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Verstimmt, verzerrt, vergesslich: Das Zusammenwirken emotionaler und kognitiver Dysfunktionen bei Depression

Depressed, biased, forgetful: The interaction of emotional and cognitive dysfunctions in depression

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Zusammenfassung

Bei Depressionen kommt es charakteristischerweise zu Veränderungen des emotionalen Befindens, z. B. dem verminderten Erleben positiver Emotionen, sowie zu kognitiven Beeinträchtigungen, wie Konzentrations- und Gedächtnisschwierigkeiten. Diese emotionalen und kognitiven Dysfunktionen sind eng miteinander verknüpft und tragen entscheidend zur Entstehung und Aufrechterhaltung der depressiven Symptomatik bei. So zeigen Patienten mit Depression beispielsweise eine negativ-verzerrte Informationsverarbeitung, die sowohl die Aufmerksamkeit und das Gedächtnis als auch die Reaktion auf Feedback betrifft. Hinzu kommt eine erhöhte Vermeidungsmotivation bezüglich negativ bewerteter Zustände und eine gleichzeitig verminderte Motivation zur Annährung an positive Ziele. Zudem zeigen depressive Patienten auch häufig einen veränderten Denkstil, der als Rumination bezeichnet wird und das wiederholte, intensive Nachdenken über Ursachen, Folgen und Symptome der eigenen negativen Gefühle umfasst. Die verschiedenen Zusammenhänge zwischen diesen emotionalen, motivationalen und kognitiven Symptomen depressiver Patienten sollen in dieser Arbeit übersichtsartig dargestellt werden. Dabei wird vor allem auch der Einfluss ihres Zusammenwirkens auf die kognitive Leistungsfähigkeit genauer beleuchtet. Die hier hervorgehobene klinische Relevanz der emotional-kognitiven Dysfunktionen sollte auch in therapeutischen Interventionen vermehrt Berücksichtigung finden.

Summary

Major depressive disorder is characterized by changes in the emotional state, e. g. the diminished experience of positive emotions, as well as cognitive impairments such as concentration and memory difficulties. These emotional and cognitive dysfunctions are closely interrelated and play a key role for the development and maintenance of depressive symptoms. For instance, patients with depression show negatively biased information processing that affects attention and memory as well as their reaction to feedback. In addition, there is an increased motivation to avoid negatively evaluated conditions and at the same time a reduced motivation to approach positive goals. Furthermore, depressed patients often show a specific style of thinking, called rumination, which involves repeated, intensive thinking about the causes, consequences and symptoms of one’s own negative feelings. In this review, the different relationships between emotional, motivational and cognitive symptoms of depressive patients will be presented and the influence of their interaction on cognitive performance will be discussed. The highlighted clinical relevance of emotional-cognitive dysfunctions should be considered more often in therapeutic interventions for depressed patients.

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  1. Klinik für Psychiatrie und Psychotherapie – Forschungsabteilung, Evangelisches Klinikum Bethel (EvKB), Remterweg 69–71, 33617, Bielefeld, Deutschland

    Lorenz B. Dehn & Thomas Beblo

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Dehn, L.B., Beblo, T. Verstimmt, verzerrt, vergesslich: Das Zusammenwirken emotionaler und kognitiver Dysfunktionen bei Depression. Neuropsychiatr 33, 123–130 (2019). https://doi.org/10.1007/s40211-019-0307-4

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