Understanding cognitive impairment in mood disorders: mediation analyses in the UK Biobank cohort.
Understanding cognitive impairment in mood disorders: mediation analyses in the UK Biobank cohort.
复制标题
DOI：
10.1192/bjp.2019.188
复制
发表时间：
2019-11
期刊：
影响因子：
--
通讯作者：
Evans JJ
中科院分区：
文献类型：
--
作者：
Cullen B;Smith DJ;Deary IJ;Pell JP;Keyes KM;Evans JJ
认知障碍与情绪障碍患者的持续性残疾密切相关，但解释这一人群认知障碍的因素尚不清楚。估计（a）双相情感障碍和（B）重性抑郁症对认知功能的总体影响，以及由潜在可改变的中间因素解释的影响程度。使用英国生物样本库队列基线数据的横断面研究。参与者被分类为双相情感障碍（n = 2709），重度抑郁症（n = 50 975）或无情绪障碍（n = 102 931和n = 105 284）。结果是推理、反应时间和记忆力的计算机测试。潜在的介质是心脏代谢疾病和精神药物。通过图形方法进行分析，并使用回归、基于倾向评分的方法和G计算控制混杂因素。在视觉空间记忆测试中发现了小幅度的组间差异。在不同的估计方法中，双相情感障碍组的Z评分差异在-0.23到-0.17（95%CI-0.39到-0.03）之间，而重性抑郁症组的Z评分差异约为-0.07（95%CI-0.10到-0.03）。在双相情感障碍组中，四分之一的效应是通过精神药物介导的（−0.05; 95% CI −0.09至−0.01）。未发现通过心脏代谢疾病介导的证据。在一个大型的社区样本中，在中老年人，双相情感障碍和抑郁症与较低的视觉空间记忆表现，部分可能是由于精神药物的使用。随着老年人比例的持续增长，情绪障碍及其治疗对人口认知健康的重要性将日益增加。
Cognitive impairment is strongly linked with persistent disability in people with mood disorders, but the factors that explain cognitive impairment in this population are unclear. To estimate the total effect of (a) bipolar disorder and (b) major depression on cognitive function, and the magnitude of the effect that is explained by potentially modifiable intermediate factors. Cross-sectional study using baseline data from the UK Biobank cohort. Participants were categorised as having bipolar disorder (n = 2709), major depression (n = 50 975) or no mood disorder (n = 102 931 and n = 105 284). The outcomes were computerised tests of reasoning, reaction time and memory. The potential mediators were cardiometabolic disease and psychotropic medication. Analyses were informed by graphical methods and controlled for confounding using regression, propensity score-based methods and G-computation. Group differences of small magnitude were found on a visuospatial memory test. Z-score differences for the bipolar disorder group were in the range −0.23 to −0.17 (95% CI −0.39 to −0.03) across different estimation methods, and for the major depression group they were approximately −0.07 (95% CI −0.10 to −0.03). One-quarter of the effect was mediated via psychotropic medication in the bipolar disorder group (−0.05; 95% CI −0.09 to −0.01). No evidence was found for mediation via cardiometabolic disease. In a large community-based sample in middle to early old age, bipolar disorder and depression were associated with lower visuospatial memory performance, in part potentially due to psychotropic medication use. Mood disorders and their treatments will have increasing importance for population cognitive health as the proportion of older adults continues to grow.
登录
查看更多内容
影响因子：
5
作者：
De Stavola BL;Daniel RM;Ploubidis GB;Micali N
通讯作者：
Micali N
影响因子：
5
作者：
Fry A;Littlejohns TJ;Sudlow C;Doherty N;Adamska L;Sprosen T;Collins R;Allen NE
通讯作者：
Allen NE
影响因子：
5
作者：
Balanza-Martinez, Vicent;Selva, Gabriel;Tabares-Seisdedos, Rafael
通讯作者：
Tabares-Seisdedos, Rafael
影响因子：
2.8
作者：
Parker, Gordon;Brotchie, Heather
通讯作者：
Brotchie, Heather
影响因子：
105.7
作者：
Hutcheon, Jennifer A.;Chiolero, Arnaud;Hanley, James A.
通讯作者：
Hanley, James A.