| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 894.2 KB | Adobe PDF |
Autores
Orientador(es)
Resumo(s)
Enquadramento Teórico: A Perturbação Depressiva Major (PDM) é uma patologia
psiquiátrica cujas manifestações clínicas se evidenciam ao nível emocional, cognitivo e
funcional, sendo considerada pela Organização Mundial de Saúde (OMS), a maior causa
de incapacidade no mundo. Contudo, as manifestações cognitivas entre sujeitos com
PDM, mais frequentes ao nível da atenção, das funções executivas e da memória, parecem
não ser homogéneas, observando-se doentes com alterações mais severas do que outros.
Uma das possíveis explicações para a heterogeneidade encontrada entre estudos, poderá
ser a Reserva Cognitiva (RC), um conceito que sugere que a estimulação cognitiva ao
longo de toda a vida, através de diversos tipos de atividades, resulta numa maior
capacidade do cérebro para lidar com os danos decorrentes de uma patologia. Assim, este
estudo pretende averiguar a influência da RC, medida pela Cognitive Reserve Index
questionare (CRIq), na performance cognitiva de sujeitos com PDM, em comparação
com um grupo de controlo através de testes neuropsicológicos.
Metodologia: Foram recrutadas, através de uma amostragem por conveniência,
catorze pessoas de ambos os sexos e com idades compreendidas entre os 51 e os 67 anos
e escolaridade entre os 4 e os 22 anos, com diagnóstico clínico de PDM. Doze pessoas
sem história prévia de doenças psiquiátricas ou neurológicas, com idades compreendidas
entre os 50 e os 69 anos e escolaridade entre os 4 e os 22 anos, foram também recrutadas
por conveniência. Aplicou-se o MoCA, a prova de Vocabulário da WAIS-III, a Memória
Lógica I e II, Pares de Palavras I e II e a Sequência de Letras e Números (SLN) da WMSIII, o Trail Making Test parte A e parte B (TMT A e B) e a prova de Fluência Verbal
Fonémica, na avaliação neuropsicológica.
Resultados: Foram encontradas diferenças significativas no desempenho entre os
grupos na Memória Lógica II e na Fluência Verbal Fonémica. No Grupo Clínico
III
observaram-se correlações significativas entre a RC total e o desempenho no TMT A,
TMT B-A, SLN e na Fluência Verbal Fonémica. A CRI-Tempo Livre apresentou
correlações significativas exatamente com as mesmas provas que a CRI-Total; a CRIescola apresentou correlações significativas com todas as provas e a CRI-Trabalho só
apresentou uma correlação significativa com a SLN. No Grupo de Controlo, apenas se
observaram correlações significativas entre a CRI-Escola e a Memória Lógica II, Pares
de Palavras II e a SLN; e a CRI-Tempo Livre com o TMT A.
Conclusões: A RC parece desempenhar um papel relevante na manutenção do
funcionamento cognitivo na PDM, embora fatores como a escolaridade, mas sobretudo
as atividades de tempo livre, pareçam ter um peso maior do que fatores como a profissão.
Os resultados obtidos sugerem a RC pode atuar como um mecanismo compensatório da
cognição de sujeitos com PDM, particularmente ao nível do funcionamento executivo.
