Executive dysfunction and long-term outcomes of geriatric depression
Executive dysfunction and long-term outcomes of geriatric depression
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DOI：
10.1001/archpsyc.57.3.285
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发表时间：
2000-03-01
影响因子：
--
通讯作者：
Hull, J
中科院分区：
文献类型：
--
作者：
Alexopoulos, GS;Meyers, BS;Hull, J
背景：本研究调查了执行力和记忆障碍与老年重度抑郁症缓解后残留抑郁症状和体征的复发、复发和病程的关系。方法：58 名重度抑郁症缓解的老年受试者接受持续去甲替林治疗（血浆水平 60-150 ng/mL）16 周，然后随机分配接受去甲替林维持治疗或安慰剂，最多 2 周。 年。在使用情感障碍和精神分裂症时间表进行访谈后，使用研究诊断标准和 DSM-IV 标准进行诊断。使用痴呆评定量表评估执行功能障碍和记忆力，使用费城多相仪器评估残疾和社会支持，并使用累积疾病评定量表评估医疗负担。 结果：异常的起始和坚持评分，但与老年抑郁症的复发和复发以及整个组和受试者的抑郁症状波动相关，但与记忆障碍无关。 在随访期间从未达到复发或再发标准的人。记忆障碍、残疾、医疗负担、社会支持和既往发作史并没有显着影响该样本中抑郁症的结果。 结论：发现执行功能障碍与老年重度抑郁症的复发和复发以及残余抑郁症状有关。这些观察结果如果得到证实，将有助于临床医生识别需要警惕随访的患者。这项研究的结果为研究特定前额叶通路在老年患者诱发或持续抑郁综合征或症状中的作用提供了理论依据。
Background: This study investigated the relationship of executive and memory impairment to relapse, recurrence, and course of residual depressive symptoms and signs after remission of geriatric major depression.Methods: Fifty-eight elderly subjects remitted from major depression received continuation nortriptyline treatment (plasma levels 60-150 ng/mL) for 16 weeks and then were randomly assigned to either nortriptyline maintenance therapy or placebo for up to 2 years. Diagnosis was made using the Research Diagnostic Criteria and the DSM-IV criteria after an interview using the Schedule for Affective Disorders and Schizophrenia. Executive dysfunction and memory were assessed with the Dementia Rating Scale, disablity and social support were rated with the Philadelphia Multiphasic Instrument, and medical burden was assessed with the Cumulative Illness Rating Scale.Results: Abnormal initiation and perseveration scores, but not memory impairment, were associated with relapse and recurrence of geriatric depression and with fluctuations of depressive symptoms in the whole group and in subjects who never met criteria for relapse or recurrence during the follow-up period. Memory impairment, disability, medical burden, social support, and history of previous episodes did not significantly influence the outcome of depression in this sample.Conclusions: Executive dysfunction was found to be associated with relapse and recurrence of geriatric major depression and with residual depressive symptoms. These observations, if confirmed, will aid clinicians in identifying patients in need of vigilant follow-up. The findings of this study provide the rationale for investigation of the role of specific prefrontal pathways in predisposing or perpetuating depressive syndromes or symptoms in elderly patients.