Objective To investigate the characteristics of cognitive function and its correlation to neuroendocrine status in patients with refractory depression.
Methods A total of 41 patients diagnosed by ICD-10 as depression onset who have been treated with more than two antidepressants drugs, fulfilled the criteria of refractory depression. Another 40 patients diagnosed by ICD-10 as depression onset but who have not been treated, or have been treated with only one antidepressant drug were selected as controls. Patients in both groups were evaluated by WAIS-RC, STROOP, VF, TRAILS A, B, TOH and M-WCST, and the concentrations of CORT, ACTH, T3, FT3, T4, FT4, TSH were also determined.
Results A significant difference was found in VF between the refractory depression group and the control group. This showed that the damage to short-term memory, attention and interference rejection capability was much more serious in the refractory depression group. The ACTH concentration in the refractory depression group was significantly different from that of the control group, which indicated that the damage to the Hypothalamic-pituitary-adrenal axis was more serious in the refractory depression group. In particular in relation to memory and attention defect.
Conclusion Changes in the levels of CORT, ACTH, TSH, FT3 and T4 may be correlated to cognitive function damage in patients with refractory depression.
Citation:
LI Zhe,SUN Xueli,HUANG Yi,ZHANG Bo. Correlation between Neuroendocrine and Cognitive Function in Patients with Refractory Depression. Chinese Journal of Evidence-Based Medicine, 2007, 07(8): 575-579. doi:
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- 1. J Affect Disord, 2002, 68(223): 261-271.
- 2. Gen Hosp Psychiatry, 2004, 26(4):302-309.
- 3. J Gerontol B Psychol Sci Soc Sci, 1998, 53(4): 234-239.
- 4. J Gerontol A Biol Sci Med Sci, 1999, 54(3): 111-116.
- 5. Howland RH, Gewirtz GR, Guscott R. Compiled by Fu SJ. Dysthyreosis and refractory depression. Foreign Medical Sciences, Section of Psychiatry, 1994, 21(1): 40-43.
- 6. Fossati P, Coyette F, Ergis AM: Influence of age and executive functive functioning on verbal memory of inpatients with depression.
- 7. Fraser SA, Kroenke K, Callahan CM, et al. Low yield of thyroid-stimulating hormone testing in elderly patients with depression.
- 8. Ehnvall A, Sjogren M, Zachrisson OC, et al. HPA axis activation determined by the CRH challenge test in patients with few versus multiple episodes of treatment- refractory Depression. Eur Arch Psychiatry Clin Neurosci, 2004, 254(6): 349.
- 9. Kirkegaard C, Faber J. The role of thyroid hormones in depression. Eur J Endocrinology, 1998, 138(1): 1-9.
- 10. Wahlin A,Wahlin TB, Small BJ, et al. Influences of thyroid stimulating hormone on cognitive functioning in very old age.
- 11. Prinz PN, Scanlan JM, Vitaliano PP, et al.Thyroid hormones: Positive relationships with cognition in healthy, euthyroid older men.
- 12. Howland RH, Gewirtz GR, Guscott R. 符少剑, 编译. 甲状腺功能障碍与难治性抑郁症. 国外医学精神病学分册, 1994, 21(1): 40~43.