Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, 030001, China.
Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, 030001, China.
Eur Arch Psychiatry Clin Neurosci. 2023 Aug;273(5):1129-1137. doi: 10.1007/s00406-022-01475-9. Epub 2022 Aug 15.
This study aims to investigate the role of cognitive function in the efficacy prediction of selective serotonin reuptake inhibitors (SSRIs) for depression patients and to further the understanding of the relationship between baseline cognitive function and depression trajectory.
This was part of a multicenter study for major depressive disorder. The study included 172 first-episode depression patients and 93 recurrent depression patients who had their cognitive function assessed at baseline and followed up for 8 weeks of SSRI treatment.
After constructing a 2-level hierarchical linear model with depression change- and cognitive function-level variables, the processing speed at baseline was the best predictor for the improvement of depression at each follow-up in first-episode patients (G11 = 0.03, P = 0.042). The treatment prediction model slope varied across patients depending on the processing speed scores at baseline. With the receiver operating characteristic curve, the combination of sociodemographic characteristics, sedative hypnotics, baseline 17-item Hamilton Rating Scale for Depression (HAMD), and cognitive function showed the highest predictive power in major depressive disorder remission, resulting in a classification accuracy of 71.5%, a sensitivity of 82.5%, and a specificity of 55.1% (AUC = 0.713; P < 0.001).
Baseline cognitive function could help clinicians to better understand the trajectory of first-episode depression patients during acute treatment with SSRIs.
本研究旨在探讨认知功能在选择性 5-羟色胺再摄取抑制剂(SSRIs)治疗抑郁症患者疗效预测中的作用,并进一步了解基线认知功能与抑郁轨迹之间的关系。
这是一项多中心重度抑郁症研究的一部分。该研究纳入了 172 例首发抑郁症患者和 93 例复发性抑郁症患者,他们在基线时进行了认知功能评估,并接受了 8 周的 SSRI 治疗。
构建了一个包含抑郁变化和认知功能水平变量的 2 水平分层线性模型后,基线时的处理速度是首发患者在每个随访时抑郁改善的最佳预测指标(G11=0.03,P=0.042)。治疗预测模型斜率因基线处理速度得分而异。通过受试者工作特征曲线,结合社会人口统计学特征、镇静催眠药、基线 17 项汉密尔顿抑郁量表(HAMD)和认知功能,对重度抑郁症缓解具有最高的预测能力,分类准确率为 71.5%,敏感度为 82.5%,特异性为 55.1%(AUC=0.713;P<0.001)。
基线认知功能可以帮助临床医生更好地了解 SSRIs 急性治疗首发抑郁症患者的抑郁轨迹。