通往认知健康的经验之路：既往患有与压力相关的精疲力竭症患者的认知恢复

The experienced route to cognitive health: Cognitive recovery in persons with prior stress-related Exhaustion disorder.

作者信息

Nelson Andreas, Aronsson Ingela, Tillfors Maria, Neely Anna Stigsdotter, Gavelin Hanna M

机构信息

Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.

Department of Psychology, Umeå University, Umeå, Sweden.

出版信息

BMC Psychiatry. 2025 Apr 14;25(1):375. doi: 10.1186/s12888-025-06713-7.

DOI:10.1186/s12888-025-06713-7

PMID:40229758

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11995536/

Abstract

BACKGROUND

People diagnosed with stress-related exhaustion disorder report high levels of cognitive symptoms. This study aimed to explore how persons diagnosed with Exhaustion disorder (ED) experienced cognitive functioning and recovery 6-10 years after participating in a rehabilitation programme. Specifically, it investigated the experiences of current functioning, change over time, and what had been barriers or facilitators for cognitive recovery.

METHODS

Semi-structured interviews were conducted for 38 persons previously diagnosed with ED (Mean age: 52; Females: 32) and explored using thematic analysis.

RESULTS

The analysis resulted in four themes: "'It's different now': Remaining cognitive symptoms", "The bigger picture: Cognitive recovery in context", "Overcoming challenges: Strategies for coping with cognitive symptoms", and "The approach towards cognition matters". The participants' experiences varied but included descriptions on how cognitive functioning had become better with some remaining symptoms. These difficulties were reported across cognitive domains, yet often centred around upholding executive control. Cognitive recovery was seen in the context of overall well-being and recovery which differed between the participants. Facilitators and barriers thus varied between persons, and included both restorative and compensatory strategies, external conditions, the degree of worry, and development of a more acceptant or self-compassionate view on cognition and oneself.

CONCLUSIONS

The results show that cognitive recovery in ED is multifaceted. 6-10 years after rehabilitation, experiences included improvement of everyday cognitive functioning, but also lingering challenges, often related to maintenance of executive control. Recovery was influenced by factors such as general well-being, restorative or compensatory strategies, worrying, or the adaptation of more accepting or self-compassionate perspectives. The findings indicate a need for tailored, person-centred approaches to supporting cognitive recovery.

TRIAL REGISTRATION

Participants were recruited as part of the Rehabilitation for Improved Cognition (RECO) trial (ClinicalTrials.gov: NCT03073772, date of registration: 8 March, 2017). This study was preregistered on the Open Science Framework (osf.io: https://doi.org/10.17605/OSF.IO/S2W6X ).

摘要

背景

被诊断为与压力相关的疲惫障碍的人报告有高水平的认知症状。本研究旨在探讨被诊断为疲惫障碍（ED）的人在参加康复计划6至10年后如何体验认知功能和恢复情况。具体而言，它调查了当前功能的体验、随时间的变化，以及认知恢复的障碍或促进因素。

方法

对38名先前被诊断为ED的人（平均年龄：52岁；女性：32名）进行了半结构化访谈，并采用主题分析法进行探索。

结果

分析产生了四个主题：“现在不同了”：残留的认知症状、“大局观”：情境中的认知恢复、“克服挑战”：应对认知症状的策略，以及“对认知的态度很重要”。参与者的经历各不相同，但包括了关于认知功能如何在仍有一些症状的情况下变得更好的描述。这些困难在认知领域都有报告，但往往集中在维持执行控制方面。认知恢复是在整体幸福感和恢复的背景下看到的，参与者之间存在差异。因此，促进因素和障碍因人而异，包括恢复性和补偿性策略、外部条件、担忧程度，以及对认知和自身形成更接纳或自我同情的看法。