Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
ICOnnecta't E-Health Program, Institut Català d'Oncologia, Hospital Duran I Reynals, Avinguda de La Granvia de L'Hospitalet, 199-203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain.
Eur Arch Psychiatry Clin Neurosci. 2023 Aug;273(5):1095-1104. doi: 10.1007/s00406-022-01487-5. Epub 2022 Sep 9.
Many individuals with major depression disorder (MDD) who achieve remission of depressive symptoms, do not perceive themselves as fully recovered. This study explores whether clinical remission is related to functional remission and to patient's perception of recovery, as well as, which factors are associated with their functional and subjective remission. 148 patients with MDD in partial clinical remission were included. Demographics and clinical variables were collected through semi-structured interviews. Objective cognition was evaluated through a neuropsychological battery and subjective cognition through a specific questionnaire. The patient's psychosocial functioning and the perception of their remission were also assessed. Apart from descriptive analysis, Pearson correlations and backward stepwise regression models explored the relationship between demographic, clinical, and cognitive factors with patients' functional and self-perceived remission. From the whole sample, 57 patients (38.5%) were considered to achieve full clinical remission, 38 patients (25.7%) showed functional remission, and 55 patients (37.2%) perceived themselves as remitted. Depressive symptoms and objective and subjective executive function were the factors associated with psychosocial functioning. Besides, depressive symptoms, objective and subjective attention, and subjective executive function were the significant explanatory variables for self-perception of remission. The concept of full recovery from an episode of MDD should not only include the clinician's perspective but also the patient's psychosocial functioning along with their self-perceived remission. As residual depressive symptoms and cognition (objective and subjective) are factors with great contribution to a full recovery, clinicians should specifically address them when choosing therapeutic strategies.
许多患有重度抑郁症（MDD）的患者在症状缓解后，仍认为自己没有完全康复。本研究旨在探讨临床缓解是否与功能缓解和患者对康复的感知有关，以及哪些因素与功能和主观缓解有关。共纳入 148 例处于部分临床缓解的 MDD 患者。通过半结构化访谈收集人口统计学和临床变量。通过神经心理测验评估客观认知，通过特定问卷评估主观认知。还评估了患者的心理社会功能和对缓解的感知。除了描述性分析外，Pearson 相关分析和逐步回归模型还探讨了人口统计学、临床和认知因素与患者功能和自我感知缓解之间的关系。在整个样本中，57 例（38.5%）患者被认为达到完全临床缓解，38 例（25.7%）患者达到功能缓解，55 例（37.2%）患者自我感知缓解。抑郁症状以及客观和主观执行功能是与心理社会功能相关的因素。此外，抑郁症状、客观和主观注意力以及主观执行功能是自我感知缓解的显著解释变量。从 MDD 发作中完全康复的概念不仅应包括临床医生的观点，还应包括患者的心理社会功能以及他们的自我感知缓解。由于残留的抑郁症状和认知（客观和主观）是全面康复的重要因素，临床医生在选择治疗策略时应特别注意这些因素。
