Relationship of cognitive impairment with depressive symptoms and psychosocial function in patients with major depressive disorder: Cross-sectional analysis of baseline data from PERFORM-J
Relationship of cognitive impairment with depressive symptoms and psychosocial function in patients with major depressive disorder: Cross-sectional analysis of baseline data from PERFORM-J
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DOI：
10.1016/j.jad.2019.07.064
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发表时间：
2019-11-01
影响因子：
6.6
通讯作者：
Fernandez, Jovelle
中科院分区：
文献类型：
--
作者：
Sumiyoshi, Tomiki;Watanabe, Koichiro;Fernandez, Jovelle
背景：越来越多的证据表明，重度抑郁症（MDD）患者存在认知障碍。日本重度抑郁症相关功能结局的前瞻性流行病学研究（CIM-J）是一项为期6个月的非干预性、前瞻性、多中心流行病学研究。使用基线数据，认知症状和心理社会功能之间的关系进行了分析，在日本患者的MDD。方法：共518例日本门诊患者（年龄18-65岁）与MDD开始新的抗抑郁药单药治疗（一线或开关从以前的药物）参加。评估措施包括：医生评定的蒙哥马利-艾斯伯格抑郁量表数字符号替代测验（DSST）（客观认知）;和患者自评感知缺陷问卷-抑郁（PDQ-D）（主观认知）;希恩残疾量表（SDS）;工作效率和活动障碍问卷（WPAI）结果：超过一半的患者表现出大于1个标准差下降低于正常的客观认知，如DSST测量。抑郁症状的严重程度与主观认知（PDQ-D）呈正相关，但与客观认知（DSST）无关。抑郁程度和主观认知与心理社会功能显著相关，如SDS和WPAI（缺勤项目除外）。相反，客观认知和心理社会功能之间的关联并不显着。局限性：只有门诊病人招募。职业和工作相关的压力水平没有考虑到。结论：日本MDD患者的认知功能障碍的发病率很高。这些患者的认知和心理社会功能之间的关系表明需要针对MDD认知障碍的治疗。
Background: Evidence is accumulating for the presence of cognitive impairment in patients with major depressive disorder (MDD). The Prospective Epidemiological Research on Functioning Outcomes Related to Major Depressive Disorder in Japan (PERFORM-J) study is a 6-month, non-interventional, prospective, multicenter, epidemiological study. Using baseline data, the relationship between cognitive symptoms and psychosocial function was analyzed in Japanese patients with MDD.Methods: A total of 518 Japanese outpatients (aged 18-65 years) with MDD initiating new antidepressant monotherapy (first-line or switch from a previous drug) participated. Assessment measures were: physician-rated Montgomery-Asberg Depression Rating Scale (MADRS) (depression severity); Digit Symbol Substitution Test (DSST) (objective cognition); and patient-rated Perceived Deficits Questionnaire - Depression (PDQ-D) (subjective cognition); Sheehan Disability Scale (SDS); Work Productivity and Activity Impairment questionnaire (WPAI) (psychosocial function); and EuroQol-5 Dimension-5 Level (quality of life).Results: Over half of patients exhibited a greater than 1 standard deviation decline below norm in objective cognition, as measured by the DSST. Severity of depressive symptoms correlated positively with subjective (PDQ-D), but not objective (DSST) cognition. Depression severity and subjective cognition were significantly associated with psychosocial function, as measured by the SDS and WPAI (except the absenteeism items). Conversely, the association between objective cognition and psychosocial function was not significant.Limitations: Only outpatients were recruited. Occupations and job-related stress levels were not taken into account.Conclusions: Japanese patients with MDD presented a high incidence of cognitive impairment. The relationships between cognitive and psychosocial function in these patients suggest a need for therapeutics targeting cognitive impairment of MDD.