Toxic effects of depression on brain function: Impairment of delayed recall and the cumulative length of depressive disorder in a large sample of depressed outpatients
Toxic effects of depression on brain function: Impairment of delayed recall and the cumulative length of depressive disorder in a large sample of depressed outpatients
复制标题
DOI：
10.1176/appi.ajp.2008.07040574
复制
发表时间：
2008-06-01
影响因子：
17.7
通讯作者：
Goodwin, Guy M.
中科院分区：
文献类型：
--
作者：
Gorwood, Philip;Corruble, Emmanuelle;Goodwin, Guy M.
目的：目前一个重要的假设认为，严重抑郁症与海马之间的关系本质上是有毒的。本研究的目的是评估抑郁对海马功能影响的普遍性。方法：参与者是8229名门诊患者，他们1)根据临床评估符合DSM-IV的重度抑郁症标准，2)在相隔几周的两次访问中测试延迟回忆，这是一种与人类海马完整性特别相关的记忆功能。结果：正如预期的那样，在出现抑郁症时，受试者当前疾病的严重程度是表现的主要决定因素，而不是他们以前抑郁史的强度（过去发作的次数和长度）。然而，在第二次就诊的临床反应之后，既往抑郁史的长度变得比当前症状更重要。以下因素有显著的独立影响：年龄、受教育程度和职业。结论：先前的小样本研究评估了记忆功能，或多或少地针对海马体，表明年龄、性别、教育水平、抑郁发作的长度和强度有很大的差异。因此，需要一个非常大的样本来解开先前抑郁史的中心效应。正如本研究中一般实践样本所证明的那样，过去抑郁的时间长短会损害记忆表现的假设得到了支持，这表明抑郁负担与认知之间存在有毒联系。这一发现对公共卫生具有重要意义。
Objective: An important current hypothesis suggests that the relationship between severe depression and the hippocampus is essentially toxic. The purpose of this study was to assess the generalizability of the impact of depression on hippocampal function.Method: Participants were 8,229 outpatients who 1) fulfilled DSM-IV criteria for major depressive disorder based on clinical assessment and 2) were tested for delayed recall, a memory function that is particularly related to hippocampal integrity in humans, during two visits several weeks apart.Results: As expected, at presentation with depression, the subjects' current illness severity was the major determinant of performance, as opposed to the intensity of their previous depressive history (the number and length of past episodes). However, following clinical response at the second visit, the length of previous depressive history became more significant than current symptoms. The following factors had significant, independent impact: age, education level, and profession.Conclusions: Previous studies of small samples assessed for memory function, more or less specific to the hippocampus, have shown great variability in age, gender, education level, and the length and intensity of depressive episode. Hence, a very large sample was required to disentangle the central effect of previous depressive history. As demonstrated in a general practice sample in this study, the hypothesis that the length of past depression impairs memory performance is supported, suggesting that there is a toxic link between the burden of depression and cognition. This finding has important implications for public health.