Factors Influencing Cognitive Impairment and Rehabilitation in Patients with Depression

Huakui XIANG, Yang LIU

Department of Rehabilitation and Advancement, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China

Abstract [Objectives] To study the impact of basic demographic variables on the cognitive function of patients with depression, to further understand the personality characteristics of patients with depression with impaired cognitive function and the coping style of daily dealing with problems, and analyse the correlation among them. [Methods] The score of Self-Rating Depression Scale (SDS) was used as the inclusion criteria, with a total score of more than 60 indicating moderate depression and a total score of more than 130 as the criteria. Inclusion criteria were only met when the two criteria were met. Eysenck Personality Questionnaire (EPQ-RSC) and Simple Coping Style Questionnaire (SCSQ) were used to study the personality characteristics and coping styles of depressed patients with impaired cognitive function. A total of 113 people were surveyed, and 75 were finally included. SPSS software was used for analysis, independent sample t test was used for demographic variables, and one-way ANOVA was performed for multiple groups of levels. Pearson correlation analysis was used in the correlation study of personality characteristics, coping style and cognitive function of depression. Multiple regression analysis was used to predict the effects of personality traits and coping styles on cognitive impairment of depression. [Results] Factors influencing cognitive function include age, gender, place of origin, only-child or not, and education level. There was no significant statistical difference. Neuroticism was positively correlated with cognitive impairment in depression (γ=0.438, P<0.05); the extraverted dimension was negatively correlated with cognitive impairment of depression (γ=-0.335, P<0.05); Positive coping styles were negatively correlated with cognitive impairment in depression (γ=-0.415, P<0.05), negative coping style was positively correlated with cognitive impairment of depression (γ=0.299, P<0.05). [Conclusions] Demographic variables have little influence on the cognitive function of patients with depression. Personality characteristics and coping styles are closely correlated with the cognitive function of depression. Neuroticism, negative and positive ways have significant influence and predictive effect on the cognitive function of depression.

Key words Depression, Cognitive function, Influencing factors, Personality traits, Coping strategies

1 Introduction

According to statistics, at present, the number of people diagnosed with depression in the world is about 300 million, and the incidence rate of depression has increased by 18%. It was predicted that depression would become a major factor of death and disability by 2020[1]. Some studies have shown that about 90% of patients with depression will have cognitive impairment at different levels, which may exist for a long time[2]. At present, studies on the etiology of depression mainly focus on two aspects. One is from the perspective of pathophysiology, the occurrence of stress events causes patients to directly bear too much pressure and experience too much emotion, but mainly depressed. The other is from a biological point of view. There are changes in the brain centers of depressed patients[3]. Nowadays, most of the studies on the influencing factors of cognitive impairment in patients with depression focus on a single dimension, and no more specific conclusions have been reached. Cognitive impairment will not go away when people with depression are not treated and it may last. Depression itself can lead to a series of painful experiences, which, in addition to cognitive impairment, can have a serious impact on learning, family life and social interaction. To understand the cognitive factors of patients, improve their cognition, increase their prognosis and recovery hope, so that they can return to society as soon as possible. Depression susceptibility has receiving more and more attention by scholars. As an internal source of disease, it will cause depressive symptoms under certain conditions, and the susceptibility to depression is closely related to cognition. Patients in social life, because there is no appropriate coping style, no strong psychological support, no sound personality, so that patients are in no expectation, pessimistic and other bad emotions, further increase the loss of cognitive function of patients with depression. At present, there are more and more treatment schemes aiming at the impairment of cognitive function, but many treatments only include a single basic demographic data when considering the influencing factors, and there are few studies on the two factors of personality characteristics and coping style. Therefore, studying the relationship between them could provide some direction for future treatment plans.

2 Research methods

2.1 SubjectsPatients first diagnosed in the outpatient department of our hospital (Taihe Hospital, Hubei University of Medicine) or previously diagnosed with this recurrence were observed online for a week, and 75 patients with depression were eventually included in the questionnaire released through the network. Inclusion criteria: came to our hospital voluntarily, and the score of Self-Rating Depression Scale (SDS) was greater than 60; Dysfunctional Attitude Questionnaire score > 130.

2.2 Research toolsDemographic data: including five indicators, namely, age, gender, birthplace origin, only-child, and education level. Depression symptom assessment: Self-Rating Depression Scale (SDS) was used, and its reliability and validity were well tested in the research center[6]. This tool included 20 questions, half of which were reverse scoring questions, and used a four-point scale to self-rate a number of emotional traits during the week. The total score was multiplied by 1.25 to get a standard score, the higher the standard score, the more severe the depressive symptoms. Due to the particularity of the research subjects, the inclusion criteria of this study were strict. Only people with moderate depression and severe depression were included, which means the standard score is greater than or equal to 60. Dysfunctional Attitude Assessment: Dysfunctional Attitude Questionnaire (DAS) was used. DAS was divided into eight factor structures to construct cognitive structures from multiple perspectives. This tool had 40 questions, 10 of which were scored in reverse, on a seven-point scale. The inclusion criterion was that the test score was greater than 130, the higher the score was, the more severe the cognitive dissonance was, and the scale had good reliability and validity[7]. The measurement tool was scored as a single item, with one point added to "Yes" and zero points to "No". The higher the score, the more obvious some personality characteristics in this dimension will be. The Simple Coping Style Questionnaire (SCSQ) consisted of 20 questions about actions that people might take in their daily lives. This tool was divided into two dimensions, and the average score of the first 12 questions was used to evaluate positive factors. The negative dimension was the same, and the question was the rest of it. The evaluation method was mainly through scoring, and 0-3 four-level scoring method was used for statistics. The higher the total score, the more obvious the relative factor tendency, and the reliability and validity of this scale was well verified[9].

