重度抑郁高中生自杀行为认知功能分析  

Impaired cognitive functioning in suicidal behavior among high school students with severe depressive symptoms

作　　者：窦连杰 金玲玲[1] 张洪波[2] 王君[2] 

机构地区：[1]安徽医科大学公共卫生学院,合肥230032 [2]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系

出　　处：《中国学校卫生》2016年第3期368-370,375,共4页Chinese Journal of School Health

基　　金：安徽高校省级自然科学重点项目(KJ2011A156);安徽高校省级优秀青年人才基金项目(2011SQRL066);安徽省大学生创新训练项目(AH201410366099)

摘　　要：目的探讨重度抑郁情绪高中生发生自杀行为的认知功能机制及其在性别和自杀行为类别上的差异,为抑郁青少年自杀行为的预防和干预研究提供参考。方法对从合肥市某高中一、二年级在校生中筛选出的37例伴自杀行为的抑郁高中生(病例组),按性别、年级和自杀行为类别1∶1匹配原则,选取37名无自杀行为的抑郁情绪高中生为对照组,采用威斯康星卡片分类测验(WCST)评估认知功能。结果病例组与对照组在完成分类数(Cc)(3.32±2.28与4.24±2.00)、错误应答数(Re)(56.43±19.33与47.30±16.43)、持续性应答数(Rp)(57.19±24.45与46.35±13.07)、持续性错误数(Rpe)(35.49±20.60与25.19±10.14)及概念化水平(Rfp)(51.78±20.05与65.38±21.11)上比较差异均有统计学意义(t值分别为-2.14,2.51,2.34,2.73,-2.88,P值均<0.05);其中女生病例组与对照组在Rp,Rpe及Rfp的比较差异有统计学意义(t值分别为2.52,2.81,2.17,P值均<0.05),而男生两组间在7个认知功能指标上的比较差异均无统计学意义(P值均>0.05)。抑郁学生产生自杀计划可能与Cc,Rpe及Rfp相关联(P值均<0.05),发生自杀未遂可能与Cc,Rp及Rfp相关联,而自杀意念与7个认知功能指标均无统计学意义(P值均>0.05)。结论抑郁引发自杀行为可能与认知功能损伤有关,尤以抑郁女生更为明显。Objective To explore possible cognitive mechanism involved in suicidal behavior among depressive students in high school. Methods A case-control study including 37 depressive students with suicidal behavior（ cases） and 37 depressive students without suicidal behavior（ controls） was carried out. The cases and controls were matched for gender, grade and suicidal behavior category. Cognitive function was measured by Wisconsin Card Sorting Test（ WCST）. Results There were significant differences in categories completed（ Cc）（ 3. 32 ± 2. 28 and 4. 24 ± 2. 00）, error responses（ Re）（ 56. 43 ± 19. 33 and 47. 30 ± 16.43）, perseverative responses（ Rp）（ 57. 19 ± 24. 45 and 46. 35 ± 13. 07）, rerseverative errors（ Rpe）（ 35. 49 ± 20. 60 and 25. 19 ±10. 14） and percent conceptual level responses（ Rfp）（ 51. 78 ± 20. 05 and 65. 38 ± 21. 11） between case and control group, differences was statistically significant in Rp, Rpe and Rfp in girls not in boys. In depressive students, suicidal plan might be associated with Cc, Be and Rfp, while attempted suicide might be associated with Cc, Rp and Rfp（ P〈0. 05）, but suicidal ideation showed no association with seven index reflecting cognitive function（ P〉0. 05）. Conclusion Suicidal behavior induced by depression might be associated with cognitive dysfunction, especially in girls with depression.

关 键 词：抑郁 自杀 认知 学生 

分 类 号：B846[哲学宗教—心理学] R395.6[医药卫生—医学心理学]