发作期与恢复期老年抑郁症的认知功能及精神行为症状特征  

Characteristics of cognitive function and psychotic symptoms in patients with late life depression during acute and remitted status

作　　者：张敏[1] 钟笑梅[1] 陈贲[2] 陈辛茹[1] 彭琪[2] 麦乃铿 张蔚茹[1] 欧阳聪[1] 吴玉洁 梁琬苑 宁玉萍[1] ZHANG Min;ZHONG Xiaomei;CHEN Ben;CHEN Xinru;PENG Qi;MAI Naikeng;ZHANG Weiru;OUYANG Cong;WU Yujie;LIANG Wanyuan;NING Yuping(The Affiliated Brain Hospital of Guangzhou Medical University(Guangzhou Huiai Hospital).Guangzhou 510145,China)

机构地区：[1]广州医科大学附属脑科医院(广州市惠爱医院)神经内科,广州510145 [2]广州医科大学附属脑科医院(广州市惠爱医院)精神科

出　　处：《中国神经精神疾病杂志》2018年第8期466-470,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：国家自然科学基金(面上项目)(编号:81571333);省重大科技专项(编号:2016B010108003)

摘　　要：目的比较发作期老年抑郁症(late life depression,LLD)、恢复期LLD患者及对照组认知功能和精神行为症状的特点。方法纳入发作期LLD患者96例,恢复期LLD患者76例,正常对照125名,采用简易精神状态检查(mini-mental state examination,MMSE)、记忆与执行筛查量表(memory and executive screening,MES)、阿尔茨海默病评定量表认知部分(Alzheimer disease assessment scale-cognitive subscale,ADAS-cog)进行认知功能评估,采用神经精神问卷(neuropsychiatric inventory,NPI)进行精神行为症状评估。结果 认知方面,发作期、恢复期LLD患者MMSE、MES、ADAS-cog评分均差于对照组(P<0.05),而发作期LLD与恢复期LLD患者相比差异均无统计学意义(P>0.05)。精神行为症状方面,发作期LLD组NPI总分,以及激越、抑郁、焦虑、淡漠、易激惹、睡眠行为障碍、食欲障碍得分均高于恢复期LLD组与对照组(P<0.05),恢复期LLD组则在NPI总分及抑郁、焦虑、淡漠得分高于对照组(P<0.05)。结论 恢复期LLD患者持续存在认知功能损害,同时也残留抑郁、焦虑、淡漠等精神行为症状。Objective To investigate the characteristics of cognitive function and psychotic symptoms in patients with late life depression(LLD)during acute and remitted status.Methods One hundred seventy-two patients with LLD and 125 normal controls were recruited.The LLD group was divided into acute LLD(n=96)and remitted LLD(n=76)groups.Cognitive functions and psychotic symptoms were evaluated by using the Mini-Mental State Examination(MMSE),Memory and Executive Scale(MES),Alzheimer's Disease Assessment Scale-cognitive subscale(ADAS-cog)and Neuropsychiatric Inventory(NPI),respectively.Results There were significant differences among three groups in MMSE,MES,ADAS-cog and four subscores of ADAS-cog(all P<0.01).MMSE,MES and ADAS-cog scores in patients with LLD both in acute and remitted status were significantly worse than those in the control group(P<0.05).There was no significant difference in those parameters between acute LLD and remitted LLD(P>0.05).NPI's total score and subscores of agitation,depression,anxiety,apathy,irritability,sleep behavior disorder and dysorexia were significantly higher in patients with acute LLD than in the remitted LLD group and control group(P<0.05).NPI's total score and subscores of depression,anxiety and apathy were also significantly higher in patients with remitted LLD than in the control group(P<0.05).Conclusion Cognitive functional impairment and some psychotic symptoms such as depression,anxiety and apathy still persist in patients with LLD in the remitted status.

关 键 词：老年抑郁症 认知功能 精神行为症状 

分 类 号：R749.4[医药卫生—神经病学与精神病学]