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Cognitive impairment in major depressive disorder

机译：重大抑郁症的认知障碍

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摘要

Cognitive dysfunction is a symptomatic domain identified across many mental disorders. Cognitive deficits in individuals with major depressive disorder (MDD) contribute significantly to occupational and functional disability. Notably, cognitive subdomains such as learning and memory, executive functioning, processing speed, and attention and concentration are significantly impaired during, and between, episodes in individuals with MDD. Most antidepressants have not been developed and/or evaluated for their ability to directly and independently ameliorate cognitive deficits. Multiple interacting neurobiological mechanisms (eg, neuroinflammation) are implicated as subserving cognitive deficits in MDD. A testable hypothesis, with preliminary support, posits that improving performance across cognitive domains in individuals with MDD may improve psychosocial function, workplace function, quality of life, and other patient-reported outcomes, independent of effects on core mood symptoms. Herein we aim to (1) provide a rationale for prioritizing cognitive deficits as a therapeutic target, (2) briefly discuss the neurobiological substrates subserving cognitive dysfunction, and (3) provide an update on current and future treatment avenues.
机译：认知功能障碍是在许多精神障碍中发现的症状结构域。具有重大抑郁症（MDD）的个体中的认知缺陷对职业和功能性残疾有显着贡献。值得注意的是，在MDD的个体中，学习和记忆，高管功能，处理速度和关注和浓度，诸如学习和记忆，执行功能，处理速度和关注和浓度。大多数抗抑郁药尚未开发和/或评估其直接和独立改善认知缺陷的能力。多种相互作用的神经生物学机制（例如，神经引发）被涉及在MDD中的占用认知缺陷。具有初步支持的可经测试假设，使具有MDD的个人中的认知结构域的性能提高可能改善心理社会功能，工作场所功能，生活质量和其他患者报告的结果，与核心情绪症状的影响无关。在此，我们的目标是（1）提供优先考虑认知缺陷作为治疗靶标的基本原理，（2）简要讨论植入认知功能障碍的神经生物学底物，并且（3）提供关于当前和未来治疗途径的更新。

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