Castellano Sabrina, Torrent Carla, Petralia Maria Cristina, Godos Justyna, Cantarella Rita Anna, Ventimiglia Andrea, De Vivo Simona, Platania Silvia, Guarnera Maria, Pirrone Concetta, Drago Filippo, Vieta Eduard, Di Nuovo Santo, Popovic Dina, Caraci Filippo
Department of Educational Sciences, University of Catania, Catania, Italy.
Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
Neuropsychiatr Dis Treat. 2020 Feb 28;16:589-595. doi: 10.2147/NDT.S224754. eCollection 2020.
Cognitive dysfunction represents a distinct biological and clinical dimension in major depression disorders (MDD) and cognitive performance strongly affects psychosocial functioning in patients diagnosed with MDD.
To assess which neurocognitive variables at baseline predict the functional outcome of MDD patients in a 1-year follow-up study as assessed by Functioning Assessment Short Test (FAST) and whether the improvement observed on affective and cognitive symptoms in our 12 week-prospective observational study after treatment with selective serotonin reuptake inhibitors (SSRIs) and selective noradrenalin reuptake inhibitors (SNRIs) can affect the following long-term psychosocial functional outcome at 1 year in the same MDD patients.
We recruited a total of 31 patients (8 males; 23 females) with MDD who had previously completed a pharmacological treatment with SSRIs (n = 22) or SNRIs (n = 9) for 12 weeks, and then continued the same pharmacological treatment for 1 year. After an average 1-year follow-up, they were interviewed with the FAST to assess functional outcome. Multivariate analyses were applied to identify clinical and neurocognitive predictors of functional outcome.
Total Montreal Cognitive Assessment (MoCA), Digit Span forward (Span F) and backward (Span B), and 15 Rey words immediate recall (Rey I) scores significantly correlated with FAST. However, after performing regression models only Rey immediate recall score was useful to predict long-term functional outcome (Pearson correlation coefficient R= -0.68, p < 0.001) in four specific subdomains of FAST. When considering changes in affective and cognitive symptoms at the end of the 12 weeks of pharmacological treatment with SSRI or SNRIs (T1-T0) by multiple regression analysis, we found that Span -test predicted scores in the FAST leisure domain, whereas, changes in Span F, Frontal Assessment Battery (FAB) and Rey I predicted psychosocial functioning in the specific "cognitive" subdomains of FAST.
Our data suggest that long-term psychosocial functioning can be influenced by neurocognitive performance at baseline, with verbal memory playing a key role in overall functioning. Furthermore, improvement in verbal memory can predict functional outcome at one year in MDD patients with a recent history of partial response to antidepressants.
认知功能障碍是重度抑郁症（MDD）中一个独特的生物学和临床维度，认知表现强烈影响被诊断为MDD患者的心理社会功能。
在一项为期1年的随访研究中，评估哪些基线神经认知变量可预测MDD患者的功能结局（通过功能评估简短测试（FAST）进行评估），以及在我们为期12周的前瞻性观察研究中，经选择性5-羟色胺再摄取抑制剂（SSRI）和选择性去甲肾上腺素再摄取抑制剂（SNRI）治疗后，观察到的情感和认知症状改善是否会影响同一MDD患者1年后的长期心理社会功能结局。
我们共招募了31例MDD患者（8例男性；23例女性），这些患者之前已完成12周的SSRI（n = 22）或SNRI（n = 9）药物治疗，然后继续相同的药物治疗1年。平均随访1年后，用FAST对他们进行访谈以评估功能结局。应用多变量分析来确定功能结局的临床和神经认知预测因素。
蒙特利尔认知评估（MoCA）总分、数字广度顺背（Span F）和倒背（Span B）以及15个雷伊词语即刻回忆（Rey I）得分与FAST显著相关。然而，在进行回归模型分析后，仅雷伊即刻回忆得分可用于预测FAST四个特定子领域的长期功能结局（皮尔逊相关系数R = -0.68，p < 0.001）。当通过多元回归分析考虑在使用SSRI或SNRI进行12周药物治疗结束时（T1 - T0）情感和认知症状的变化时，我们发现Span -测试可预测FAST休闲领域的得分，而Span F、额叶评估量表（FAB）和雷伊I的变化可预测FAST特定“认知”子领域的心理社会功能。
我们的数据表明，长期心理社会功能可能受基线神经认知表现的影响，言语记忆在整体功能中起关键作用。此外，言语记忆的改善可预测近期对抗抑郁药有部分反应史的MDD患者1年后的功能结局。
