抑郁症患者的认知功能特点

摘要

Objective To study the characteristics of cognitive impairment in depressive patients. Method 80 depressive patients and 80 healthy volunteers were included in the study. Their cognitive function was assessed with trail making test A and B, verbal fluency test (animals), modified Wisconsin card sorting test, and Tower of Hanoi test. 17-Hamilton Depression Scale (HAMD17) was used to assess characteristics of symptoms. A brief psychiatric rating scale (BPRS) was used to screen the patients with psychiatric symptoms. Results (1) Neuropsychological results about trail making test A or B, verbal fluency test, WCST, Tower of Hanoi test were much worse in depressive patients than in normal control (P＜0.05). (2) The neuropsychological results of psychotic depressive patients with psychotic symptoms were worse than that of the ones without psychotic symptoms. There was significant difference at time of trail making test Af (77.2±49.3) s, (59.2±29.3) s, respectively] and B f(121.6±40.0) s, (84.7±36.4) s,respectively [between them(P＜0.05). Conclusion The cognitive impairment was wide in depressive patients and more serious in psychotic depressive patients.%目的 研究伴或不伴有精神病性症状的抑郁症患者认知功能损害的特点.方法 与80例健康对照组进行比较,80例抑郁症患者组均符合ICD-10抑郁发作诊断标准,汉密尔顿抑郁量表评分(Hamilton Depression Scale,HAMD17)≥17分.分别采用言语流畅性测验(动物数)、威斯康星卡片分类测验-改良版(modified Wisconsin card sorting test,M-WCST)(48张)、汉诺塔测验、连线测验A和B等神经心理工具进行认知功能评定;采用简明精神病评定量表(Brief Psychiatry Rating Scale,BPRS)筛查和评定出22例伴有精神病性症状的抑郁症患者.结果 (1)与正常组比较,抑郁症患者各项神经心理学测验成绩均差,并且差异有显著性(P＜0.05).(2)有精神病性症状的抑郁症患者与无精神病性症状的抑郁症患者比较,伴有精神病性症状的患者各项神经心理成绩均差于无精神病性症状者,仅连线测验A时间分别为(77.2±49.3)s,(59.2±29.3)s,连线测验B时间分别为(121.6±40.0)s,(84.7±36.4)s,差异有显著性(P＜0.05).结论 与健康对照比较,抑郁症患者存在广泛的认知损害,有精神病性症状的患者认知损害程度更严重.