IntroductionMajor depressive disorder (MDD) is a highly recurrent mental illness accompanied by impairment of neurocognitive function. Lack of insight may affect patients’ motivation to seek treatment, resulting in poor clinical outcomes. This study explores the relationship of insight to neurocognitive function and the risk of recurrence of depressive episodes in patients with MDD.MethodsDemographic, clinical variables, and neurocognitive function measured with Intra-Extra Dimensional Set Shift (IED) from the Cambridge Neuropsychological Test Automated Battery (CANTAB) were collected from 277 patients with MDD. Among them, 141 participants completed a follow-up visit within 1–5 years. Insight was measured using the 17-item Hamilton Depression Rating Scale (HAM-D). To explore the factors associated with recurrence, binary logistic regression models were used.ResultsPatients with MDD, without insight, had significantly higher total and factor scores (anxiety/somatization, weight, retardation, and sleep) on the HAM-D and worse performance in the neurocognition task, compared to those with insight. Furthermore, binary logistic regression revealed that insight and retardation can predict recurrence.ConclusionLack of insight is associated with recurrence and impaired cognitive flexibility in patients with MDD.

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自知力与神经认知功能和抑郁症复发风险的关系：一项自然随访研究

IntroductionMajor depressive disorder (MDD) 是一种高度复发的精神疾病，伴有神经认知功能障碍。缺乏洞察力可能会影响患者寻求治疗的积极性，从而导致临床结果不佳。本研究探讨了自知力与神经认知功能的关系以及 MDD 患者抑郁发作复发的风险。 CANTAB）是从 277 名 MDD 患者中收集的。其中，141 名参与者在 1-5 年内完成了随访。使用 17 项汉密尔顿抑郁量表 (HAM-D) 测量洞察力。为了探索与复发相关的因素，使用二元逻辑回归模型。结果与有 MDD 的患者相比，没有自知力的 MDD 患者在 HAM-D 上的总分和因子分（焦虑/躯体化、体重、发育迟缓和睡眠）显着更高，在神经认知任务中的表现更差洞察力。此外，二元逻辑回归显示洞察力和迟滞可以预测复发。结论缺乏洞察力与 MDD 患者的复发和认知灵活性受损有关。