| 郑朝盾,陈映梅,谭就维,刘国雄,蔡颖莲,蓝晓凤,周燕玲.难治性抑郁症与首发未用药抑郁症患者认知功能比较[J].四川精神卫生杂志,2021,34(5):429-434.Zheng Chaodun,Chen Yingmei,Tan Jiuwei,Liu Guoxiong,Cai Yinglian,Lan Xiaofeng,Zhou Yanling,Comparison of cognitive function in patients with treatment-resistant depression and drug-naive first-episode major depressive disorder[J].SICHUAN MENTAL HEALTH,2021,34(5):429-434 |
| 难治性抑郁症与首发未用药抑郁症患者认知功能比较 |
| Comparison of cognitive function in patients with treatment-resistant depression and drug-naive first-episode major depressive disorder |
| 投稿时间：2021-01-23 |
| DOI：10.11886/scjsws20210123001 |
| 中文关键词: 重性抑郁障碍 难治性抑郁 认知功能 首发 |
| 英文关键词:Major depressive disorder Treatment-resistant depression Cognitive function First-episode |
| 基金项目:国家自然科学基金（项目名称：BDNF介导海马神经重塑在氯胺酮治疗抑郁-疼痛共病种的作用研究，项目编号：81801343），广东基础与应用基础研究基金（项目名称：基于“犬尿酸-谷氨酸”通路探讨氯胺酮抗抑郁的作用机制，项目编号：2019A1515011366） |
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| 中文摘要: |
| 目的 探究难治性抑郁症患者与首发未用药抑郁症患者认知功能的差异，并分析抑郁症临床症状严重程度与认知功能的关系，为改善预后提供参考。方法 连续入组2016年11月-2019年12月在广州市某医院门诊就诊的首发未用药抑郁症患者119例、难治性抑郁症患者82例，并从社区招募71名健康人群作为健康对照组。采用汉密尔顿抑郁量表17项版（HAMD-17）及汉密尔顿焦虑量表（HAMA）评估被试的抑郁及焦虑症状，采用精神分裂症认知功能成套测验共识版（MCCB）评估认知功能，包括处理速度、工作记忆、语言学习与记忆、视觉学习与记忆。采用多元协方差分析比较三组认知功能的差异，采用偏相关分析分别探索两组患者组内HAMD-17、HAMA评分与MCCB四个维度评分的关系。结果 难治性抑郁症组和首发未用药抑郁症组MCCB的处理速度、视觉学习与记忆评分均低于健康对照组，难治性抑郁症组的工作记忆评分低于健康对照组，差异均有统计学意义（P<0.05或0.01）；难治性抑郁症组的处理速度、视觉学习与记忆评分均低于首发未用药抑郁症组，差异均有统计学意义（P<0.05或0.01）。偏相关分析结果显示，两组患者同组内HAMD-17、HAMA评分与MCCB四个认知功能维度评分均无相关性（P均>0.05）。结论 与首发未用药抑郁症患者和健康人群相比，难治性抑郁症患者的处理速度、视觉学习与记忆功能损伤更突出。而首发未用药抑郁症患者与难治性抑郁症患者，认知功能缺陷与抑郁、焦虑严重程度无相关性。 |
| 英文摘要: |
| Objective To explore the differences of cognitive function in patients with treatment-resistant depression and drug-naive first-episode major depressive disorder， and to examine the relationship between severity of clinical symptoms and cognitive function， so as to provide references for prognosis improvement.Methods From November 2016 to December 2019， 119 patients with drug-naive first-episode major depressive disorder and 82 patients with treatment-resistant depression in a hospital in Guangzhou were enrolled， meantime， another 71 healthy individuals recruited from the community were set as healthy control group. Clinical symptoms were assessed using Hamilton Depression Scale-17 item （HAMD-17） and Hamilton Anxiety Scale （HAMA）. Cognitive domains， including speed of processing， working memory， verbal learning and memory， and visual learning and memory were measured with the MATRICS Consensus Cognitive Battery （MCCB）. Multiple covariance analysis was used to compare the differences in cognitive function among three groups. Thereafter， partial correlation analysis was performed within patient groups to explore the relationship of HAMD-17/HAMA score with the four dimensions of MCCB.Results The speed of processing， visual learning and memory scores of treatment-resistant depression group and drug-naive first-episode depression group were lower than those of healthy control group， and the working memory score of the treatment-resistant depression group was lower than that of the healthy control group， with statistical significance （P<0.05 or 0.01）. The speed of processing， visual learning and memory scores of treatment-resistant depression group were significantly lower than those of drug-naive first-episode depression group （P<0.05 or 0.01）. Partial correlation analysis within patient groups found that HAMD-17/HAMA total score had no correlation with the four dimensions of MCCB （P>0.05）.Conclusion Compared with drug-naive first-episode major depressive disorder patients and healthy controls， the impairments of speed of processing， visual learning and memory are more severe in patients with treatment-resistant depression. Moreover， the cognitive function impairment in patients with drug-naive first-episode major depressive disorder and treatment-resistant depression has no correlation with the severity of depressive and anxious symptoms. |
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