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第二代抗抑郁药物治疗对重性抑郁障碍患者注意力和心理加工速度的影响:一项结构方程模型的荟萃分析研究。

The effect of second-generation antidepressant treatment on the attention and mental processing speed of patients with major depressive disorder: A meta-analysis study with structural equation models.

机构信息

Facultad de Psicología. Universidad Michoacana San Nicolás de Hidalgo, Gral. Francisco Villa 450, 58110, Morelia, Mexico.

Doctorado de Psicología Clínica y de la Salud. Facultat de Psicologia. Universitat de Barcelona, Spain.

出版信息

Psychiatry Res. 2022 Aug;314:114662. doi: 10.1016/j.psychres.2022.114662. Epub 2022 Jun 2.

Abstract

Major depressive disorder (MDD) has been linked to attention and mental processing speed deficits that can be improved after pharmacological treatment. However, it is unclear whether a class of antidepressants is more effective than others to ameliorate these deficits in MDD. Additionally, the possible effects of clinical and demographic variables on improving MDD attention and processing speed deficits after antidepressant treatment are unknown. We aimed to study the possible neuropsychological effects of second-generation antidepressant classes on the attention and processing speed of MDD patients and the potential influences of clinical and demographic variables as moderators of these effects using a meta-analytic approach. Twenty-five papers were included in our study. A structural equation model meta-analysis was performed. The improvement of attention and processing speed after pharmacological treatment is clinically relevant but incomplete. Selective serotonin reuptake inhibitors (SSRIs) and dual inhibitors are the drugs causing the greatest improvement in the processing speed of MDD patients. Antidepressant class is an important variable linked to processing speed improvement after MDD treatment. However, the degree of improvement in both cognitive functions is strongly influenced by some clinical and demographic variables of depressed patients, such are age and education of the MDD patients, the duration of the antidepressant treatment, and the depression status of the patients.

摘要

重度抑郁症(MDD)与注意力和心理处理速度缺陷有关,这些缺陷可以通过药物治疗得到改善。然而,目前尚不清楚是否有一种抗抑郁药比其他药物更能有效改善 MDD 患者的这些缺陷。此外,抗抑郁治疗后临床和人口统计学变量对改善 MDD 注意力和处理速度缺陷的可能影响尚不清楚。我们旨在使用荟萃分析方法研究第二代抗抑郁药类对 MDD 患者注意力和处理速度的可能神经心理学影响,以及临床和人口统计学变量作为这些影响的调节剂的潜在影响。我们的研究纳入了 25 篇论文。进行了结构方程模型荟萃分析。药物治疗后注意力和处理速度的改善具有临床意义,但并不完全。选择性 5-羟色胺再摄取抑制剂(SSRIs)和双重抑制剂是导致 MDD 患者处理速度改善最大的药物。抗抑郁药类是与 MDD 治疗后处理速度改善相关的重要变量。然而,这两种认知功能的改善程度受到 MDD 患者的一些临床和人口统计学变量的强烈影响,例如 MDD 患者的年龄和教育程度、抗抑郁治疗的持续时间以及患者的抑郁状况。

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