单相抑郁与双相抑郁患者执行功能的对照研究  

A control study of execute function about unipolar depression and bipolar depression patient

作　　者：关念红[1] 张明[1] 魏钦令[1] 刘海润[1] 张晋碚[1] 

机构地区：[1]中山大学附属第三医院精神科,广州510630

出　　处：《中华行为医学与脑科学杂志》2009年第2期114-117,共4页Chinese Journal of Behavioral Medicine and Brain Science

摘　　要：目的了解单、双相抑郁患者治疗前后执行功能特点及其影响因素。方法对27例单相抑郁和30例双相抑郁患者予以3月药物治疗，治疗前、后分别评定24项汉密尔顿抑郁量表（HAMD）、功能大体评定量表（GAF）、威斯康星卡片分类测验（WCST）、字色混淆测验（Stroop）、词汇流畅性测验，与26名正常对照进行比较。结果词汇流畅性得分是单、双相抑郁组治疗前后[分别为（15．37±5．04）分，（16．33±4．16）分，（15．53±5．38）分，（16．47±4．99）分]都低于正常对照组[（21．62±7．80）分]；Stroop-C是单相抑郁治疗前后的得分[分别为（108．78±6．61）分，（108．26±8．34）分]都低于正常对照[（111．46±1．27）分]，治疗后双相抑郁[（111．20±2．78）分]高于单相抑郁；Stroop-CW得分双相抑郁治疗前[（67．53±28．87）分]低于正常对照[（84．27±26．34）分]；WCST完成第一个分类所需的应答数是单相抑郁治疗前后的得分[分别为（35．44±36．03）分，（32．52±33．88）分]都高于正常对照[（18．88±11．51）分]，治疗后双相抑郁[（32．30±24．09）分]高于正常对照；非持续错误数是治疗前单相抑郁[（23．33±8．66）分]高于双相抑郁[（18．03±8．95）分]和正常对照[（18．04±7．75）分]。逐步多元回归分析显示，在单相抑郁组治疗前，词汇流畅性、Stroop-CW与阻滞因子分呈负相关；WCST完成的分类数与认识障碍因子得分呈负相关；WCST完成第一个分类所需的应答数与体重因子得分呈负相关；双相抑郁组治疗前，词汇流畅性与认识障碍因子得分呈负相关；WCST完成测验的总应答数与认识障碍因子得分呈正相关；WCST完成第一个分类所需应答数、非持续性错误与睡眠障碍因子分呈负相关。结论单双相抑郁都存在执行功能障碍，均受临床症状严重程度的影响，但损害存在差异，双相抑郁�Objective To explore the execute function and the influential factors in unipolar depression and bipolar depression. Methods 27 unipolar depression patients and 30 bipolar depression patients were taken the drug treatment for 12 weeks,and 26 healthy people were involved as controls. The depression severity was assessed with the 24-item Hamilton Depression Scale （ HAMD ）, Hamilton Anxiety Scale （ HAMA）, Global Assessment Function（GAF） and execute function with a series of neuropsychological tests including Wisconsin cards sorting test（WCST） ,Stroop, Verbal Fluency Test. Results In comparison with the controls,before and after treatment, unipolar depression patients and bipolar depression patients had lower scores of the Verbal Fluency Test, Before and after treatment, unipolar depression patients had lower scores of the Stroop-C and after treatment, bipolar depression patients had higher scores of the Stroop-C than unipolar depression patients. Before treatment, bipolar depression patients had higher scores of the Stroop-CW. In comparison with the controls, before and after treat- ment,unipolar depression patients had higher scores of the completion of the first request for the number of respondents in WCST and bipolar depression patients had higher scores after treatment. Before treatment, unipolar depression patients had higher scores of the random errors in WCST. Linger regression analysis showed that before treatment of unipolar depression patients , the scores of Verbal Fluency Test and Stroop-CW were negatively correlated to the retardation factor score, categories completes in the WCST was negatively correlated to recognizing obstacles factor score, completion of the first request for the number of respondents in WCST was negatively correlated to weight factor score. To bipolar depression patients before treatment, the scores of Verbal Fluency Test were negatively correlated to recognizing obstacles factor score, total test in the WCST was positively correlated to recognizing obstacles facto

关 键 词：单相抑郁 双相抑郁 执行功能 神经心理学测验 

分 类 号：R686[医药卫生—骨科学]