Features of cognitive impairment and related risk factors in patients with major depressive disorder: A case-control study
Features of cognitive impairment and related risk factors in patients with major depressive disorder: A case-control study
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重性抑郁症患者认知障碍特征及相关危险因素：病例对照研究
DOI：
10.1016/j.jad.2022.03.063
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发表时间：
2022
影响因子：
6.6
通讯作者：
Nan Zhang
中科院分区：
文献类型：
--
作者：
Meisheng Wang;Deju Yin;Lijun Liu;Shuzhe Zhou;Qi Liu;Hongjun Tian;Jing Wei;Kerang Zhang;Gang Wang;Qiaoling Chen;Gang Zhu;Xueyi Wang;Tianmei Si;Xin Yu;Xiaozhen Lv;Nan Zhang
背景认知障碍（CI）是导致重度抑郁症（MDD）功能丧失的常见症状。然而，中青年MDD患者CI的特点及其相关危险因素尚不清楚。方法在本病例对照研究中，从中国9个中心招募了18至55岁急性发病MDD患者和健康对照（HC）。 MDD 患者的诊断基于 DSM-IV、小型国际神经精神病学访谈和 17 项汉密尔顿抑郁量表评分≥14。认知功能，包括注意力/警觉性、学习、记忆、处理速度和执行功能，通过神经心理学电池进行评估，并在 MDD 患者和 HC 之间进行比较。 MDD 患者在至少 2 个领域得分低于平均 HC 得分 1.5 个 SD 被定义为患有 CI。采用Logistic回归分析识别MDD患者CI的危险因素。结果与HCs（n=302）相比，MDD患者（n=631）在所有认知领域均表现出显着损害（P<0.001）； 168 名 MDD 患者（26.6%）患有 CI。男性（OR：1.712；95% CI：1.165–2.514；P<0.01）与 CI 呈正相关；首次发病年龄（OR：0.974；95% CI：0.957–0.991；P < 0.05）和合并焦虑症（OR：0.514；95% CI：0.332–0.797；P < 0.01）与 CI 呈负相关。 局限性 生物标志物和神经影像学未用于研究 CI 可能的生物学机制和神经基础结论 CI 在成人急性发作性 MDD 中较为突出；男性和首次发病年龄较小是独立危险因素，共病焦虑症是保护因素。
BackgroundCognitive impairment (CI) is a common symptom contributing to functional loss in major depressive disorder (MDD). However, the features of CI and its related risk factors in young and middle-aged MDD patients remain unclear.MethodsIn this case-control study, 18- to 55-year-old acute-onset MDD patients and healthy controls (HCs) were recruited from nine centers in China. MDD patients were diagnosed based on the DSM-IV, the Mini-International Neuropsychiatric Interview, and a 17-item Hamilton Rating Scale for Depression score ≥ 14. Cognitive function, including attention/vigilance, learning, memory, processing speed and executive function, was assessed with a neuropsychological battery and compared between MDD patients and HCs. MDD patients scoring 1.5 SDs below the mean HC score in at least 2 domains were defined as having CI. Logistic regression analysis was used to identify risk factors for CI in MDD patients.ResultsCompared with HCs (n= 302), MDD patients (n= 631) showed significant impairment in all cognitive domains (P< 0.001); 168 MDD patients (26.6%) had CI. Male sex (OR: 1.712; 95% CI: 1.165–2.514;P< 0.01) was positively correlated with CI; age of first onset (OR: 0.974; 95% CI: 0.957–0.991;P< 0.05) and comorbid anxiety disorders (OR: 0.514; 95% CI: 0.332–0.797;P< 0.01) were negatively correlated with CI.LimitationsBiomarkers and neuroimaging were not used to investigate the possible biological mechanism and neural basis of CI in MDD.ConclusionsCI was prominent in adults with acute-onset MDD; male sex and younger age of first onset were independent risk factors, and comorbid anxiety disorders were a protective factor.