Cognitive profile of patients with depressive disorders and its significance for antidepressant therapy and social functioning

The level of social functioning is one of the criteria for severity of depressive disorder, and restoration of social functions is one of the main goals of antidepressant therapy. The characteristics of cognitive impairment and their effect on social functioning in patients with nonpsychotic depressive disorders were examined in this study. Working age out-patients (71 people) of both sexes with a primary or a recurrent depressive episode or with dysthymia who had a MADRS total score at least 15, did not take psychopharmacological drugs and signed informed consent form were included in the study. Along with clinical and psychopathological examination, the severity of depressive symptoms was measured using the Montgomery-Asberg Depression Rating Scale (MADRS) and the Hamilton Rating Scale for Depression (HAMD-17). The level of social functioning was assessed using the Sheehan Disability Scale (SDS) and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-les-Q), as well as the Personal and Social Performance Scale (PSP) and the Rustanovich Scale of Social Functioning. The study of patients cognitive functioning included testing of memory (memory for faces), attention (the Landolt broken ring test), reaction speed (the simple sensorimotor reaction), psychomotor functioning (the finger-tapping test) and executive functions (the Stroop test, the reaction to a moving object). The cognitive tests battery was carried out with the help of the hardware-software psychodiagnostic complex «MP-05». As a result of the study, it was found that the indices of social functioning in patients with depressive disorders correlated with the level of severity of depressive symptoms, duration of depressive disorder, professional status of patients and impairment of cognitive functions. The average cognitive profile of the studied patients with depression was characterized predominantly by impaired executive functions, however, in cases of the most severe manifestations of depressive symptoms, a significant reduction in many cognitive functions, including memory, attention and reaction speed, was noted. Patients who had the lowest rates of social functioning were also characterized by a more pronounced reduction in all cognitive indices. The use of SSRI antidepressants not only facilitated the reduction of depressive symptoms, but also improved social functioning in patients with depressive disorders. The use of nootropic drugs in combination with antidepressants in a number of patients allowed a more significant reduction in the symptoms of depression and a more pronounced improvement in cognitive performance, especially executive functions, due to which they had more increase in the levels of social functioning and quality of life compared with patients on antidepressant monotherapy.

социальное функционирование, когнитивные функции, депрессивные расстройства, антидепрессанты, ноотропные препараты, social functioning, cognitive impairment, depressive disorders, antidepressants, nootropicdrugs

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