Uniwersytet Medyczny im. Piastów Śląskich we Wrocławiu, Katedra Psychiatrii, Zakład Psychoterapii i Chorób Psychosomatycznych.
Psychiatr Pol. 2020 Jun 30;54(3):453-466. doi: 10.12740/PP/OnlineFirst/105415.
Cognitive dysfunctions are part of the symptomatology of depressive disorders but they may persist even after the patient reaches symptomatic remission. As persistent symptoms of depression, cognitive dysfunctions may inhibit and restrict the patient's functioning in many spheres and significantly impair its quality. In addition, they increase the risk of somatic diseases and contribute to the increase of benefits disbursed from state aid. Furthermore, it is a factor negatively affecting the prognosis of depressive disorders because it increases the risk of recurrence of depression and reduces the susceptibility to pharmacotherapy. Neural network dysfunctions and changes in morphometry in particular areas of the brain are responsible for the persistence of cognitive deficits after MDD treatment. Most of currently used thymoleptics facilitate remission of depressive disorders but do not lead to reversal of cognitive deficits. There is growing evidence that antidepressants used in clinical practice can improve cognitive functions regardless of their impact on the affective component. The aim of the present study is to discuss the neurobiological mechanisms of cognitive dysfunctions and their clinical symptoms, and to present therapeutic prospects for patients with persistent cognitive dysfunctions in depressive disorders.
认知功能障碍是抑郁障碍症状学的一部分，但即使在患者达到症状缓解后，它们仍可能持续存在。作为持续性抑郁症状，认知功能障碍可能会在许多方面抑制和限制患者的功能，并显著降低其生活质量。此外，它们还会增加患躯体疾病的风险，并导致国家援助支出的增加。此外，它还是一个对抑郁障碍预后产生负面影响的因素，因为它会增加抑郁复发的风险，并降低对药物治疗的敏感性。神经网络功能障碍和大脑特定区域的形态学变化是导致 MDD 治疗后认知缺陷持续存在的原因。目前大多数使用的抗抑郁药可促进抑郁障碍的缓解，但不会导致认知缺陷的逆转。越来越多的证据表明，临床实践中使用的抗抑郁药可以改善认知功能，而不论其对情感成分的影响如何。本研究的目的是讨论认知功能障碍的神经生物学机制及其临床症状，并为抑郁障碍中持续性认知功能障碍患者的治疗提供前景。
