Guerrera Claudia Savia, Platania Giuseppe Alessio, Varrasi Simone, De Vivo Simona, Pirrone Concetta, Vezzosi Venera Francesca, Tascedda Fabio, Drago Filippo, Di Nuovo Santo, Blom Johanna M C, Castellano Sabrina, Caraci Filippo
Department of Educational Sciences, University of Catania, Catania, Italy.
Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
CNS Neurol Disord Drug Targets. 2024;23(2):262-270. doi: 10.2174/1568007X04666230313091253.
Different studies have been conducted to understand how patients with unipolar and bipolar depression differ in terms of cognitive and affective symptoms as well as in psychosocial function. Furthermore, the impact of antidepressants, second-generation antipsychotics, and mood stabilizers on these dimensions needs to be characterized, as well as the best psychometric approach to measure changes after pharmacological treatment.
This study aims to analyze the impact of psychotropic drugs on cognitive, affective, and psychosocial functioning in MDD and BD patients; to test the sensitivity of psychometric tools for measuring those changes; also, to understand how psychosocial abilities are associated with affective and cognitive dimensions in patients with MDD and BD.
A total of 22 patients with MDD and 21 patients with BD in the depressive phase were recruited. Several psychometric tests were administered to assess affective, cognitive, and psychosocial symptoms before and after 12 weeks of drug treatment (T0 and T1) with different psychotropic drugs including second-generation antidepressants, second-generation antipsychotics and mood stabilizers (lamotrigine).
MDD patients showed significant improvement in MoCA, Delayed Recall of Rey's 15 Words and HDRS, while a significant worsening was detected on Digit Span Backwards and on FAST scores. Instead, patients with BD showed significant improvements in the MoCA as the MDD patients, but only a trend of improvement (non-statistically significant) on the BDI-II. A positive correlation was detected in both groups between FAST and HDRS and BDI-II scores, especially in BD patients.
Our results demonstrate that drug treatment with psychotropic drugs can improve cognitive and affective symptoms, but not all psychometric tools may be equally sensitive to detect those changes in MDD vs. BD patients. Moreover, we found that affective and cognitive dimensions can be considered as different psychopathological dimensions both in unipolar and bipolar depression.
已开展不同研究以了解单相抑郁和双相抑郁患者在认知和情感症状以及社会心理功能方面的差异。此外，还需要明确抗抑郁药、第二代抗精神病药和心境稳定剂对这些方面的影响，以及测量药物治疗后变化的最佳心理测量方法。
本研究旨在分析精神药物对重度抑郁障碍（MDD）和双相障碍（BD）患者认知、情感和社会心理功能的影响；测试心理测量工具对测量这些变化的敏感性；同时，了解MDD和BD患者的社会心理能力与情感和认知维度之间的关联。
共招募了22例MDD患者和21例处于抑郁发作期的BD患者。在使用包括第二代抗抑郁药、第二代抗精神病药和心境稳定剂（拉莫三嗪）在内的不同精神药物进行12周药物治疗之前和之后（T0和T1），进行了多项心理测量测试，以评估情感、认知和社会心理症状。
MDD患者在蒙特利尔认知评估量表（MoCA）、雷伊15词延迟回忆和汉密尔顿抑郁量表（HDRS）方面有显著改善，而在倒背数字广度和功能及症状自评量表（FAST）得分上有显著恶化。相反，BD患者与MDD患者一样在MoCA上有显著改善，但在贝克抑郁量表第二版（BDI-II）上只有改善趋势（无统计学意义）。两组中FAST与HDRS和BDI-II得分之间均检测到正相关，尤其是在BD患者中。
我们的结果表明，使用精神药物进行药物治疗可改善认知和情感症状，但并非所有心理测量工具在检测MDD与BD患者的这些变化时都同样敏感。此外，我们发现，在单相和双相抑郁中，情感和认知维度均可被视为不同的精神病理维度。
