Jiao Qingyan, Dong Yeqing, Ma Xiaojuan, Ji Shiyi Suzy, Liu Xinyu, Zhang Jian, Sun Xia, Li Dazhi, Luo Xingguang, Zhang Yong
Unit of Bipolar Disorder, Tianjin Anding Hospital, Tianjin, 300222, People's Republic of China.
Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, People's Republic of China.
Neuropsychiatr Dis Treat. 2024 Feb 23;20:353-361. doi: 10.2147/NDT.S453447. eCollection 2024.
Major depressive disorder (MDD) is associated with worse cognitive functioning. We aim to examine the association between baseline cognitive functioning and the reduction rate in HDRS-17 total scores and to highlight the predictors of the reduction rate in HDRS-17 total scores in MDD with first-episode, drug-naïve (FED) patients.
Ninety FED patients were recruited consecutively and evaluated using the 17-item Hamilton Depression Rating Scale (HDRS-17), the 14-item Hamilton Anxiety Scale (HAMA-14), the Functioning Assessment Short Test (FAST) and the MATRICS Consensus Cognitive Battery (MCCB) at baseline and again at week 8.
Eighty-four FED patients completed the study. Comparison showed that response group had significantly higher T scores in TMT-A, BACS-SC, WMS-III, BVMT-R, MSCEI and CPT-IP, but showed significantly lower scores in FAST total scores including autonomy, occupational functioning, cognitive functioning, interpersonal relationship than non- response group (all < 0.05). Partial correlation analysis also found that the reduction rate in HDRS-17 total scores could be negatively associated with autonomy, cognitive functioning and interpersonal relationship domains as well as total FAST scores, also was further positively associated with T-scores of BACS-SC, CPT-IP and MSCEI in MCCB, even when accounting for potential confounders. Furthermore, the levels of cognitive function domain, autonomy domain in FAST, and BACS-SC, CPT-IP in MCCB may predict the reduction rate in HDRS-17 total scores in FED patients (all < 0.05).
Our findings underscore significant correlations between baseline functioning and the reduction rate in HDRS-17 total scores in FED patients. Moreover, better baseline cognitive function, autonomy, speed of processing and attention/vigilance are more likely to predict patients' response to antidepressant treatment, indicating pre-treatment better cognitive functioning may be predictors to treatment response in FED.
重度抑郁症（MDD）与较差的认知功能相关。我们旨在研究基线认知功能与17项汉密尔顿抑郁量表（HDRS-17）总分降低率之间的关联，并强调首发、未用药（FED）的MDD患者中HDRS-17总分降低率的预测因素。
连续招募90例FED患者，并在基线时以及第8周再次使用17项汉密尔顿抑郁量表（HDRS-17）、14项汉密尔顿焦虑量表（HAMA-14）、功能评估简短测试（FAST）和MATRICS共识认知成套测验（MCCB）进行评估。
84例FED患者完成了研究。比较显示，反应组在连线测验A（TMT-A）、贝克认知筛查量表（BACS-SC）、韦氏记忆量表第三版（WMS-III）、本顿视觉保持测验修订版（BVMT-R）、轻度认知功能扩展量表（MSCEI）和连续性能测试-抑制控制（CPT-IP）中的T分显著更高，但在FAST总分中，包括自主性、职业功能、认知功能、人际关系方面的得分显著低于无反应组（均P<0.05）。偏相关分析还发现，HDRS-17总分降低率与自主性、认知功能和人际关系领域以及FAST总分呈负相关，即使在考虑潜在混杂因素时，也与MCCB中BACS-SC、CPT-IP和MSCEI的T分呈正相关。此外，认知功能领域、FAST中的自主性领域以及MCCB中的BACS-SC、CPT-IP水平可能预测FED患者HDRS-17总分的降低率（均P<0.05）。
我们的研究结果强调了基线功能与FED患者HDRS-17总分降低率之间的显著相关性。此外，更好的基线认知功能、自主性、处理速度和注意力/警觉性更有可能预测患者对抗抑郁治疗的反应，表明治疗前更好的认知功能可能是FED患者治疗反应的预测因素。
