青少年双相障碍Ⅱ型和单相抑郁的认知功能比较研究  

Cognitive function in adolescents with bipolar disorder-Ⅱ or unipolar depression

作　　者：汤义平[1] 陈倩倩[1] 陆强[1] 姜义彬 许学明[1] 曹敏敏[1] 蔡志杰[1] 王筱芳[1] 

机构地区：[1]台州市第二人民医院心身科,31700

出　　处：《浙江医学》2015年第12期1061-1064,1067,共5页Zhejiang Medical Journal

基　　金：浙江省医学会临床科研基金项目(2011ZYC-A115)

摘　　要：目的比较青少年双相障碍Ⅱ型和单相抑郁症之间认知功能的差异。方法对54例青少年双相障碍Ⅱ型和83例青少年单相抑郁症患者在抑郁发作时作认知功能测验,包括:中国韦氏成人智力量表(WAIS-RC)、连线测验(TMT)、持续操作测验(CPT)、韦氏记忆量表(WMS-RC)、词语流畅性测验(VF)、威斯康星卡片分类测验-改良版(WCST),并与50例健康对照组比较。经过6周治疗后,对抑郁症状缓解(HAMD≤7分)患者重复上述认知功能测验。结果入组时双相障碍Ⅱ型和单相抑郁两组在认知功能方面广泛受损,表现为TMT-A、WAIS-RC数字符号、CPT、WAIS-RC数字广-倒背、WAIS-RC视觉再生、VF、WCST和TMT-B项目上与健康人群相比明显成绩差,差异均有统计学意义(均P<0.01),但双相障碍Ⅱ型和单相抑郁两组间比较差异无统计学意义(P>0.05)。治疗6周后,对两组临床痊愈的患者重复测验,发现两者在WAIS-RC数字符号和WAIS-RC视觉再生方面存在持续性损伤,与健康对照组比较差异均有统计学意义(P<0.05)。双相障碍Ⅱ型患者在CPT项目上存在损伤,与健康对照组比较差异有统计学意义(P<0.05)。而单相抑郁症患者表现为VF和TMT-B项目上存在损伤,与健康对照组比较差异有统计学意义(P<0.05)。结论双相障碍Ⅱ型和单相抑郁在抑郁状态时,认知功能广泛受损,两者比较无统计学差异。在抑郁症状缓解后,双相障碍Ⅱ型表现为持续性注意功能障碍,而单相抑郁表现为执行功能障碍。Objective To compare the cognitive function in adolescents with bipolar disorder- Ⅱ and those with u-nipolar depression. Methods Fifty four adolescents with bipolar disorder- Ⅱ （bipolar group）, 83 adolescents with unipolar de-pression （unipolar group） and 50 healthy adolescents （control） were enrol ed in the study. Wechsler Adult Intel igence Scale （WAIS- RC）, Trail Making Test（TMT）, Continuous Performance Test （CPT）, Wechsler Memory Scale（WMS- RC）, Verbal Fluency（VF） and Wisconsin Card Sorting Test （WCST） were performed in al subjects, the tests were performed again after 6 weeks of treat-ment and patients experienced remission（HAMD≤7）, Results Before treatment the TMT- A, WAIS- RC numerical symbols, CPT, WAIS- RC digit span subtest, WAIS- RC visual reproduction, VF, WCST and TMT- B scores in patients were worse than those in healthy controls （P〈0.01）. However, there were no significant differences between bipolar and unipolar groups （P〉0.05）. After six- week treatment, there was stil significant difference in WAIS- RC numerical symbols and WAIS- RC visual reproduction be-tween patients and healthy groups（P〈0.05）. The bipolar patients had difficulty in CPT, compared to healthy group（P〈0.05）, while the abilities of VF and TMT- B in unipolar patients were stil lower compared to healthy group（P〈0.05）. Conclusion The cognitive function in adolescents with bipolar disorder- Ⅱ or unipolar depression is general y damaged. At the remission of the disease bipolar patients have difficulty in sustained attention, while unipolar patients show the decline of executive function.

关 键 词：双相障碍Ⅱ型 单相抑郁症 认知功能 持续性注意 执行功能 

分 类 号：R749.4[医药卫生—神经病学与精神病学]