无抽搐电休克治疗对中青年抑郁患者认知功能影响及性别差异  

Gender differences in the impact of modified electroconvulsive therapy on cognitive function in middle-aged and young patients with depression

作　　者：孙倩 姜玮[1,2] 李艳茹[1,2] 王楠[1,2] 侯冷冰[1,2] 任艳萍[1,2] SUN Qian;JIANG Wei;LI Yanru;WANG Nan;HOU Lengbing;REN Yanping(The National Clinical Research Center for Mental Disorders&Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospi-tal,Capital Medical University,Beijing 100088;Advanced Innovation Center for Human Brain Protection,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京安定医院,精神疾病诊断与治疗重点实验室,国家精神心理疾病临床医学研究中心,北京100088 [2]首都医科大学人脑保护高精尖创新中心

出　　处：《中国神经精神疾病杂志》2024年第6期343-348,共6页Chinese Journal of Nervous and Mental Diseases

基　　金：首都卫生发展科研专项(编号:2018-3-1171)。

摘　　要：目的初步探索无抽搐电休克治疗(modified electroconvulsive therapy,MECT)对中青年抑郁发作患者认知功能的影响及其性别差异。方法纳入首都医科大学附属北京安定医院住院的中青年抑郁发作患者,完成6次MECT,分别在基线、第3次MECT后、第6次MECT后采用17项汉密尔顿抑郁量表(17-item Hamilton depression scale,HAMD-17)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、重复成套神经心理状态测验(repeatable battery for the assessment of neuropsychological status,RBANS)对抑郁、焦虑症状和认知功能进行评分,分别在青年组和中年组中比较性别差异。结果纳入抑郁发作患者共122例,其中青年组83例、中年组39例。两组中,基线HAMD及HAMA评分、MECT后HAMD减分率均无性别差异(P>0.05)。重复测量方差分析显示,青年组中,RBANS总分、视觉广度因子分、注意因子分的时点效应具有统计学意义(P<0.05),治疗后较基线时提高,性别分组效应和交互效应无统计学意义(P>0.05)。中年组中,RBANS总分、视觉广度因子分的时点-性别分组交互效应具有统计学意义(P<0.05),女性患者RBANS总分、视觉广度因子分、注意因子分在第6次MECT后较基线时提高(P<0.05),时点效应和性别分组效应无统计学意义(P>0.05)。结论中青年抑郁患者MECT后认知功能整体有所改善,中年患者认知功能变化存在性别差异,需依据患者性别、年龄特征优化MECT方案,以减轻认知功能不良影响。Objective Preliminary exploration of the effects of modified electroconvulsive therapy(MECT)on cognitive function and gender differences in middle-aged and young patients with depressive episodes.Methods A group of middle-aged and young patients with depressive episodes,who were admitted to Beijing Anding Hospital affiliated to Capital Medical University,completed 6 rounds of MECT.The 17-item Hamilton depression scale(HAMD-17),Hamilton anxiety scale(HAMA),and repetitive battery for the assessment of neuropsychological status(RBANS)were used to score depressive symptoms,anxiety symptoms,and cognitive function at baseline,after the 3rd MECT,and after the 6th MECT,respectively.Gender differences were compared between the young and middle-aged groups.Results A total of 122 patients with depressive episodes were included,with 83 cases in the youth group and 39 cases in the middleaged group.There was no gender difference in baseline HAMD and HAMA scores,as well as the HAMD reduction rates after MECT between the two groups(P>0.05).Repeated measures ANOVA showed that in the youth group,the time effects of RBANS total score,visual breadth factor score,and attention factor score were significant(P<0.05),and increased after treatment compared to baseline.There was no significance in gender group effects or interaction effects(P>0.05).In the middle-aged group,the time and gender interaction effect of RBANS total score and visual breadth factor score was significant(P<0.05).Female patients showed an increase in RBANS total score,visual breadth factor score,and attention factor score after the 6th MECT compared to baseline(P<0.05),while there was no significance in time effect and gender group effect(P>0.05).Conclusion Middle-aged and young depressed patients showed overall improvement in cognitive function after MECT,while there were gender differences in cognitive function changes among middle-aged patients.It is necessary to optimize the MECT program based on the patient’s gender and age characteristics to reduce cognitiv

关 键 词：无抽搐电休克治疗 抑郁 抑郁发作 认知功能 年龄 性别 

分 类 号：R749.05[医药卫生—神经病学与精神病学]