四川精神卫生2024，Vol.37Issue(5)：433-438,6.DOI:10.11886/scjsws20240611001
住院青少年抑郁症患者元认知能力及其与临床症状的关系
Metacognitive capacities in relation to clinical symptoms in youth hospitalized adolescent patients with major depressive disorder
摘要
Abstract
Background Metacognition,the capacity to monitor and control one's cognitive processes,has been identified as a crucial component of effective decision-making and behavioral adaptation.Previous research has revealed cognitive deficits in patients with major depressive disorder(MDD),while findings about metacognitive capacities in patients with MDD have been inconsistent across studies,and the exact relationship between metacognitive capacities and clinical symptoms in MDD patients remains uncertain.Objective To examine the metacognitive capacities of adolescent hospitalized patients with MDD and to explore its relationship with depressive and anxiety symptoms,thus providing an unprecedented insight into the prevention of MDD.Methods A coherent 56 adolescent hospitalized patients with MDD in the Psychiatry Department at the Affiliated Hospital of Southwest Medical University from March 2022 to June 2023 and met the diagnostic criteria for depression as defined by the Diagnostic and Statistical Manual of Mental Disorders,fourth edition(DSM-IV)were enrolled as MDD group.At the same time,62 healthy individuals matched with the age and sex of the MDD group residing in Luzhou were concurrently selected as control group.The metacognitive ability of the two groups was evaluated by perceptual decision-making task and confidence rating task,and the indicators included confidence deviation,reaction time of confidence evaluation and metacognitive efficiency.Additionally,the severity of depressive and anxiety symptoms was measured with Beck Depression Inventory(BDI)and Beck Anxiety Inventory(BAI).Pearson correlation analysis was utilized to examine the relationship between metacognitive capacities and clinical symptoms.Results MDD group scored higher on BDI and BAI when compared with control group(t=-13.722,-9.674,P<0.01).In terms of decision-making performance,no statistically significant difference was noted in accuracy and response time between two groups(t=-0.655,0.975,P>0.05).In terms of metacognitive performance,MDD group reported a reduction in overall confidence,confidence in correct decisions,confidence in incorrect decisions and metacognitive efficiency compared with control group(t=3.044,2.769,2.836,3.667,P<0.01).MDD group demonstrated significantly longer confidence evaluation response time than that of control group(t=-2.561,P<0.05).Correlation analysis revealed that among the MDD patients,overall confidence,confidence in correct decisions and confidence in incorrect decisions were negatively correlated with BDI score(r=-0.310,-0.307,-0.298,P<0.05),and the overall confidence and confidence in correct decisions were negatively correlated with BAI score(r=-0.284,-0.280,P<0.05),while no statistical significance existed in the correlation between confidence in incorrect decisions and BAI score(r=-0.229,P>0.05).Furthermore,metacognitive efficiency in MDD patients exhibited negative correlation with both BDI and BAI scores(r=-0.269,-0.290,P<0.05).Conclusion Hospitalized adolescent patients with MDD have impaired metacognition,and metacognitive capacity is found to be associated with severity of depressive and anxiety symptoms.关键词
抑郁症/抑郁症状/元认知/元认知效率Key words
Major depressive disorder/Depressive symptom/Metacognition/Metacognitive efficiency分类
临床医学引用本文复制引用
张毛毛,张罗雅,王昱翔,邓娟,成晓彤,刘可智,陈晶,雷威..住院青少年抑郁症患者元认知能力及其与临床症状的关系[J].四川精神卫生,2024,37(5):433-438,6.基金项目
泸州科技局-西南医科大学联合项目(项目名称:抑郁症目标导向-习惯学习系统异常及其神经机制,项目编号:2019LZXNYDJ39) （项目名称:抑郁症目标导向-习惯学习系统异常及其神经机制,项目编号:2019LZXNYDJ39）
西南医科大学校级科研项目(项目名称:rTMS治疗对抑郁障碍患者元认知及其监控决策作用的认知神经机制,项目编号:2022ZD004) Funded by Luzhou Science and Technology Bureau-Southwest Medical University Collaborative Project(number,2019LZXNYDJ39) （项目名称:rTMS治疗对抑郁障碍患者元认知及其监控决策作用的认知神经机制,项目编号:2022ZD004）
Southwest Medical University Institutional Research Project(number,2022ZD004) （number,2022ZD004）
