臨床的うつ病

Attention, Concentration and Planning Ability Improvement in Response to Depression Treatment during Acute Psychiatric Hospitalization

Abstract

Luba Leontieva, Sergey Golovko, Aadhar Adhlakha, Lyuba Polinkovsky, Charles Harris, Donald A Cibula Thomas Schwartz and James L Megna

Background: Cognitive symptoms are some of the most distressing for patients who are depressed. The goal was to investigate whether depressed patients’ cognition changed depending on treatment with SSRIs (No-NOR) vs. Norepinephrine-enhancing medications (NOR) during an inpatient stay.
Methods: This was an observational, naturalistic, pilot study that used a repeated measures design. 119 depressed inpatients, average age 39 years, 61% females, 77% Caucasian, 74% with mood disorders, 50% Cluster B traits/disorders and 32% psychoactive substance abuse disorders participated. The Trail Making Test (TMT), Hamilton Depression Rating Scale (HDRS), and Outcome Questionnaire-45(OQ-45) were used.
Results: Revealed significant differences between admission and discharge in HDRS (MA=24, MD=9, t (98)=25.30, p<0.001), and OQ-45 (MA=105, MD=72, t (97)=12.91, p<0.001) scores. Mean time to complete the TMT-A at discharge for all NOR patients was 32.92 ± 22.47 seconds, and was significantly shorter than the comparable mean for the No-NOR group (39.10 ± 18.88 seconds, t=-2.33, p=0.022).
Conclusion: Patients taking SNRIs, alone or in combination with benzodiazepines, Seroquel or TCAs (NOR), had significantly shorter completion times for the TMT-A test at discharge than did patients taking SSRIs, with or without benzodiazepines (No-NOR). This cognitive improvement developed independently of significant reductions in depressive symptomatology and interpersonal/social functioning impairment.