Study On The Relationship Between Cognitive Function And Symptoms Of First-episode Depression Patients Under Cognitive Theory Model

Background:Depression is a chronic mental disorder with high disability,high mortality and high recurrence.Depression has brought a heavy burden to both individuals and society.Different theories have different explanations for the incidence of depression.At present,cognitive integration theory holds that depression is caused by cognitive impairment,negative processing of ambiguous information and failure of emotion regulation strategies.According to the response style theory,a ruminative response style to depression will affect the severity and duration of depression.The research in cognitive neuroscience of depression found that depression may be caused by abnormal interaction among affective network,reward network,default mode network and cognitive control network.The relationship between anhedonia,rumination,cognitive flexibility and first-episode depression is still not clear yet.Objective:This study focuses on cognitive flexibility,rumination and andedonia,aiming at exploring their relationship with first-episode depression and providing reference for better understanding of the incidence and maintenance process of depression.Results:(1)CFI was significantly correlated with TEPS(r=0.333,P<0.01),TEPS-ANT(r=0.329,P<0.01)and TEPS-CON(r=0.284,P<0.05).There was a significant negative correlation between CFI and HAMD(r=-0.428,P<0.01).Cognitive flexibility played a mediating role between anhedonia and depressive symptoms (mediation effect accounts for 19.6%),and also played a mediating role between and in anhedonia(mediation effect accounts for 20.1%)and consummatory anhedonia(mediation effect accounts for 21.43%)and depressive symptoms.(2)RRS was negatively related to TEPS(r=-0.204,P<0.05)and TEPS-ANT(r=-0.268,P<0.01).Besides it was significantly correlated with HAMD(r=0.393,P<0.01).Rumination played a mediating role between anhedonia and depression symptoms(mediation effect accounts for 21.05%),and also played a mediating role between anticipatory anhedonia(mediation effect accounts for 20.76%)and depression symptoms,while the mediation effect between consummatory anhedonia and depression is not significant.(3)HAMD(t=2.609,P<0.05),RRS total score(t=2.535,P<0.05),depression(t=2.701,P<0.05)and brooding(t=2.524,P<0.05)factor of RRS were significantly improved after 8 weeks of antidepressant treatment.While reflection factor(t=1.449,P>0.05)of RRS,CFI(t=-0.74,P>0.05)and TEPS(t=-0.469,P>0.05)had no significant changes.The brooding and reflection factor of RRS can marginal significantly predict the effect of antidepressant treatment for depression(R~2=0.757,adjusted R~2=0.550,F=3644,P=0.057),while the total score of RRS,depression factor,CFI and TEPS have no significant predictive effect(P>0.05).Conclusion:(1)Cognitive flexibility is significantly correlated to anhedonia and depressive symptoms in patients with first-episode depression.The lower cognitive flexibility patients have,the higher degree of anhedonia and more serious depression they may have,and the effect of anhedonia on first-episode depression is mediated by cognitive flexibility.(2)Rumination is significantly correlated to anhedonia and depressive symptoms.The higher degree of rumination patients have,the higher degree of anhedonia and more serious depression they may have.Rumination plays a mediating role between anhedonia and depression symptoms.(3)Depressive symptoms and rumination of patients with first-episode depression improved significantly after 8weeks of antidepressant treatment.Brooding and reflection factor of rumination at baseline can marginal significantly predict the therapeutic effect of depression.The higher level of brooding at baseline indicates the worse effect of antidepressant treatment,while the higher level of reflection indicates the better effect of antidepressant treatment.