抑郁症患者治疗前后认知功能变化的分析  

An analysis on the cognitive function in depression before and after therapy

作　　者：张璐璐[1] 郑洪波[1] 邓悦[2] 何柱国[1] 马静山[1] 黎娟花[1] 

机构地区：[1]广州市精神病医院,510370 [2]广州医学院第二附属医院

出　　处：《神经疾病与精神卫生》2007年第4期262-265,共4页Journal of Neuroscience and Mental Health

基　　金：广州市医药卫生科技项目(2006-YB-1091)

摘　　要：目的研究抑郁症患者治疗前后认知功能改变及相关因素。方法对100例符合中国精神障碍分类与诊断标准的抑郁症患者(患者组),给与单一抗抑郁药治疗8周。于治疗基线和治疗末评定24项汉密尔顿抑郁量表(HAMD24)、威斯康星卡片分类测验(WCST)、中国韦氏成人记忆量表(WMS-RC)、连线A、B测验,并与100名健康志愿者(对照组)比较。结果(1)治疗后患者组的神经心理学测验成绩较治疗前均有明显提高(P<0.05或P<0.01)。(2)患者组WMS-RC中的数字广度(倒背)改变与睡眠障碍分改变呈负相关(r=-0.244,P=0.014);连线测验B的测验时间与认识障碍分呈负相关(r=-0.230,P=0.021),提笔数与绝望感分呈正相关(r=0.312,P=0.002);WCST中的分类数与认识障碍分(r=-0.197,P=0.049)、焦虑/躯体化分呈负相关(r=-0.225,P=0.024)。(3)痊愈组和症状残留组的WCST及WMS-RC检测均低于对照组(P<0.01和P<0.05)。结论抑郁症患者治疗后认知功能显著改善,与临床症状的缓解存在相关性,但仍与对照组存在统计学差异,这提示抑郁症患者认知功能损害特质性与状态性均存在。Objective To analyse the cognitive function in depression and the related factors before and after therapy. Methods 100 patients with depression were given one antidepressive for 8 weeks, and 100 healthy people were involved as controls. The depression severity was assessed with the 24--item Hamilton Depression Scale （ HAMD24）, and cognitive function with a series of neuropsychological tests including Wisconsin cards sorting test （WCST）, Wechsler memory scale of Republic of China （WMS-- RC）, Trial test A and B. Results （1） the depressed patients made improvements in the neuropsychologi- cal tests after treatment （P 〈 0.05 or P 〈 0.01 ）. （2）the improvement in number extent was negatively correlated to the alleviation in sleep disturbance symptom （r= -0. 244, P = 0. 014 ）, decrease of testing time in trial B negatively to the cognition item score of HAMD24. The scores of WCST categories negatively correlated to the reduction in cognition and anxiety/somatization. （3）Compared with controls, the recovered patients （with HAMD24 total score 〈8） and the patients with residual symptoms still have lower scores on the parameters of WCST and WMS--RC （P 〈 0.01 or P 〈 0.05 ）. Conclusions The cognitive function in patients with depression improves after treatment, with correlation to the after depression symptoms remission and statistical difference with control group.

关 键 词：抑郁症 认知功能 神经心理测验 

分 类 号：R749.4[医药卫生—神经病学与精神病学]