首发抑郁症治疗前后主观认知功能的差异及相关因素  

Differences and related factors of subjective cognitive function before and after treatment of first-episode depression

作　　者：刘林晶[1] 刘家洪[1] 蔡巧乐 朱程[1] 杨智英 丁洁[1] 叶敏捷[1] LIU Lin-jing;LIU Jia-hong;CAI Qiao-le;ZHU Cheng;YANG Zhi-ying;DING Jie;YE Min-jie(The Affiliated Kangning Hospital of Wenzhou Medical University,Wenzhou 325007,China)

机构地区：[1]温州医科大学附属康宁医院,325007

出　　处：《临床精神医学杂志》2021年第2期124-126,共3页Journal of Clinical Psychiatry

基　　金：浙江省医药卫生科技计划项目(2019KY670)。

摘　　要：目的:探讨首发抑郁症治疗前后主观认知功能的差异及相关因素,为改善抑郁症疗效和康复提供可能的新视角。方法:收集首发抑郁症门诊或住院患者100例,采用选择性5-羟色胺再摄取抑制剂(SSRIs)类抗抑郁药治疗。搜集一般资料、治疗前和治疗24周临床量表、认知量表、生化指标、电生理指标。结果:完成研究80例,首发抑郁症患者治疗后主观认知功能改善不明显[(26.85±7.42)vs(22.49±5.83),u=1.867,P=0.066],治疗前后主观认知功能差值与首次发病年龄(r=-0.295,P=0.003)、运动活跃度(r=-0.331,P=0.004)、有早年创伤(r=-0.273,P=0.010)呈负相关,与自杀意念量表(SIOSS)减分(r=0.324,P=0.002)、25羟维生素D水平增加(r=0.269,P=0.030)、超敏C反应蛋白(hs-CRP)减分(r=2.363,P=0.021)呈正相关,与汉密尔顿抑郁量表(HAMD-17)减分(r=0.064,P=0.065)、可重复的成套神经心理状态测验(RBANS)总分增高(r=0.102,P=0.091)、事件诱发电位P300潜伏期减分(r=0.021,P=0.315)、波幅增分(r=0.861,P=0.058)无明显相关。结论:首发抑郁症患者治疗前后主观认知功能差异不明显,主观认知功能可能为独立于抑郁症状、客观认知功能的又一核心症状,可能与早年的创伤、消极意念的持续存在、运动活跃度、维生素D和hs-CRP相关。Objective:To explore the differences and related factors of subjective cognitive function before and after treatment of first-episode depression,and provide a possible new perspective for impro-ving the efficacy and rehabilitation of depression Method:A hundred outpatients or inpatients with first-episode depression were collected,treated with selective serotonin reuptake inhibitors(SSRIs),and their general data,clinical scale before and after 24-week's treatment,perceived deficits questionnaire-depression,biochemical indicatorsand electrophysiological indicators were collected and evaluated.Results:80 patients completed the study and their change of subjective cognitive function after treatment was not obvious[(26.85±7.42)vs(22.49±5.83),u=1.867,P=0.066].Differences in subjective cognitive function before and after treatment was negatively related to age of first onset(r=-0.295,P=-0.003),motor activity(r=-0.331,P=0.004),and early trauma(r=-0.273,P=0.010);it was positively related to score reduction of self-rating idea of suicide scale(SIOSS)(r=0.324,P=0.002),25 hydroxy vitamin D level increase(r=0.269,P=0.030),hypersensitive C reactive protein(hs-CRP)reduction(r=2.363,P=0.021);and it was irrelevant to Hamilton's depression scale(HAMD-17)score decrease(r=0.064,P=0.065),repeatable battery for the assessment of neuropsycological status(RBANS)total score increase(r=0.102,P=-0.091),P300 latency decrease(r=0.021,P=0.315)and amplitude increase of event-related potential(r=0.861,P=0.058).Conclusion:The differences of the subjective cognitive function before and after treatment of first-episode depressions is not obvious,subjective cognitive function may be another core symptom of depression,which is independent from depressive symptoms and objective cognitive function.It may be associated with early trauma,the continued presence of suicidal ideation,low exercise activity,inflammatory markers HS-CRP,and 25-hydroxyvitamin D.

关 键 词：首发抑郁症 主观认知功能 相关因素 

分 类 号：R749.4[医药卫生—神经病学与精神病学]