情感性精神障碍患者认知功能障碍的对照研究

Control study of cognitive functioning in mood disorder

目的探讨情感性精神障碍患者是否存在认知功能损害,比较各亚型患者认知功能损害的特征。方法对120例(抑郁症组、双相抑郁组、躁狂组及双相躁狂组各30例)情感性精神障碍患者(以下简称患者组)使用汉密尔顿抑郁量表(17项)、YOUNG 躁狂量表、临床疗效总评量表、威斯康星卡片分类测验(WCST)、韦氏智力量表、韦氏记忆量表及 Halstead-Retain 神经心理成套检查(HRB-RC)分别于治疗前和治疗第12周末评定及比较。对照组为30名正常人。结果 (1)各亚型患者组治疗前 WCST 操作的总测验次数、持续错误数、随机错误数、分类数、智商(IQ)值、记忆商(MQ)值,以及抑郁症组、双相抑郁组的正确数与对照组比较,差异均有统计学意义(P<0.05或 P<0.01)。各亚型患者组治疗第12周末与对照组比较,WCST 操作的总测验次数、持续错误数、随机错误数、分类数及 MQ 值的差异有统计学意义(P<0.05或 P<0.01)。在各患者组中,WCST 操作的总测验次数、随机错误数、分类数、IQ 值和 MQ 值治疗前与治疗第12周末的差异均有统计学意义(P<0.05或 P<0.01),而组间的差异无统计学意义(P>0.05)。(2)治疗前与治疗第12周末比较,各患者组中的 HRB-RC 测验的连线乙、触摸总时间、范畴,抑郁症组中的连线甲,抑郁症组、双相抑郁组治疗前的敲击次数等,与对照组的差异均有统计学意义(P<0.05或 P<0.01)。结论部分情感性精神障碍患者存在认知功能损害,各亚型患者间的差异不明显。

Objective To explore the cognitive functioning in patients with mood disorder, and make comparison between patients with different subtypes of mood disorders. Methods Altogether 120 patients with different subtypes of mood disorders, including major depressive disorder, bipolar depression, unipolar mania, and bipolar mania （30 in each subtype ）, and 30 normal controls were involved in the study. The patients were measured with the Hamilton Depression Scale-17 items, YOUNG＇s Mania Rating Scale, Clinical Global Impression, Wisconsin Card Sorting Test （WCST）, Wechsler Adult Intelligence Scale-RC （WAIS）, Wechsler Memory Scale （WMS） and Halstead-Reitan-Battery-Revised in China（ HRB- RC） at pre-and post-treatment （ 12 weeks ）. Results At pre-treatment, the patients had higher scores in WCST total trials, preservative errors, random errors, and lower scores in categories control, WAIS-IQ, WMS-MQ than normal controls. After treatment, patients showed fewer score in WCST than controls as well, but there were no significant differences in WCST score between patients with different subtypes of mood disorder （P 〉 0. 05 ）. As to the tests of Link B, touch time and category of HRB-RC, the patients had higher scores than normal controls （ P 〈 0. 05 or P 〈 0.01 ）. Conclusion The patients with mood disorder may have cognitive impairments which may be aggravated by mood symptoms, and could not improve even after mood symptom remission in some patients.