Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden.
BMC Psychiatry. 2023 Aug 7;23(1):565. doi: 10.1186/s12888-023-05048-5.
Patients with stress-related mental disorders often report cognitive impairment, but studies investigating objective cognitive impairment in patients with stress-related disorders have produced inconsistent findings.
The primary aim of this study was to investigate objective cognitive functioning in patients diagnosed with the stress-related disorders adjustment disorder or exhaustion disorder, compared to a healthy normative group. Secondary aims were to conduct subgroup analyses of cognitive functioning between the diagnostic groups and explore associations between self-reported symptoms and cognitive functioning.
Cognitive test results on a digitally self-administered cognitive test battery from 266 patients (adjustment disorder, n = 131; exhaustion disorder, n = 135) were cross-sectionally compared with results from a healthy normative group (N = 184 to 692) using one-tailed t-tests. ANOVAs were conducted for subgroup analyses, and regression analyses for associations between self-reported symptoms and cognitive functioning. Effect sizes were calculated.
Patients performed significantly worse than the normative group on all measures with small to moderate effect sizes ranging from d = -.13 to -.57. Those diagnosed with exhaustion disorder performed worse than norms on more measures than did patients with adjustment disorder, but no significant differences between diagnostic groups were found on any measure. Self-reported memory impairment was weakly associated with one of two memory measures. No clear associations between self-reported burnout symptoms and objective cognitive functioning were found.
This study adds to the literature indicative of small to moderate objective cognitive impairments in patients diagnosed with stress-related mental disorders. Further exploration into mechanisms of cognitive functioning in different populations is needed for development of theoretical models that may explain the weak correlation between self-reported symptoms and objective measures.
ClinicalTrial.gov: NCT04797273. Trial registration date 15 March 2021. This study was also pre-registered on Open Science Framework (osf.io) with https://doi.org/10.17605/OSF.IO/TQXZV .
与压力相关的精神障碍患者常报告认知障碍，但研究压力相关障碍患者的客观认知障碍得出的结果并不一致。
本研究的主要目的是比较诊断为应激相关障碍（适应障碍或耗竭障碍）的患者与健康对照组之间客观认知功能的差异。次要目的是对诊断组之间的认知功能进行亚组分析，并探讨自我报告症状与认知功能之间的关联。
使用数字自我管理认知测试电池，对 266 名患者（适应障碍，n=131；耗竭障碍，n=135）的认知测试结果进行了横断面比较，与健康对照组（n=184 至 692）的结果进行了比较，使用单侧 t 检验。对于亚组分析，进行方差分析，对于自我报告症状与认知功能之间的关联，进行回归分析。计算效应大小。
与对照组相比，患者在所有测试中表现明显较差，效应大小从 d=-.13 到 -.57 不等，处于小到中等水平。被诊断为耗竭障碍的患者在更多的测试中表现比适应障碍患者更差，但在任何测试中，两组诊断组之间均无显著差异。自我报告的记忆障碍与两种记忆测试中的一种弱相关。自我报告的倦怠症状与客观认知功能之间没有明显的关联。
本研究进一步证实了诊断为应激相关精神障碍患者存在小到中等程度的客观认知障碍。需要进一步探索不同人群认知功能的机制，以发展可能解释自我报告症状与客观测量之间弱相关性的理论模型。
ClinicalTrial.gov：NCT04797273。试验注册日期为 2021 年 3 月 15 日。本研究还在 Open Science Framework（osf.io）上预先注册，网址为 https://doi.org/10.17605/OSF.IO/TQXZV 。