3 Results and analysis

Correlation between cognitive function and EPQ-RSC and SCSQ scores in patients with depression. DAS was positively correlated with neuroticism (γ=0.438,P<0.05), and negatively correlated with extroversion (γ=-0.335,P<0.05). The cognitive function score DAS was negatively correlated with positive coping (γ=-0.415,P<0.05) and positively correlated with negative coping (γ=0.299,P<0.05), as shown in Table 1.

Table 1 Correlation between cognitive function of depression and EPQ-RSC and SCSQ scores

The predictive effect of personality characteristics and coping style on cognitive function of patients with depression in the multiple regression analysis of cognitive function of patients with depression by personality characteristics and coping styles, the dependent variable was the cognitive function of patients with depression, and the predictive variables were psychoticism, extraversion, neuroticism, concealment, positive coping and negative coping. Equation modelP<0.05, indicating that the regression equation has practical value.R2was 0.487, indicating that the predictive variable could explain 48.7% of the change in the dependent variable. Among them, the positive coping stylet=-4.648,P<0.05, indicating a significant negative impact on cognitive function; the negative coping stylet=4.717,P<0.05, indicating a significant positive impact on cognitive function; the personality characteristics of neuroticismt=2.507,P<0.05, indicating a significant positive impact on cognitive function (Table 2).

Table 2 Multiple regression analysis of personality characteristics and coping styles on cognitive function of patients with depression

4 Discussion

Both personality characteristics and coping styles are related to cognitive function of depression[14]. Related studies have shown that compared with normal cognitive function, depression patients have obvious personality differences, and there is an obvious emotional instability, sensitive, impulsive, restrain oneself and not good at expressing feelings, this study found that in the personality dimensions, cognitive impairment, the more severe the neurotic tend to be more nervous in the daily tasks, patients can experience significant emotional hyperactivity, anxiety, and depression, and the more neurotic the person, the more likely he or she is to experience cognitive impairment of depression. Neurotic personality will interfere with people’s performance of various activities in daily life. Meanwhile, neurotic personality will often have anxious thoughts, which often occupy the brain of patients, causing the normal turnover of cognitive function. In the dimension of personality characteristics, the more obvious the introversion characteristics are, the more serious the cognitive impairment of patients with depression will be. Introversion means that people with depression are withdrawn, not socially active, immersed in their own pessimistic world, and stereotypical, which can affect cognitive function. Dai Yuanyuanetal.found that neuroticism is a risk factor for cognitive impairment of depression, while extroverted personality is a protective factor. It is consistent with the relevant results of personality characteristics in this study. Different from previous studies, there is no correlation between psychoticism and cognitive impairment in depression.

The existing trend of research is focusing on certain factors on the effect of cognitive function and depression, but because of the complexity of the depression, cognitive functions are also many factors. In this study, we discussed a man’s characteristics and coping styles and sorting out of the relationship between cognitive function in patients with depression, for the prevention, treatment and prognosis of depression in the future. At the same time, we should also recognize the influence of coping style, use the right way to make patients feel supported, slowly restore normal social interaction, improve life happiness and satisfaction, and reduce the prevalence of disease.

It is recommended to conduct intervention in line with the personality characteristics of patients with depression in the early stage, take effective measures to alleviate cognitive damage and improve the recovery rate. At the same time, it is also recommended to care about the influence of personality characteristics in clinical treatment. Due to the limitations of network research, the sample size is not large enough. At the same time, if you want to do further follow-up research, it may be difficult in the network world.

Since most of the questionnaires are self-rated and conducted online without a mentor, the reliability of the scores may be affected. In the selection of questionnaires, due to the limitation of questionnaire questions, most of the simple questionnaires ignored many factors and did not get further and sufficient analysis. And the failure to further propose appropriate treatment plan and apply it to daily treatment. Personality traits and coping styles associated with cognitive function in patients with depression has a relationship, and personality traits and coping styles of some factors on cognitive function in patients with depression has a significant impact, this study result to the cognitive function of prevention and treatment of depression provides a new way of thinking, focus on personality traits and coping styles in clinical treatment, efforts to improve the life quality of depression patients, reduce the incidence and improve their prognosis.