Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
J Affect Disord. 2021 Feb 1;280(Pt A):121-126. doi: 10.1016/j.jad.2020.11.078. Epub 2020 Nov 11.
This study aimed to evaluate cognitive function in patients with anxious depression.
This was a part of the "Objective Diagnostic Indicators and Individualized Drug Intervention of Major Depressive Disorder (MDD)" study. All participants, including patients with MDD and healthy controls (HCs), completed the 17-item Hamilton Depression Scale (HAMD) and the Hamilton Anxiety Scale (HAMA). Anxious depression was defined as a HAMD anxiety/somatization factor score ≥7. Cognitive function was assessed at baseline and at the end of week 8. HC cognitive function was assessed at baseline.
A total of 1048 people were included in the analysis, including 328 patients in the anxious depression group (G1=328), 221 patients in the MDD without anxious depression group (G2=221), and 499 in the HC group (G3=499). There were significant differences in the HAMA at baseline (t=13.050, p<0.001), HAMD at baseline (t=16.722, p<0.001), and HAMA at weekend 8 (z=-3.477, p=0.001) between G1 and G2. Cognitive functioning on the Hopkins Verbal Learning Test-Revised (HVLT-R) (t=2.948, p=0.003) and the Brief Visual Memory Test-Revised (BVMT-R) (t=2.843, p=0.005) was better in G1 than in G2 at baseline. Cognitive functioning on the HVLT-R (OR=1.081, p=0.006) was better in G1 than in G2 at weekend 8. The Stroop-color-word test (SCWT) (OR=0.976, p=0.004) and the Continuous Performance Test (CPT) (OR=0.698, p=0.007) showed significant differences at baseline; however, after the acute treatment phase, there were no significant differences in executive function (assessed by SCWT) (p=0.148) or attention/vigilance (assessed by CPT) (p=0.416) between G1 and G3.
Patients with anxious depression have more severe depressive symptoms but better cognitive function, especially for verbal learning, compared with nonanxious depression patients. After the acute treatment phase, executive function and attention/vigilance in anxious depression patients may be remitted.
本研究旨在评估焦虑性抑郁症患者的认知功能。
这是“客观诊断指标与重度抑郁症(MDD)个体化药物干预研究”的一部分。所有参与者,包括 MDD 患者和健康对照组(HCs),均完成了 17 项汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)的评估。焦虑性抑郁症的定义为 HAMD 焦虑/躯体化因子评分≥7。认知功能在基线和第 8 周末进行评估。HC 的认知功能在基线时进行评估。
共有 1048 人纳入分析,其中焦虑性抑郁症组 328 例(G1=328),非焦虑性抑郁症 MDD 组 221 例(G2=221),HC 组 499 例(G3=499)。G1 和 G2 之间基线时 HAMA(t=13.050,p<0.001)、HAMD(t=16.722,p<0.001)和周末 8 时 HAMA(z=-3.477,p=0.001)存在显著差异。G1 在基线时的霍普金斯词语学习测验修订版(HVLT-R)(t=2.948,p=0.003)和简短视觉记忆测验修订版(BVMT-R)(t=2.843,p=0.005)认知功能更好。G1 在第 8 周末的 HVLT-R(OR=1.081,p=0.006)认知功能优于 G2。基线时斯克里文色词测验(SCWT)(OR=0.976,p=0.004)和连续作业测验(CPT)(OR=0.698,p=0.007)存在显著差异,但急性治疗阶段后,G1 和 G3 之间的执行功能(SCWT 评估)(p=0.148)或注意力/警觉性(CPT 评估)(p=0.416)无显著差异。
与非焦虑性抑郁症患者相比,焦虑性抑郁症患者的抑郁症状更严重,但认知功能更好,尤其是在词语学习方面。在急性治疗阶段后,焦虑性抑郁症患者的执行功能和注意力/警觉性可能会得到缓解。