双相I型障碍缓解期患者与抑郁发作期患者的神经认知功能  

Neurocognitive functioning in bipolar I disorder patients with euthymia or depression state

作　　者：李志营[1,2,3] 高慧敏[1,2,3] 朱玥[1,2,3] 石川[1,2,3] 马燕桃[1,2,3] 于欣[1,2,3] 

机构地区：[1]北京大学第六医院 [2]北京大学精神卫生研究所 [3]卫生部精神卫生学重点实验室(北京大学),北京100191

出　　处：《中国心理卫生杂志》2014年第5期332-338,共7页Chinese Mental Health Journal

基　　金：北京市科委首都特色临床应用研究Z121107001012040

摘　　要：目的:比较双相I型障碍(BD)患者缓解期与抑郁发作期的神经认知功能。方法:选取符合美国精神障碍统计与诊断手册第4版(DSM-IV)诊断标准的BD缓解期患者29例、BD抑郁发作期患者30例及健康对照27例,使用精神分裂症认知功能成套测验-共识版(MCCB),对三组的持续注意、学习、记忆、精细动作、社会认知、执行功能及信息处理速度7个领域的神经认知特点进行比较。归纳BD缓解期组和抑郁发作期组的首次抑郁发作年龄、终生抑郁发作次数、首次躁狂发作年龄、终生躁狂发作次数、家族史及临床用药等临床指标的特征;用汉密顿抑郁量表(HAMD)、大体功能评定量表(GAF)评定抑郁和功能情况。结果:BD缓解期组HAMD得分低于BD抑郁发作期组[(4.1±2.9)vs.(17.6±3.3),P<0.01],而GAF得分高于BD抑郁发作组[(70.6±14.0)vs.(57.8±11.2),P<0.01]。BD缓解期和BD抑郁发作期患者的MCCB记忆、精细动作、执行功能及总体认知功能得分低于健康对照组[(46.8±4.7)vs.(49.7±4.3),(45.4±6.0)vs.(49.7±4.3);均P<0.05];BD缓解期患者的词语记忆测验得分低于BD抑郁发作期患者[(45.6±9.3)vs.(51.4±8.3),P<0.05],沟槽钉板非利手测验得分高于BD抑郁发作组[(44.5±10.9)vs.(37.6±12.4),P<0.05];两组其他认知测验结果差异无统计学意义。结论:BD缓解期及抑郁发作期患者均存在认知功能受损,BD缓解期患者词语记忆能力比抑郁发作期患者差,非利手精细运动能力优于抑郁发作期患者,提示神经认知功能缺损可能是BD的素质性指标之一。Objective：To compare the neurocognitive function among patients with bipolar I disorder （BD） in either euthymic or major depressive state. Methods： A total of 59 patients w ith BD,in w hich 29 in euthymic state and 30 in major depressive episode state,and 27 healthy controls （HC） w ere enrolled in this study betw een September 2010 and December 2012. Diagnosis w as made according to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition （DSM-IV） criteria. The cognitive characteristics in seven major domains including sustained attention,learning,memory,fine motor,social cognition,executive function and information processing speed w ere assessed w ith the MATRICS Consensus Cognitive Battery （MCCB） and compared among the three groups. Clinical variables including onset age of first major depressive episode,times of lifetime major depressive episodes,onset age of first manic episode and times of lifetime manic episodes w ere also collected and summarized among patients w ith BD. The Hamilton Depression Scale （HAMD） and Global Assessment of Functioning （GAF） w ere used to assess the severity of clinical symptoms. Results： The patients w ith BD in euthymia state got low er HAMD total scores [ （4. 1 ± 2. 9） vs. （17. 6 ± 3. 3）,P〈0. 01] and higher GAF total scores [ （70. 6 ± 14. 0） vs. （57. 8 ± 11. 2）,P〈 0. 01] than the patients in major depressive episode state. Compared w ith the HC group,the patients in euthymia and major depressive episode both had low er scores in fields of memory,fine motor,executive function and overall cognitive function [ （46. 8 ± 4. 7） vs. （49. 7 ± 4. 3）, （45. 4 ± 6. 0） vs. （49. 7 ± 4. 3）,Ps 〈 0. 05]. The patients in euthymia state scored low er in verbal memory test [ （45. 6 ± 9. 3） vs. （51. 4 ± 8. 3）,P 〈 0. 05] and higher in non-dominant hand of grooved pegboard test [ （44. 5 ± 10. 9） vs. （37. 6 ± 12. 4）,P 〈 0. 05] than those in major depressive episode state. There w ere no

关 键 词：双相情感障碍 神经认知功能 缓解 抑郁发作 临床研究 

分 类 号：R749.4[医药卫生—神经病学与精神病学] B842.1[医药卫生—临床医学]