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<article article-type="review-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/ms2023-246</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-7926</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КОГНИТИВНЫЕ РАССТРОЙСТВА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>COGNITIVE DISRODERS</subject></subj-group></article-categories><title-group><article-title>Когнитивные нарушения и депрессия</article-title><trans-title-group xml:lang="en"><trans-title>Cognitive impairment and depression</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9097-898X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Преображенская</surname><given-names>И. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Preobrazhenskaya</surname><given-names>I. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Преображенская Ирина Сергеевна – доктор медицинских наук, профессор  кафедры  нервных болезней  и нейрохирургии  Института клинической медицины имени Н.В. Склифосовского.</p><p>119991, Москва, ул. Трубецкая, д. 8, стр. 2</p></bio><bio xml:lang="en"><p>Irina S. Preobrazhenskaya -  Dr. Sci. (Med.), Professor of the Department of Nervous Diseases  and Neurosurgery, Sklifosovsky Institute  of Clinical Medicine, Sechenov  First Moscow State  Medical University (Sechenov University).</p><p>8, Bldg. 2, Trubetskaya  St., Moscow, 119991</p></bio><email xlink:type="simple">preobrazhenskaya_i_s@staff.sechenov.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)<country>Россия</country></aff><aff xml:lang="en">Sechenov First Moscow State  Medical University (Sechenov University)<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>23</day><month>11</month><year>2023</year></pub-date><volume>0</volume><issue>21</issue><fpage>34</fpage><lpage>43</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Преображенская И.С., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Преображенская И.С.</copyright-holder><copyright-holder xml:lang="en">Preobrazhenskaya I.S.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/7926">https://www.med-sovet.pro/jour/article/view/7926</self-uri><abstract><p>Обсуждается общность когнитивных нарушений и депрессии. Нарушения в когнитивной сфере  являются основными симптомами  депрессивного  расстройства,  и наиболее  часто именно  когнитивные нарушения  снижают работоспособность и  качество  жизни  пациентов  с  клинически  значимой  депрессией.  Наиболее  частыми когнитивными  расстройствами у таких пациентов являются: дефицит внимания (как зрительного, так и слухоречевого), снижение уровня кратковременной и оперативной  памяти, трудности, возникающие  при  обработке  информации  любой модальности, снижение  скорости обработки информации, а также трудности выстраивания программы деятельности и контроля за ее исполнением. Когнитивным симптомом, требующим дополнительного  обсуждения, является т. н. когнитивное  искажение  – смещение фокуса от положительных стимулов к отрицательным, а также неверные реакции на отрицательную обратную связь и принятие решений. Депрессивный  эпизод  развивается  на  фоне  дисметаболических  и дисфункциональных  церебральных изменений  в миндалевидном  теле, поясной коре, гиппокампе, орбитофронтальной  и медиобазальной лобной коре. Когнитивные нарушения у пациентов, перенесших  депрессию, сохраняются и после выхода из депрессии. По образному выражению,  принятому в  научной  среде  специалистов,  изучающих когнитивные  нарушения  при  депрессии,  каждый депрессивный  эпизод образует непреходящие  «когнитивные рубцы». Предположительно, когнитивная дисфункция может быть одним  из факторов  риска  развития  депрессивного  расстройства. Депрессия,  в свою очередь,  является  фактором риска развития деменции, в т. ч. при болезни Альцгеймера и сосудистом поражении головного мозга: проведенные исследования  показали,  что  трансформация   выраженных  когнитивных  нарушений,  связанных  с  депрессией,  в  деменцию у пожилых пациентов  за пять лет может достигать 70%. Несомненную общность депрессии  и когнитивной дисфункции подчеркивает частота представленности  депрессии  у пациентов с когнитивными нарушениями.</p></abstract><trans-abstract xml:lang="en"><p>The commonality of cognitive impairment and depression is discussed. Cognitive symptoms are the main symptoms of depressive disorder  and, most often, it is cognitive  impairment that  reduces  the performance and quality of life of depressed patients. The most common  cognitive  disorders  in depressed patients are: attention deficit (both visual and auditory), decrease in the  level of short-term and operative  memory, difficulties in processing  information  of any modality, a decrease in the speed of information processing, as well as difficulties in building an activity program and monitoring her execution. A cognitive symptom that requires further  discussion  is the so-called  cognitive  distortion  – a shift in focus from positive  to negative  stimuli, as well as incorrect reactions  to negative  feedback and decision making. A depressive  episode  develops  against  the background  of dysmetabolic and dysfunctional  cerebral  changes  in the  amygdala,  cingulate  cortex, hippocampus,  orbitofrontal and  mediobasal frontal  cortex. Cognitive impairment in patients who have had depression persists  after recovery from depression;  according  to the figurative expression  adopted in the scientific community of specialists  studying cognitive impairment in depression, each depressive  episode  forms permanent “cognitive scars”. Presumably, cognitive  dysfunction  may be one of the  risk factors  for the  development of a depressive  disorder; depression, in turn, is a risk factor for the development of dementia, including in Alzheimer’s disease and cerebrovascular disease: studies  have shown that the transformation of severe cognitive impairment associated with depression into dementia in elderly patients can reach 70% in five years. The undoubted commonality of depression and cognitive dysfunction is emphasized by the frequency of depression in patients with cognitive impairment.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>деменция</kwd><kwd>большое когнитивное расстройство</kwd><kwd>малое когнитивное расстройство</kwd><kwd>субъективное когнитивное расстройство</kwd><kwd>сосудистые когнитивные нарушения</kwd><kwd>болезнь Альцгеймера</kwd><kwd>сосудистые антагонисты NMDA-рецепторов</kwd></kwd-group><kwd-group xml:lang="en"><kwd>dementia</kwd><kwd>major neurocognitive disorder</kwd><kwd>minor neurocognitive disorder</kwd><kwd>subjective  cognitive disorder</kwd><kwd>vascular cognitive impairment</kwd><kwd>Alzheimer’s disease</kwd><kwd>NMDA receptor  antagonists</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Bahar-Fuchs A, Martyr A, Goh A, Sabatés Ju, Clare L. 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