抑郁障碍患者认知损害及评估新进展

New advances in cognitive impairment associated with depressive disorder and its evaluation

抑郁障碍是一种常见的精神障碍性疾病,主要特征是情绪症状,如情绪低落、思维迟缓和意志活动减退。越来越多的证据表明,抑郁障碍患者认知损害主要与额顶叶认知控制网络的损害有关。其中,执行功能、记忆力和注意力是最常受影响的领域,可通过特定的神经心理学检查来评估。执行功能可通过连线测试Part B、斯特鲁普色词测验等进行评估;记忆力可通过韦克斯勒记忆量表和Rey听觉言语学习测验来评估,注意力可通过连续性能测试、Delis-Kaplan执行功能系统测试、CogitExⅡ进行评估。目前,关于抑郁障碍患者的认知功能已有新型综合评估手段,如THINC-it、严重认知障碍概况、双相情感障碍等级评价认知部分等。对抑郁障碍患者认知损害的特定领域进行更精细的评估有利于提高筛查和诊断的准确率,对其分子学研究及未来的靶向治疗也具有极大意义。

Depressive disorder is a common mental disorder characterized by emotional symptoms,such as low mood,slow thinking,and decreased will activity.More and more evidences indicate that the cognitive impairment in patients with depressive disorder is mainly related to the impairment of the frontal parietal cognitive control network.Of these,executive function,memory,and attention are the most commonly affected areas and can be assessed by specific neuropsychological tests.Executive function can be evaluated by trail making test part B,Stroop color-word test,etc.Memory is assessed by Wechsler memory scale and Rey auditory verbal learning test,and attention is assessed by continuous performance test,Delis-Kaplan executive function system test,CogitExⅡ.At present,there are new comprehensive assessment methods for the cognitive function of patients with depressive disorder,such as THINC-it,severe cognitive impairment profile,cognitive component of rating bipolar disorder.A more detailed assessment of specific areas of cognitive impairment in patients with depressive disorders will improve the accuracy of screening and diagnosis,and have great implications for molecular studies and future targeted therapies.