| 宋仕琪,刘剑波,闫梦霄,周敏思,高铭,冯文泰,卢建平.伴精神病性症状及童年期创伤的重度抑郁发作青少年患者执行功能情况[J].四川精神卫生杂志,2023,36(3):202-208.Song Shiqi,Liu Jianbo,Yan Mengxiao,Zhou Minsi,Gao Ming,Feng Wentai,Lu Jianping,Executive function in adolescent patients with major depressive episode with psychotic symptoms and childhood trauma[J].SICHUAN MENTAL HEALTH,2023,36(3):202-208 |
| 伴精神病性症状及童年期创伤的重度抑郁发作青少年患者执行功能情况 |
| Executive function in adolescent patients with major depressive episode with psychotic symptoms and childhood trauma |
| 投稿时间：2023-01-18 |
| DOI：10.11886/scjsws20230118001 |
| 中文关键词: 青少年 重度抑郁发作 精神病性症状 童年期创伤 执行功能 |
| 英文关键词:Adolescents Major depressive episode Psychotic symptoms Childhood trauma Executive function |
| 基金项目:广东省高水平临床重点专科（深圳市配套建设资助经费）资助（项目编号：SZGS013）；广东省基础与应用基础研究基金项目（项目名称：FKBP5基因表观遗传修饰调控脑功能中介童年创伤与青少年抑郁障碍的自杀意念关系，项目编号：2019A1515110047）；深圳市科技计划项目（项目名称：父母童年创伤“跨代”影响青少年抑郁障碍的抑郁情绪和脑功能的机制研究，项目编号：JCYJ20190809155019338） |
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| 中文摘要: |
| 背景 有无精神病性症状的重度抑郁发作患者执行功能存在差异，且童年期创伤可能影响重度抑郁发作患者的执行功能，既往研究对象大多为成年抑郁发作患者，缺少对重度抑郁发作青少年患者的相关研究。目的 比较有无精神病性症状及童年期创伤的重度抑郁发作青少年患者执行功能的差异。方法 纳入2020年8月-2021年11月在深圳市康宁医院儿少精神科住院的、符合《国际疾病分类（第10版）》（ICD-10）重度抑郁发作诊断标准的青少年患者共112例，同期通过公开宣传招募健康对照组27例。使用剑桥神经心理自动化成套测试（CANTAB）中的运动控制任务（MOT）、空间工作记忆（SWM）、快速视觉信息处理（RVP）三个任务评定患者的执行功能，采用儿童期创伤问卷（CTQ-SF）评定童年期创伤类型。结果 与健康对照组相比，重度抑郁发作患者MOT任务平均延迟时更长（Z=-3.407，P=0.001），SWM任务中的组间错误反应总数更多（Z=-3.291，P=0.001）、组内错误反应总数更多（Z=-3.461，P=0.001）、双重错误反应总数更多（Z=-3.218，P=0.001）、错误反应总数更多（Z=-3.312，P=0.001）、策略分数更高（Z=-2.437，P=0.015）以及平均延迟时更长（Z=-2.055，P=0.040），RVP任务中的击中总数更少（Z=-3.196，P=0.001）、漏报总数更多（Z=-3.179，P=0.001）、拒绝总数更少（Z=-2.772，P=0.006）、击中概率更低（Z=-3.187，P=0.001）以及A′分数更低（Z=-3.070，P=0.002）。与不伴精神病性症状的重度抑郁发作青少年患者相比，伴精神病性症状者SWM任务中的双重错误反应总数更少（Z=-2.566，P=0.010）。相较于未经历过情感忽视的重度抑郁发作青少年患者，经历过情感忽视者MOT任务中的平均延迟时更长（Z=-3.183，P=0.001），RVP任务中的击中总数更少（Z=-2.445，P=0.014）、漏报总数更多（Z=-2.467，P=0.014）、击中概率更低（Z=-2.445，P=0.014）、A′分数更低（Z=-2.089，P=0.037）。相较于未经历过情感虐待的重度抑郁发作青少年患者，经历过情感虐待的患者MOT任务中的平均延迟时更长（Z=-2.552，P=0.011）。结论 重度抑郁发作青少年患者存在大部分类型的执行功能异常，不伴精神病性症状和伴有童年期创伤的患者执行功能更差。 |
| 英文摘要: |
| Background There are differences in executive function between major depressive episode patients with or without psychotic symptoms， and childhood trauma may affect the executive function of patients with major depressive episode. Previous research studies predominantly focused on adult patients with major depressive episode， with a lack of studies specifically focusing on adolescent patients with major depressive episode.Objective To investigate the differences in executive function among adolescent patients with major depressive episode， with or without psychotic symptoms and childhood trauma.Methods A total of 112 hospitalized adolescent patients with major depressive episode who met the criteria of the International Classification of Diseases， tenth edition （ICD-10） were included in the study. The participants were recruited from the Department of Child and Adolescent Psychiatry， Shenzhen Kangning Hospital during the period from August 2020 to November 2021. Additionally， 27 healthy controls were recruited through public advertisements. The Cambridge Neuropsychological Test Automated Battery （CANTAB） was used to assess executive function through the administration of the Motor Screening Task （MOT）， Spatial Working Memory（SWM） and Rapid Visual Information Processing （RVP） modules. Childhood Trauma Questionnaire-Short Form （CTQ-SF） was used to assess the trauma type.Results Compared with healthy controls， adolescent patients with major depressive episode had a longer mean delay （Z=-3.407， P=0.001） in the MOT task. In the SWM task， the patients had a higher total number of intergroup error responses （Z=-3.291， P=0.001）， a higher total number of intragroup error responses （Z=-3.461， P=0.001）， more total number of double error responses （Z=-3.218， P=0.001）， a higher total error responses （Z=-3.312， P=0.001）， higher strategy scores （Z=-2.437， P=0.015） and longer average delay time （Z=-2.055， P=0.040）. In the RVP task， the patients had fewer hits （Z=-3.196， P=0.001）， more misses （Z=-3.179， P=0.001）， fewer rejections （Z=-2.772， P=0.006）， lower hit probability （Z=-3.187， P=0.001） and lower A′ scores （Z=-3.070， P=0.002）.Compared with adolescent patients with major depressive episode without psychotic symptoms， those with psychotic symptoms had a lower total number of double error responses （Z=-2.566， P=0.010） in SWM task. Compared with adolescent patients with major depressive episode who did not experience emotional neglect， those who experienced emotional neglect had longer average delay time （Z=-3.183， P=0.001） in MOT task， fewer total hits （Z=-2.445， P=0.014）， more total missed reports （Z=-2.467， P=0.014）， lower hit probability （Z=-2.445， P=0.014） and lower A′scores （Z=-2.089， P=0.037） in RVP task. Adolescent patients with major depressive episode who had experienced emotional abuse had longer average delay time in MOT task than those who had not experienced emotional abuse （Z=-2.552， P=0.011）.Conclusion Adolescent patients with major depressive episode exhibit abnormalities in a majority of executive function domains. Specifically， those without psychotic symptoms and with childhood trauma demonstrate significantly impaired executive function. ［Funded by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties （number， SZGS013）， Basic and Applied Basic Research Fund of Guangdong Province （number， 2019A1515110047）， Shenzhen Science and Technology Planning Project （number， JCYJ20190809155019338）］ |
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