摘要
目的探讨缓解期抑郁症患者认知功能的特点。方法以2017年1月-2017年7月于沈阳军区总医院首次就诊的抑郁症患者130例和100名健康人作为研究对象。采用汉密尔顿抑郁量表（HAMD）评价抑郁症的严重程度。采用威斯康星卡片分类测试、斯特鲁色词测验、连线测试、词语流畅性测验和韦氏记忆测验分别对缓解期抑郁症患者的信息处理速度、词语流畅性、工作记忆、认知灵活性、联接记忆和逻辑记忆等方面进行评估。使用草酸艾司西酞普兰对抑郁症患者进行治疗，治疗前和治疗6个月后评价患者的抑郁情绪和认知功能。结果抑郁症组87例和健康对照组69人最终纳入本研究。治疗前，抑郁症组认知功能明显较健康对照组差，差异有统计学意义（P〈0．05）。治疗6个月后，根据DSM-5的标准，75例抑郁症患者达到抑郁症缓解标准。治疗6个月后，抑郁症患者HAMD评分从（34．52±5．01）分下降至（5．01±2．98）分，差异有统计学意义（F=23．132，P〈0．05），且与健康对照组比较差异无统计学意义（P=0．689）。抑郁症患者治疗6个月后，除信息处理速度、词语流畅性外，其他认知功能（工作记忆、认知灵活性、联接记忆和逻辑记忆即刻／延时）均明显改善，差异有统计学意义P〈0．05）。结论抑郁症患者发病期会出现认知功能（信息处理速度、词语流畅性、工作记忆、认知灵活性、联接记忆和逻辑记忆即刻／延时）损伤。缓解期时，除信息处理速度、词语流畅性外，其他认知功能均明显改善，结果提示信息处理速度、词语流畅性可能是抑郁症的内表型，而其他认知因子可能是状态型。
Objective To investigate the cognitive function in patients with depressive disorder in remission. Methods A total of 130 depressive patients, who were first diagnosed in the General Hospital of Shenyang Military Region from January 2017 to July 2017, and 100 healthy controls were selected as the research subjects. The Hamilton Depression Scale （HAMD） was used to evaluate the severity of patients. The Wisconsin Card Sorting Test, Stroop Color-Word Test, Trail Making Test, Verbal Fluency Test and Wecbsler Memory Scale were used to evaluate information processing speed, word fluency, working memory, cognitive flexibility, link memory, and logical memory of all subjects. Escitalopram Oxalate tablets was used to treat patients. Depressed mood and cognitive function of patients were assessed before treatment and 6 months after. Results Finally 87 cases of the depression group and 69 of the control group were recruited in this research. Before treatment, the cognitive function in depression group was significantly lower than that in healthy control group, with statistical significance （P 〈 0.05）. After 6 months of treatment, according to the standard of DSM-5, 75 depressive disorder patients have met the criteria of remission. After 6 months of treatment, the HAMD score of depressive disorder patients decreased from （34.52 ~ 5.01） to （5.01 ＋ 2.98）, and the difference was statistically significant （F=23.132, P 〈 0.05）. However there was no significant difference between the depression groups and the healthy control group （P=0.689）. After 6 months of treatment, cognitive functions （working memory, cognitive flexibility, connection memory and logical memory instantly / delayed） improved significantly except for information processing speed and word fluency in depressive disorder patients （P 〈 0.05）. Conclusions Cognitive impairment （information processing speed, word fluency, working memory, cognitive flexibility, connection memory and logical memory immediate / delayed） occurs during the onset of depressive disorder. During the remission period, other cognitive functions were significantly improved besides information processing speed and word fluency. The results shows that information processing speed and word fluency were probably the phenotypes of depressive disorder, while other cognitive factors may be state types.
作者
崔永璐
Cui Yonglu Psychology(Department,General Hospital of Shenyang Military Region,Shenyang 110000,China)
出处
《神经疾病与精神卫生》
2018年第7期493-497,共5页
Journal of Neuroscience and Mental Health
关键词
抑郁症
缓解期
认知功能
内表型
状态型
Depressive disorder
Remission period
Cognitive function
Phenotype
State type
