摘要
目的探讨单相抑郁(UPD)与双相抑郁(BPD)患者在不同情绪面孔刺激下执行持续注意任务时的事件相关电位(ERPS)的特点及其与治疗转归的关系。方法比较36例单相抑郁患者(UPD组)、36例双相抑郁患者(BPD组)治疗前后以及36例健康志愿者(对照组)情绪面孔诱发的N170电位及靶刺激诱发的P300电位的特征,采用17项汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)、住院精神患者社会功能评定量表(SSPI)评定患者组病情严重程度及治疗效果。结果治疗前情绪面孔刺激下颞枕区N170波幅BPD组<UPD组<对照组(P<0.05),顶枕区P300潜伏期BPD组>UPD组>对照组(P<0.05)。治疗后N170波幅患者组均比治疗前升高,但BPD组仍低于对照组(P<0.05);P300潜伏期患者组均比治疗前缩短,但BPD组仍长于对照组(P<0.05)。在4种情绪面孔中以恐惧面孔刺激的P300波幅最低,潜伏期最长(P<0.05)。患者组N170波幅与HAMD、HAMA评分均呈负相关(P<0.05),与SSPI评分均呈正相关(P<0.05);患者组P300潜伏期与HAMD、HAMA评分均呈正相关(P<0.05),与SSPI评分均呈负相关(P<0.05)。结论双相抑郁患者治疗前后均存在认知功能损害,难以像单相抑郁患者那样恢复到正常认知水平,且认知功能损害与疗效相关。
Objective To study the characteristics of brain potential evoked by different emotional faces during sustained attention tasks in patients with unipolar depression（ UPD） and bipolar depression（ BPD）,as well as its relationship with treatment outcomes. Methods Indexes of N170 potentials evoked by emotional faces and P300 potentials evoked by target stimulus were collected in 36 UPD patients at pre-and post-treatment,36 BPD patients at pre-and post-treatment,as well as in 36 healthy controls. All patients were assessed with 17-Item Hamilton Depression Rating Scale（ HAMD-17）,Hamilton Anxiety Rating Scale（ HAMA）,Scale of Social Function in Psychiatric Inpatients（ SSPI） to evaluate the severity of illness and the curative efficacy. Results Before the treatment,descending order by pre-treatment N170 amplitude in temporal occipital evoked by emotional faces were control group,UPD group and BPD group（ P〈0. 05）,and the descending order by P300 latency in parietal occipital were BPD group,UPD group,control group（ P〈0. 05）. N170 amplitude in BPD group and UPD group increased significantly after the treatment compared with baseline,but the post-treatment N170 amplitude in BPD group was significantly lower than that in control group（ P〈0. 05）. P300 latency in BPD group and UPD group decreased significantly after the treatment,but the post-treatment P300 latency in BPD group was significantly longer than that in control group（ P〈0. 05）.Fearful face evoked the smallest P300 amplitude and the longest P300 latency of the 4 emotional faces（ P〈0. 05）. N170 amplitudes in BPD group and UPD group were negatively correlated with the scores of HAMD,HAMA（ P〈0. 05）,and positively correlated with the score of SSPI（ P〈0. 05）. P300 latencies in BPD group and UPD group were positively correlated with the scores of HAMD,HAMA（ P〈0. 05）,and negatively correlated with the score of SSPI（ P〈0. 05）. Conclusion The cognitive dysfunction existed in patients with bipolar depression no matter in pre-treatment stage or in post-treatment stage,which was unlikely to recovery after treatment just as unipolar depression. The cognitive dysfunction in patients with depression was correlated with the treatment efficacy.
出处
《精神医学杂志》
2016年第2期109-114,共6页
Journal of Psychiatry
基金
广东省江门市科技计划项目(编号:2014020)
关键词
单相抑郁
双相抑郁
情绪面孔
事件相关电位
治疗转归
Unipolar depression
Bipolar depression
Emotional faces
Event-related potentials（ERPS）
Treatment outcome
