青少年抑郁症患者药物治疗后认知功能障碍的影响因素研究  

Study on influencing factors of cognitive dysfunction after drug treatment in adolescent patients with depression

作　　者：张静静[1] 刘锟[1] 夏清荣 宁伟 Zhang Jingjing;Liu Kun;Xia Qingrong;Ning Wei(Department of Psychology,Fuyang Third People's Hospital,Fuyang 236000,China;Department of Psychology,Anhui Mental Health Center,Hefei 230022,China)

机构地区：[1]阜阳市第三人民医院精神科,236000 [2]安徽省精神卫生防治中心精神科,合肥230022

出　　处：《神经疾病与精神卫生》2022年第8期565-569,共5页Journal of Neuroscience and Mental Health

基　　金：2020年安徽省重点研究与开发计划项目(202004j07020001)。

摘　　要：目的探讨青少年抑郁症患者药物治疗后认知功能障碍的影响因素。方法回顾性分析2019年1月至2022年4月在阜阳市第三人民医院住院治疗的212例青少年抑郁症患者的临床资料,将治疗后蒙特利尔认知评估量表(MoCA)评分≥26分的患者纳入认知功能无障碍组(n=141),评分<26分的患者纳入认知功能障碍组(n=71)。比较两组患者的年龄、性别、体重指数(BMI)、病程、吸烟、家族史、饮酒、社会支持评定量表(SSRS)评分、17项汉密尔顿抑郁量表(HAMD-17)评分、文化程度、抑郁程度。采用受试者工作特征(ROC)曲线分析年龄和SSRS评分预测青少年抑郁症患者治疗后认知功能障碍的价值。采用多因素Logistic回归分析青少年抑郁症患者治疗后认知功能障碍的危险因素。结果两组患者性别、BMI、病程、有无家族史、HAMD-17评分、抑郁程度比较,差异无统计学意义(P>0.05)。认知功能障碍组患者的年龄及吸烟、饮酒、初中文化程度患者占比高于认知功能无障碍组,SSRS评分低于认知功能无障碍组,差异有统计学意义(P<0.05)。年龄、SSRS评分预测青少年抑郁症患者治疗后认知功能障碍的ROC曲线下面积分别为0.896、0.964(P<0.05)。多因素Logistic回归分析显示,14~18岁(OR=1.571,95%CI=1.251~1.973)、吸烟(OR=1.457,95%CI=1.187~1.788)、饮酒(OR=1.254,95%CI=1.093~1.439)、初中文化程度(OR=1.513,95%CI=1.178~1.943)、SSRS评分<20分(OR=1.593,95%CI=1.251~2.028)为青少年抑郁症患者治疗后认知功能障碍的危险因素(P<0.05)。结论青少年抑郁症患者治疗后认知功能障碍受年龄、吸烟、饮酒、文化程度、社会支持度的影响,临床中应该给予密切关注,预防患者认知功能的损害。Objective To explore the influencing factors of cognitive dysfunction after drug treatment of adolescent patients with depression.Methods The clinical data of 212 cases of adolescent depression hospitalized in Fuyang Third People's Hospital from January 2019 to April 2022 were analyzed retrospectively.According to the score of Montreal Cognitive Assessment(MoCA)after treatment,patients were divided into cognitive dysfunction free group(n=141,score of MoCA equal and over 26)and cognitive dysfuntion group(n=71,score of MoCA under 26).The basic data of the two groups were collected and compared,including age,gender,body mass index(BMI),course of disease,smoking history,family history,drinking history,Social Support Rating Scale(SSRS),17-Items Hamilton Depression Scale(HAMD-17),educational level,type of depression attack.Receiver operating characteristic(ROC)curve was used to analyze the value of age and SSRS score in predicting cognitive dysfunction in adolescent patients with depression after treatment.Multivariate Logistic regression was used to analyze the risk factors of cognitive dysfunction in adolescent patients with depression after treatment.Results There was no significant difference in gender,BMI,course of disease,family history,HAMD-17 score and depression attack type between the two groups(P>0.05).The age and the rates of smoking,drinking and junior high school education patients in the cognitive dysfunction group was higher than those in the cognitive dysfunction free group,while the score of SSRS in the cognitive dysfunction group were lower than those in the cognitive dysfunction free group,and the differences were statistically significant(P<0.05).The areas under the ROC curve of age and SSRS score predicting cognitive dysfunction in adolescent patients with depression after treatment were 0.896 and 0.964,respectively(P<0.05).Multivariate Logistic regression analysis showed that age between 14 to 18 years old(OR=1.571,95%CI=1.251-1.973),smoking(OR=1.457,95%CI=1.187-1.788),drinking(OR=1.254,95%CI=1.0

关 键 词：抑郁症 青少年 认知功能障碍 影响因素 

分 类 号：R749.4[医药卫生—神经病学与精神病学]