うつ病寛解後の再発リスクと認知スコアの関連を解析 (Cognitive scores tied to relapse risk in depression)

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2026-05-07 バーミンガム大学

英国のバーミンガム大学の研究チームは、うつ病寛解後に認知機能が比較的高い患者ほど、再発リスクが高い可能性があることを明らかにした。研究では、注意力や記憶力、問題解決能力などの認知機能と、うつ病再発との関連を長期追跡データから分析した。その結果、認知能力が高い患者は日常生活への適応が良好に見える一方で、過剰な反芻思考や自己分析傾向を維持しやすく、再発につながる可能性が示唆された。研究者らは、従来は認知機能低下が重視されてきたが、高い認知能力も再発予測因子となり得る点を指摘している。また、うつ病治療後の評価では、単なる症状改善だけでなく、思考パターンや感情調節特性を含めた包括的評価が重要だと強調した。本研究は、再発予防の個別化医療や心理療法設計に新たな視点を提供する成果とされる。

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認知機能と将来のうつ病:うつ病の既往歴のある人とない人におけるリスクとの関連性 Cognition and future depression: associations with risk in those with and without a history of depression

Angharad N de Cates ,Angeline Lee,Laura Winchester,…
BMJ Mental Health  Published:6 May 2026
DOI:https://doi.org/10.1136/bmjment-2025-302332

うつ病寛解後の再発リスクと認知スコアの関連を解析 (Cognitive scores tied to relapse risk in depression)

Abstract

Background Cognitive impairments are common in depression and often persist beyond mood resolution. However, the relationship between cognitive performance, its neurological underpinnings, and future depression risk is unclear, limiting strategies for primary and secondary prevention.

Objective Our objective was to determine whether cognition associates with subsequent depression, both relapse and first-episode occurrences.

Methods 1862 UK Biobank participants with a history of International Classification of Diseases (ICD)-10-defined depression in remission (RD) (mean (SD) age: 52.7 (7.13) years) were age-matched and sex-matched to 1862 participants without depression history or current antidepressant use. Cognitive scores were compared between groups at the composite (z-score), domain and task levels. MRI-derived phenotypes assessed brain network structure and functional connectivity. Longitudinal associations with future depression were assessed using logistic regression models and a Cox proportional hazards model controlling for key confounders.

Findings Participants with RD had a higher risk of future depression (33%) than controls (13%), including when we accounted for temporal differences in longitudinal assessment (HR=3.16 (95% CI 2.71 to 3.67), global proportional hazard assumption p=0.07). Composite cognitive performance in controls was inversely associated with future depression risk (risk estimated marginal means: 0.25% at −1SD, 0.20% at mean, 0.15% at +1 SD). In RD, this relationship was reversed (0.74% at −1SD, 0.90% at mean, 1.10% at +1 SD). Executive functioning, processing speed and reasoning task scores all contributed. Higher grey matter in default mode network regions was associated with better concurrent cognitive performance across all participants, but not with future depression risk. Other MRI findings were limited.

Conclusions RD carried a threefold higher risk of future depression than controls. Cognitive performance was a risk marker for future depression in both groups but in opposing directions. Neuroimaging metrics provided little predictive value.

Clinical implications Personalised risk factor assessment for depression is likely to be dependent on depression history. Those without previous history of diagnosed depression are at higher risk of future depression when cognitive performance is lower at baseline. RD is a high-risk group for future depression, and those with relatively higher cognitive performance may be more likely to report future depressive symptoms.

医療・健康
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