A longitudinal analysis of the relationship between emotional symptoms and cognitive function in patients with major depressive disorder.

IF 5.9 2区医学 Q1 PSYCHIATRY

Psychological Medicine Pub Date : 2025-05-02 DOI:10.1017/S0033291725001011

Jingjing Zhou, Jinjie Xu, Zizhao Feng, Rui Liu, Le Xiao, Ruinan Li, Xiaoya Li, Xueshan Zhang, Jing Liu, Yuan Feng, Jia Zhou, Gang Wang

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引用次数: 0

Abstract

Background: The relationship between emotional symptoms and cognitive impairments in major depressive disorder (MDD) is key to understanding cognitive dysfunction and optimizing recovery strategies. This study investigates the relationship between subjective and objective cognitive functions and emotional symptoms in MDD and evaluates their contributions to social functioning recovery.

Methods: The Prospective Cohort Study of Depression in China (PROUD) involved 1,376 MDD patients, who underwent 8 weeks of antidepressant monotherapy with assessments at baseline, week 8, and week 52. Measures included the Hamilton Depression Rating Scale (HAMD-17), Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16), Chinese Brief Cognitive Test (C-BCT), Perceived Deficits Questionnaire for Depression-5 (PDQ-D5), and Sheehan Disability Scale (SDS). Cross-lagged panel modeling (CLPM) was used to analyze temporal relationships.

Results: Depressive symptoms and cognitive measures demonstrated significant improvement over 8 weeks (p < 0.001). Baseline subjective cognitive dysfunction predicted depressive symptoms at week 8 (HAMD-17: β = 0.190, 95% CI: 0.108-0.271; QIDS-SR16: β = 0.217, 95% CI: 0.126-0.308). Meanwhile, baseline depressive symptoms (QIDS-SR16) also predicted subsequent subjective cognitive dysfunction (β = 0.090, 95% CI: 0.003-0.177). Recovery of social functioning was driven by improvements in depressive symptoms (β = 0.384, p < 0.0001) and subjective cognition (β = 0.551, p < 0.0001), with subjective cognition contributing more substantially (R² = 0.196 vs. 0.075).

Conclusions: Subjective cognitive dysfunction is more strongly associated with depressive symptoms and plays a significant role in social functioning recovery, highlighting the need for targeted interventions addressing subjective cognitive deficits in MDD.

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重度抑郁症患者情绪症状与认知功能关系的纵向分析。

背景：重度抑郁障碍（MDD）患者情绪症状与认知功能障碍的关系是理解认知功能障碍和优化康复策略的关键。本研究探讨重度抑郁症的主客观认知功能与情绪症状之间的关系，并评估其对社会功能恢复的贡献。方法：中国抑郁症前瞻性队列研究（PROUD）纳入1376名重度抑郁症患者，他们接受了8周的抗抑郁单药治疗，并在基线、第8周和第52周进行评估。测量方法包括汉密尔顿抑郁评定量表（HAMD-17）、抑郁症状自我报告快速量表（QIDS-SR16）、中文简短认知测验（C-BCT）、抑郁知觉缺陷问卷-5 （PDQ-D5）和Sheehan残疾量表（SDS）。交叉滞后面板模型（CLPM）用于分析时间关系。结果：8周后，抑郁症状和认知功能均有显著改善（p < 0.001）。基线主观认知功能障碍预测第8周抑郁症状(HAMD-17: β = 0.190, 95% CI: 0.108-0.271；Qids-sr16: β = 0.217, 95% ci: 0.126 ~ 0.308)。同时，基线抑郁症状（QIDS-SR16）也预测随后的主观认知功能障碍（β = 0.090, 95% CI: 0.003-0.177）。社会功能的恢复是由抑郁症状（β = 0.384, p < 0.0001）和主观认知（β = 0.551, p < 0.0001）的改善驱动的，其中主观认知的贡献更大（R2 = 0.196 vs. 0.075）。结论：主观认知功能障碍与抑郁症状的相关性更强，并在社会功能恢复中发挥重要作用，强调有针对性地干预重度抑郁症主观认知缺陷的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychological Medicine 医学-精神病学

CiteScore

11.30

自引率

4.30%

发文量

711

审稿时长

3-6 weeks

期刊介绍： Now in its fifth decade of publication, Psychological Medicine is a leading international journal in the fields of psychiatry, related aspects of psychology and basic sciences. From 2014, there are 16 issues a year, each featuring original articles reporting key research being undertaken worldwide, together with shorter editorials by distinguished scholars and an important book review section. The journal''s success is clearly demonstrated by a consistently high impact factor.