡眠与健康对照组和 MDD 病史组的心理运动速度更快相关，但更长或更连续的睡眠并不能减轻 MDD 与任务转换的关联。
