抑郁症患者认知功能的因子分析及影响因素

An analysis of effects of clinical factors on cognitive function in patients with depression

目的:比较抑郁症患者和健康人群之间认知功能的差异,并分析临床因素对认知功能的影响。方法:使用多元协方差分析等方法对120例抑郁症患者(研究组)和60名健康者(正常对照组)的认知功能(威斯康星卡片分类测试、韦氏记忆量表、字色干扰实验、连线实验、语言流畅性测试及画钟实验)进行比较。结果:①研究组的总应答数、持续错误数、随机错误数、字色干扰实验、连线实验A等均高于对照组(F=10.87～120.30,P<0.01或P<0.001);而正确应答数、完成分类数、记忆商数、数字累加、短时记忆、瞬时记忆、语言流畅性测试及画钟实验等均低于对照组(F=4.92～290.70,P<0.05或P<0.001);②在原始观察指标基础上提取5个因子,所代表的信息分别为f1(视觉记忆)、f2(言语记忆)、f3(注意力)、f4(处理速度)、f5(执行功能);③多元线性回归分析结果示:进入视觉记忆方程的影响因素为受教育年限和睡眠障碍;进入言语记忆方程的影响因素为受教育年限和阻滞;进入注意力方程的影响因素为阻滞和认识障碍;进入处理速度方程的影响因素为病程和阻滞;进入执行功能方程的影响因素为受教育年限、阻滞和认识障碍,均具有统计学意义(t=-2.194～5.765,P<0.05或P<0.001)。结论:抑郁症患者的认知功能在多个领域存在损害,其受教育年限、病程以及抑郁症状的严重程度等因素对认知功能有不同程度的影响。

Objective：To compare differences of cognitive function between depressive patients and healthy individuals,and analyze effects of clinical factors on cognitive function.Method：The cognitive function of 120 depressive patients and 60 healthy people was assessed by Wisconsin card sorting test,Wechsler memory scale,Stroop test,trails,verbal fluency test and clock copying.Then the data were statistically analyzed with SPSS 17.0.Results：①The results showed that the scores of total responses,preservative errors,random errors,Stroop test,and trails in research group were higher than those in control group（F=10.87~120.30,P0.01 or P0.001）.However,the scores of correct responses,number of categories completed,memory quotient,numeric accumulation,short term and instantaneous memory,verbal fluency test,and clock copying were significantly lower than those in control group（F=4.92~290.70,P0.05 or P0.001）;②Five factors based on original observation index were extracted,which represented f1（visual memory）,f2（verbal memory）,f3（attention）,f4（processing speed） and f5（executive function）;③The results of multiple linear regression analysis showed that the educational level and sleep disorder had an effect on f1,f2 was influenced by educational level and retardance,cognitive disturbance and retardance impacted f3,the course of disease and retardance affected f4,and f5 was influenced by educational level,retardance and cognitive disturbance.They were showing statistical significant difference（t=-2.194~5.765,P0.05 or P0.001）.Conclusion：The results of the study showed that the cognitive function of depressive patients was significantly lower than that of healthy individuals in many aspects,meanwhile,educational level,course of disease and the severity of symptoms of depression had the influence of different level on cognitive function.