Theoretical Background: Major Depressive Disorder (MDD) is a psychiatric disorder whose clinical manifestations are evidenced at emotional, cognitive, and functional levels, being considered by the World Health Organization (WHO) as the leading cause of disability worldwide. However, the cognitive manifestations among subjects with MDD, most frequently in attention, executive functions, and memory, do not seem to be homogeneous, with patients with more severe alterations than others. One of the possible explanations for the heterogeneity found between studies may be the Cognitive Reserve (CR), a concept that suggests that cognitive stimulation throughout life, through different types of activities, outcomes in a greater capacity of the brain to deal with the damage resulting from a pathology. Thus, this study aims to investigate the influence of CR, measured by the Cognitive Reserve Index questionnaire (CRIq), on the cognitive performance of subjects with MDD, compared to a control group through neuropsychological tests. Method: Fourteen subjects of both sexes, aged between 51 and 67 years and with an education between 4 and 22 years, with a clinical diagnosis of MDD, were recruited through a convenience sampling. Twelve subjects with no previous history of psychiatric or neurological illnesses, aged between 50 and 69 years, with an education between 4 and 22 years, were also recruited by convenience. We applied the MoCA, the WAIS-III Vocabulary test, the WMS-III Logical Memory I and II, Word Pairs I and II, and Letter and Number Sequence (SLN), the Trail Making Test part A and part B (TMT A and B), and the Phonemic Verbal Fluency test for neuropsychological assessment. Results: Significant differences were found in performance between the groups in Logical Memory II and Phonemic Verbal Fluency. In the Clinical Group, significant correlations were observed between total CR and performance in TMT A, TMT B-A, V SLN and Phonemic Verbal Fluency. The Free-Time CRI showed significant correlations with the same tests as the Total CRI; the School CRI showed significant correlations with all tests and the Work CRI only showed a significant correlation with the SLN. In the Control Group, significant correlations were only observed between the CRI-School and Logical Memory II, Word Pairs II and the SLN; and the CRI-Free Time with the TMT A. Conclusions: CR seems to play a relevant role in maintaining cognitive functioning in MDD, although factors such as schooling, but especially free-time activities seem to have a greater weight than factors such as occupation. The results suggest that CR may act as a compensatory mechanism for cognition in subjects with MDD, especially at the executive functioning
Theoretical Background: Major Depressive Disorder (MDD) is a psychiatric disorder whose clinical manifestations are evidenced at emotional, cognitive, and functional levels, being considered by the World Health Organization (WHO) as the leading cause of disability worldwide. However, the cognitive manifestations among subjects with MDD, most frequently in attention, executive functions, and memory, do not seem to be homogeneous, with patients with more severe alterations than others. One of the possible explanations for the heterogeneity found between studies may be the Cognitive Reserve (CR), a concept that suggests that cognitive stimulation throughout life, through different types of activities, outcomes in a greater capacity of the brain to deal with the damage resulting from a pathology. Thus, this study aims to investigate the influence of CR, measured by the Cognitive Reserve Index questionnaire (CRIq), on the cognitive performance of subjects with MDD, compared to a control group through neuropsychological tests. Method: Fourteen subjects of both sexes, aged between 51 and 67 years and with an education between 4 and 22 years, with a clinical diagnosis of MDD, were recruited through a convenience sampling. Twelve subjects with no previous history of psychiatric or neurological illnesses, aged between 50 and 69 years, with an education between 4 and 22 years, were also recruited by convenience. We applied the MoCA, the WAIS-III Vocabulary test, the WMS-III Logical Memory I and II, Word Pairs I and II, and Letter and Number Sequence (SLN), the Trail Making Test part A and part B (TMT A and B), and the Phonemic Verbal Fluency test for neuropsychological assessment. Results: Significant differences were found in performance between the groups in Logical Memory II and Phonemic Verbal Fluency. In the Clinical Group, significant correlations were observed between total CR and performance in TMT A, TMT B-A, V SLN and Phonemic Verbal Fluency. The Free-Time CRI showed significant correlations with the same tests as the Total CRI; the School CRI showed significant correlations with all tests and the Work CRI only showed a significant correlation with the SLN. In the Control Group, significant correlations were only observed between the CRI-School and Logical Memory II, Word Pairs II and the SLN; and the CRI-Free Time with the TMT A. Conclusions: CR seems to play a relevant role in maintaining cognitive functioning in MDD, although factors such as schooling, but especially free-time activities seem to have a greater weight than factors such as occupation. The results suggest that CR may act as a compensatory mechanism for cognition in subjects with MDD, especially at the executive functioning
Descrição
Palavras-chave
Perturbação Depressiva Major Reserva cognitiva CRIq Major Depressive Disorder Cognitive reserve