The Cognitive Function And Ways Of Coping In Depression

BackgroundDepressive disorder is a common, harmful and severe psychiatric disorder in his lifetime, its etiology is not clear yet. It is estimatated that depression will be the most important cause resulted in disability in 2002 by World Health Orgnization. There are roughly two views about etiopathogenisis of depression to this day. One regards it as a biological phenomena, the other considers it as a last stress-state from the point of pathopsychology induced by tightness of mordern social life, sharpness of competition and so on.Patients with depression exist in obvious dysfunctional cognition which assume negatively oneself, the world and the future. Automatic thoughts play a mediating role in the relationship between changes in negative schema and depressive symptoms, and make depression take place and develop. Detecting automatic thoughts and challenging maladaptive cognitions, can contribute to relieve the patient's condition and shorten the course of disease, Recently people pay more attention to the comorbid of depression and anxiety, Since compared with pure depression and anxiety , it has greater symptom severity, longer course , higher rate suicide , poorer treatment response and more negative coping ways. However, it still doesn't distinct that characters of cognitive function and coping ways and relation to anxiety in depressive disorder.ObjectiveTo explore the characteristic of automatic thoughts, dysfunctional cognition and ways of coping in depression on admission and discharge and relation to anxiety , intending to investigate the probable mechanisms of depressive disorder from the view of cognitive psychology.MethodsA cohort of thirty depressive patients was assessed respectively on admission and discharge. The assessment including Hamilton depression scale(HAMD-24 ), Hamilton Anxiety Scale(HAMA-14), the Automatic Thought Questionnaire (ATQ-30), Dysfunctional Attitude Scale (DAS) and Ways of Coping Questionnaire. Thirty healthy subjects were assessed, too.Results1. The depressive patients exist in visible dysfunctional cognition.The total scores of DAS reduced to 149.57±20.75 after four-week treatment, different from those before treatment 163.73±23.51, the difference reach statisticalsignificance (P=0.016) . And the post-treatment total scores of DAS stillsignificantly higher normal control groups (131.50±24.53 P=0.003 );In the aspectof dysfunctional cognition , except for cognitive philosophy, had a decreased tendency after treatment. Among the total , the scores of perfection(D3) of depressive patients was 18.99±4.97, and decreased to 16.20±3.84 after treatment, thedifference reach statistical significance ( P=0.019 );dependence(D6) factor decreased from 21.77±4.93 to 18.47±4.35 after treatment, the difference was significant (iM).OO8) . while there were insignificant difference in the scores of others cognitive factors.2. Depressive patients altered the ways of coping after treatment, adopted the more positive ways to deal with business.In the aspect of coping style, the scores of solving problems (P=0.012) , self-blame (P=0.047 ) and asking for help (P=0.025 ) reach statistic significance.Self-blame was applied less and solving problems and asking for help more at discharge. Accompanying the depressive symptoms 's relief, fancy avoidance and rationalization have some reduce, but have no remarkable difference. Furthermore, these three ways of coping demonstrated the striking significance compared tocontrol groups (PO.05 sSc P<0.0l) .3. Dysfunctional cognition is a mark mental status in depression.Subtracting value correlation analysis showed that Automatic Thoughts hadpositive correlation with Dysfunctional cognition (r=0.401, .P=0.028 ) , vulnerability(Dl) ( r=0.394, P=0.031), perfection(D3) (r=0.455, /*=0.011) , Independenceattitude (D7)(r=0.440, P=0.015 )and Self-blame (r=0.385, i*=0.035 );and a negativecorrelation with solving problems (r=-0.592, P=0.001) .The subtracting scores ofAutomatic Thoughts, DAS, coping-ways and every factors were not associated with those of HAMD and /or HAMA.Conclusions1. Dysfunctional cognition is a characteristic mental status in depression, independent to symptoms of depression and anxiety, provided a theory base for approaching the mechanisms of depressive disorder in the point of pathopsychology.2. The ways of coping changed significantly followed by changes of severety of the depression, fancy, avoidance and rationalization were maybe traits of depression. It is important to guide people to cope stess actively, will contribute to maintain the balance of psychic health.