Hwang Seon Hee, Kim Myung Sun, Ham Byung Joo
Department of Psychiatry, Korea University Anam Hospital, Seoul, Republic of Korea.
Department of Psychology, Sungshin Women's University, Seoul, Republic of Korea.
Psychiatry Investig. 2025 May;22(5):522-530. doi: 10.30773/pi.2024.0203. Epub 2025 May 15.
Deficits in social cognition (mentalization) and other cognitive deficits have been reported in patients with major depressive disorder (MDD) and may influence treatment response. This study examined the impact of cognitive function on treatment response of patients with MDD after 8 weeks of medication and whether the impact was mediated by mentalization.
Cognitive function (memory, attention, executive function, processing speed) and mentalization were measured in 28 patients with MDD at baseline using neuropsychological tests and self-report scales. The treatment response was defined as the rate of improvement in symptom severity and global function.
Multiple regression analyses, controlling for mentalization and cognitive function, separately revealed that delayed recall was a negative predictor of functional improvement after 8 weeks of treatment, while mentalization was a positive predictor. A single mediation model using PROCESS macro showed that delayed recall and Digit Span backward indirectly affected functional improvement, mediated by mentalization. When age at onset was controlled for as a covariate, the mediating effect lost significance, and the direct effect of delayed recall on functional improvement was still significant.
Despite the small sample size, our results provide evidence that patients with MDD and low memory (delayed recall) at baseline may benefit more from short-term pharmacological treatments.
据报道，重度抑郁症（MDD）患者存在社会认知（心理化）缺陷和其他认知缺陷，且这些缺陷可能影响治疗反应。本研究考察了认知功能对MDD患者药物治疗8周后治疗反应的影响，以及这种影响是否通过心理化介导。
在基线时，使用神经心理学测试和自我报告量表对28例MDD患者的认知功能（记忆、注意力、执行功能、处理速度）和心理化进行测量。治疗反应定义为症状严重程度和整体功能的改善率。
在控制心理化和认知功能的情况下，多元回归分析分别显示，延迟回忆是治疗8周后功能改善的负向预测因子，而心理化是正向预测因子。使用PROCESS宏的单一中介模型显示，延迟回忆和倒背数字间接影响功能改善，通过心理化介导。当将发病年龄作为协变量进行控制时，中介效应失去显著性，延迟回忆对功能改善的直接效应仍然显著。
尽管样本量较小，但我们的结果提供了证据，表明基线时记忆（延迟回忆）较差的MDD患者可能从短期药物治疗中获益更多。
