单、双相抑郁障碍认知功能损害的比较
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摘要
目的比较单、双相抑郁障碍患者认知功能损害的程度和种类,以探讨单、双相抑郁障碍认知功能损害的差异。方法对来源于武警山西总队医院2011-03至2014-02门诊和住院的符合入组标准的30例单相抑郁和28例双相抑郁患者,于急性起病期进行汉密尔顿抑郁量表评估,采用中国修订韦氏成人智力测验量表、威斯康星卡片分类测验进行神经心理学测量,并与30例健康对照组进行比较,观察神经心理测验各指标的变化。并对单、双相抑郁患者认知功能各指标与汉密尔顿抑郁量表各因子行简单相关分析。结果在认知功能测验中,单、双相抑郁障碍与健康对照组相比差异均有统计学意义(P<0.05);单相抑郁、双相抑郁障碍患者相比在操作智商方面差异有统计学意义(P<0.05)。单相抑郁患者焦虑/躯体化因子与言语量表呈负相关(P<0.05),认知功能与言语量表和操作量表呈负相关(P<0.01);双相抑郁患者躯体化/焦虑与相似、词汇成负相关(P<0.05)、与操作量表分呈负相关(P<0.01),认知功能与操作量表呈负相关。结论单、双相抑郁障碍患者均存在广泛的认知功能损伤,且与临床特征表现存在一定的相关性。但损害存在差异,双相抑郁障碍患者在操作智商方面损害略低于单相抑郁。
Objective To study significant cognitive function indicators which canhelp early diagnose bipolar depression by comparing the cognitive function between patients with bipolar depression and unipolar depression.Methods Unipolar depression group and bipolar depression group from the inpatients and outpatients of Armed Police corpshospital in Shanxi Province,had the tests in acute stage,including Scale for assessment of clinical symptoms as HAMD; neuropsychological test,as WAIS,WCST.Normal control grouphad the neuropsychological test compared with patients.And the relationships between neuropsycho1 ogical tests and clinical variables were tested using correlation analysis.Results Compared with normal control group,patientshave cognition dysfunction;there were differences between unipolar depression and bipolar depression patients in performance intelligence quotient.Some factors of HAMD were negatively correlated to WAIS scales in patients.Conclusions It is common that unipolar depression patients and bipolar depression patientshave different cognition disfunction which is correlated to clinical features.Bipolar depression cognitive impairment is slightly lighter than unipolar depression in the acute onset.
Objective To study significant cognitive function indicators which canhelp early diagnose bipolar depression by comparing the cognitive function between patients with bipolar depression and unipolar depression.Methods Unipolar depression group and bipolar depression group from the inpatients and outpatients of Armed Police corpshospital in Shanxi Province,had the tests in acute stage,including Scale for assessment of clinical symptoms as HAMD; neuropsychological test,as WAIS,WCST.Normal control grouphad the neuropsychological test compared with patients.And the relationships between neuropsycho1 ogical tests and clinical variables were tested using correlation analysis.Results Compared with normal control group,patientshave cognition dysfunction;there were differences between unipolar depression and bipolar depression patients in performance intelligence quotient.Some factors of HAMD were negatively correlated to WAIS scales in patients.Conclusions It is common that unipolar depression patients and bipolar depression patientshave different cognition disfunction which is correlated to clinical features.Bipolar depression cognitive impairment is slightly lighter than unipolar depression in the acute onset.
引文
[1]Ruggero C J,Carlson G A,Kotov R,et al.Ten-year diagnostic Consistency of bipolar disorder in a first-admission sample[J].Bipolar Disord,2010,12(1):2l-31.
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[7]周春英,顾永健,黄晓卫,等.亚综合征性抑郁患者认知功能障碍对照研究[J].临床心身疾病杂志,2010,16(1):38-40.
[8]平军辉,崔桂,梅王萍.抑郁症患者治疗前后神经心理学测验变化分析[J].临床心身疾病杂志,2011,17(2):141-142.
[9]季春梅.威斯康星卡片分类测验在执行功能障碍研究中的应用[J].神经疾病与精神卫生,2005,5(4):322-324.
[10]张迎黎,张红梅,陈佐明,等.抑郁症患者抗抑郁治疗前后认知功能变化及意义[J].山东医药,2011,51(9):22-24.
[11]卞清涛,邸晓兰,姚付新,等.情感性精神障碍患者认知功能障碍的对照研究[J].中华精神科杂志,2007,8(40):132-135.
[12]Murphy F C,Sahakian B J.Neuropsychology of bipolar disorder[J].The British journal of psychiatry[J].Supplement,2001,178(Suppl 41):S120-127.
[2]Reischies F M,Neu P.Comorbidity of mild cognitive disorder and depression:a neuropsychological analysis[J].Eur Arch Psy chiatry Clin Neurosci,2000,250(4):186-193.
[3]Koetsier G C,Volkers A C,Tulen J H,et al.CPT performance in major depressive disorder before and after treatment with imipramine or fluvoxamine[J].J Psychiatr Res,2002,36(6):391-397.
[4]Borkowska A,Rybakowski J K.Neuropsychological frontal lobe tests indicate that bipo1ar depressed patients are more impaired than unipolar[J].Bipolar Disord,2001,3(2):88-94.
[5]张明.单相抑郁与双相抑郁认知功能的对照研究[D].中山大学硕士学位论文,2008.
[6]朱玥,马燕,于欣,等.单相和双相抑郁障碍及精神分裂症患者神经认知功能的比较研究[J].中华精神科杂志,2013,46(6):325-329.
[7]周春英,顾永健,黄晓卫,等.亚综合征性抑郁患者认知功能障碍对照研究[J].临床心身疾病杂志,2010,16(1):38-40.
[8]平军辉,崔桂,梅王萍.抑郁症患者治疗前后神经心理学测验变化分析[J].临床心身疾病杂志,2011,17(2):141-142.
[9]季春梅.威斯康星卡片分类测验在执行功能障碍研究中的应用[J].神经疾病与精神卫生,2005,5(4):322-324.
[10]张迎黎,张红梅,陈佐明,等.抑郁症患者抗抑郁治疗前后认知功能变化及意义[J].山东医药,2011,51(9):22-24.
[11]卞清涛,邸晓兰,姚付新,等.情感性精神障碍患者认知功能障碍的对照研究[J].中华精神科杂志,2007,8(40):132-135.
[12]Murphy F C,Sahakian B J.Neuropsychology of bipolar disorder[J].The British journal of psychiatry[J].Supplement,2001,178(Suppl 41):S120-127.