The Study Of Cognitive Characteristics And Efficacy Of Treatment-resistant Depression

Objective: 1.To explore the clinical characteristics oftreatment-resistant depression (TRD). 2. To explore the cognitivefunctions of TRD, study the exchange of cognitive functions before andafter treatment. 3. To investigate whether there are relationships betweenthe efficacy and cognitive functions, and to provide the clinician withsome indication for treatment.Methods: Patients who meet the inclusion and exclusion criteriawere assessed with Hamiltons Rating Scale for Depression 17(HAMD)and Hamiltons Rating Scale for Anxiety (HAMA) before treatment, beassessed Modified Wisconsin Card Sorting Test (M-WSCT) and Towerof HANOI (TOH). After finishing above measurements, the patientswere treated with different treatment randomly. The patients ofnon-TRD were treated with one kind of anti-depression drugs,including TCAs, SSRIs, SNRIs. The patients of TRD were treated withVenlafaxine combined lithium, thyroxine, risperdal, olanzapine andpsychotherapy. At the sixth week after treatment, the efficacy wasevaluated with HAMD, M-WSCT and TOH would be assessed to evaluate the exchange of cognitive functions before and after treatment.Results: A total of eighty subjects were enrolled and accomplished6 weeks treatment and follow-up, including 40 patients of non-TRD and40 patients of TRD. 1. Compared to non-TRD group, the patients ofTRD group are longer course of disease, younger of the first onset,worse communication, and more alone (p＜0.05), the numbers of malepatients of TRD are higher than non-TRD. 2. Before treatment, therewas no significant difference in the symptom of depression and anxietybetween groups (p＞0.05). Most scores of HAMD of TRD patients arelower than 35. The difference of cognitive functions before treatmentwas no significant. 3. At the sixth week, the total efficacy has significantdifference between the two groups (p＞0.05). There was 67.5% TRDpatients get good efficacy, that means the treatment cases of the study(Venlafaxine combined some other drugs) are worthwhile for lots of theTRD patients. 4. There was significant difference in the cognitivefunctions before and after treatment in those efficient patients in bothgroups (p＞0.05), the dysfunctions of cognition are symptom-combined.Conclusions: Compared to responders, the patients withtreatment-resistant depression have longer course of disease, younger ofthe first onset, worse communication, and more alone, the numbers ofmale patients are higher than non-TRD. There was no significantdifference in the symptom: and cognitive functions between groups. Thedysfunctions of cognition are symptom-combined. The treatment casesof the study (Venlafaxine combined some other drugs) are worthwhilefor lots of the TRD patients.