首发重性抑郁障碍患者抑郁情绪在儿童期创伤经历和认知功能之间的调节作用  

Moderating effect of depressed mood in relationship between childhood traumatic experiences and cognitive function in patients with first-episode major depressive disorder

作　　者：王雅楠 王彦芳[1] WANG Yanan;WANG Yanfang(Department of Mental Health,First Clinical Medical College,Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一临床医学院精神卫生科,太原030001

出　　处：《山西医科大学学报》2023年第4期544-549,共6页Journal of Shanxi Medical University

基　　金：山西省卫健委科研基金项目(2022140);山西省136兴医工程项目。

摘　　要：目的探讨首发重性抑郁障碍患者儿童期创伤经历对认知功能的影响以及抑郁情绪的调节作用,为首发重性抑郁障碍患者认知功能诊疗提供新的借鉴依据。方法选取2020年9月至2022年2月住院部及门诊的130例首发未治疗的重性抑郁障碍患者与同期82名健康对照为研究对象。使用儿童期创伤问卷(childhood trauma questionnaire short form,CTQ-SF)评估患者童年经历,并据情感/躯体忽视、躯体/情感/性创伤评分是否分别大于15分、10分、10分、13分、8分,将患者组分为伴与不伴童年创伤组,使用重复性成套神经心理状态测试(repeatable battery for the assessment of neuropsychological status,RBANS)评估被试认知功能,使用17项汉密尔顿抑郁量表(17-item Hamilton depression scale,HAMD17)评估被试抑郁状态,并采用Pearson相关分析对伴童年创伤抑郁组(80例)、不伴童年创伤抑郁组(50例)、健康对照组(82例)的CTQ-SF和RBANS总分及其维度进行相关分析。结果三组在童年期创伤量表中,除性创伤外,各维度和RBANS总分及各维度评分上的差异有统计学意义(P<0.05)。相关分析提示RBANS总分与CTQ-SF总分呈负相关关系(r=-0.435,P<0.05);儿童期创伤得分对RBANS得分有显著的负向预测作用(β=-0.427,t=-6.723,P<0.05),并且HAMD17得分越高这种负向预测作用就越强(β=-0.241,t=-4.333,P<0.05)。结论首发重性抑郁障碍患者童年创伤对其认知功能有显著的负向预测作用,且抑郁情绪起调节作用。Objective To explore the influence of childhood traumatic experiences on cognitive function of first-episode major depressive disorder patients and the regulatory effect of depressive mood for providing a new reference for the treatment of cognitive function of first-episode major depressive disorder patients.Methods From September 2020 to February 2022,130 first-episode untreated major depressive disorder patients in inpatient and outpatient departments and 82 healthy controls in the same period were selected as the study subjects.Childhood trauma questionnaire short form(CTQ-SF)was used to evaluate the childhood experience of patients,and the patients were divided into depression with childhood trauma group and depression without childhood trauma group according to the scores of emotional/somatic neglect and somatic/emotional/sexual trauma greater than 15,10,10,13 and 8 respectively.Repeatable battery for the assessment of neuropsychological status(RBANS)was used to evaluate the cognitive function of the subjects,and 17-item Hamilton depression scale(HAMD 17)was used to evaluate the depressive status of the subjects.Pearson correlation analysis was used to analyze the correlation between total scores and dimensions of CTQ-SF and RBANS in depression with childhood trauma group(n=80),depression without childhood trauma group(n=50)and healthy control group(n=82).Results Except sexual trauma,the total scores of CTQ-SF and RBANS and the score of each dimension showed significant difference among the three groups(P<0.05).The total score of RBANS was negatively correlated with the total score of CTQ-SF(r=-0.435,P<0.05).Trauma score in childhood had a significant negative predictive effect on RBANS score(β=-0.427,t=-6.723,P<0.05),and the higher the score of HAMD 17 was,the stronger the negative predictive effect was(β=-0.241,t=-4.333,P<0.05).Conclusion Childhood trauma in first-episode major depressive disorder patients has a significant negative predictive effect on the cognitive function,and the depressed mood play

关 键 词：首发重性抑郁障碍 童年创伤 认知功能 HAMD 17 重复性成套神经心理状态测试 

分 类 号：R749[医药卫生—神经病学与精神病学]