残留症状对缓解期双相情感障碍患者心理社会功能的影响  

Impact of residual symptoms on psychosocial function of patients with euthymic bipolar disorder

作　　者：刘云斐 李伊沙 李伟[1] 王小敏[1] 李娜[1] 王朝敏[1] 史少霞 宋美[1] Liu Yunfei;Li Yisha;Li Wei;Wang Xiaomin;Li Na;Wang Chaomin;Shi Shaoxia;Song Mei(Department of Psychiatry,the First Hospital of Hebei Medical University,Mental Health Institute of Hebei Province,Mental Health Center of Hebei Medical University,Hebei Brain Ageing and Cognitive Neuroscience Laboratory,Hebei key laboratory of Brain science and Psychiatric-Psychologic Disease,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第一医院精神卫生科,河北省精神卫生研究所,河北医科大学精神卫生中心,河北省脑老化与认知神经科学实验室,河北省脑科学与精神心理疾病重点实验室,石家庄050000

出　　处：《神经疾病与精神卫生》2021年第11期787-793,共7页Journal of Neuroscience and Mental Health

基　　金：河北医科大学第一医院“星火”青年科研项目(XH201709)。

摘　　要：目的探讨残留症状对缓解期双相情感障碍患者心理社会功能的影响。方法采用横断面研究,选取2019年11月至2020年12月就诊于河北医科大学第一医院门诊的81例纳入符合ICD-10诊断的缓解期双相情感障碍患者,对其进行人口统计学调查,采用24项汉密尔顿抑郁量表(HAMD)、轻躁狂量表(HCL-32)、汉密尔顿焦虑量表(HAMA)测量双相情感障碍患者的残留情绪症状,采用霍普金斯词汇学习测验-修订版(HVLT-R)、简易视觉空间记忆测验-修订版(BVMT-R)、连线测试A(TMT-A)部分实验、数字广度测试评估残留的认知症状,使用功能大体评定量表(GAF)评估心理社会功能。根据功能大体评定量表评分将患者分为GAF=9组(27例)和GAF<9组(54例)。采用SPSS 22.0统计软件对数据进行分析。结果GAF<9组的女性[40.7%(22/54)]明显多于GAF=9组[33.3%(9/27)],受教育年限[12.00(9.00,13.00)年]明显少于GAF<9组[16.00(12.00,16.00)年],无职业者[40.7%(22/54)]明显多于GAF=9组[18.5%(5/27)],抗精神病药物使用剂量[(10.48±5.40)mg]明显高于GAF=9组[(7.99±5.65)mg],HAMD评分[6.00(3.75,10.00)分]明显高于GAF=9组[3.00(0,6.00)分],BVMT-RT1评分[4.00(1.00,8.00)分]明显低于GAF=9组[6.00(3.00,10.00)分],BVMT-RDR评分[7.50(3.00,11.25)分]明显低于GAF=9组[11.00(8.00,12.00)分],DST评分[14.00(12.00,16.00)分]低于GAF=9组[15.00(13.00,18.00)分]。两组患者的性别、受教育年限、婚姻、职业、吸烟、饮酒、既往史、心境稳定剂、抗抑郁药、苯二氮䓬类药物的使用、HAMD评分、DST评分、BVMT-RT1评分、BVMT-RDR评分比较,差异均有统计学意义(P<0.05)。双相情感障碍患者缓解期的整体功能与受教育年限(r=-0.34,95%CI:-0.53~-0.12,P<0.01)、HAMD评分(r=0.37,95%CI:0.16~0.56,P<0.01)、BVMT-RT1评分(r=-0.23,95%CI:-0.41~-0.02,P=0.04)、BVMT-RDR评分(r=-0.24,95%CI:-0.45~-0.02,P=0.03)、数字广度测验总分(r=-0.23,95%CI:-0.42~-0.01,P=0.04)、抗精神病药物(r=0.23,95%CI:0.02~0.44,P=0.04)�Objective To explore the impact of residual symptoms on psychosocial function of patients with euthymic bipolar disorder.Methods A cross-sectional study was conducted.A total of 81 patients with euthymic bipolar disorder diagnosed by ICD-10,who were admitted to the outpatient clinic of the First Hospital of Hebei Medical University from November 2019 to December 2020,were enrolled in this study.The demographic survey was conducted.The residual mood symptoms were measured by Hamilton Depressive Scale 24 items(HAMD-24),Hypomania Check List(HCL-32)and Hamilton Anxiety Scale(HAMA).Hopkins Verbal Learning Test revised(HVLT-R),Brief Visuospatial Memory Test revised(BVMT-R),Trail Making Test A(TMT-A)and Digit span task(DST)were used to assess the residual cognitive symptoms.The Global Assessment Function(GAF)was used to evaluate the psychosocial function.The patients were divided into two groups according to the score of GAF:high social function group(GAF=9)with 27 cases and low social function group(GAF<9)with 54 cases.All the data were analyzed by SPSS 22.0.Results Compared with the GAF=9 group,the GAF<9 group had more female[40.7%(22/54)vs 33.3%(9/27)],lower level of education[12.00(9.00,13.00)vs 16.00(12.00,16.00)],more unemployed[40.7%(22/54)vs 18.5%(5/27)],higher dosage of antipsychotics[(10.48±5.40)vs(7.99±5.65)]mg,higher HAMD score[6.00(3.75,10.00)vs 3.00(0,6.00)],lower BVMT-RT1 score[4.00(1.00,8.00)vs 6.00(3.00,10.00)],lower BVMT-RDR score[7.50(3.00,11.25)vs 11.00(8.00,12.00)]and lower DST score[14.00(12.00,16.00)vs 15.00(13.00,18.00)].The differences in gender,education,marriage,profession(χ^(2)=9.00,P=0.03),smoking history,drinking history,past history,the use of mood stabilizers,antidepressant,benzodiazepines,the score of HAMD,DST,BVMT-RT1,BVMT-RDR were statistical significant(P<0.05).The overall function of patients with euthymic bipolar disorder was correlated with education level(r=-0.34,95%CI=-0.53--0.12,P<0.01),HAMD(r=0.37,95%CI=0.16-0.56,P<0.01),BVMT-RT1(r=-0.23,95%CI=-0.41--0.02,P=0.04),BVMTRDR(r=-

关 键 词：双相情感障碍 残留症状 心理社会功能 情绪 认知 

分 类 号：R749.4[医药卫生—神经病学与精神病学]