重症抑郁症病人认知功能与焦虑的关系

Relationship between cognitive function and anxiety in patients with major depression

目的 :探讨重症抑郁症病人的认知功能性失调与焦虑障碍的关系。方法 :对24例伴有严重焦虑障碍和21例不伴有严重焦虑障碍的重症抑郁症病人在入院治疗前及常规药物治疗后 ,分别同时应用功能失调状况评定量表“DAS”、HAMD抑郁量表及Beck抑郁自评量表“BDI”进行测评与对照研究。结果 :常规药物治疗后两组患者抑郁症状严重程度(HAMD总分)明显减轻或消失 ,疗效显著(P<0.01)。但是认知功能改善存在较大差异。不伴焦虑的抑郁症在药物治疗后其认知障碍的严重程度随着抑郁症状的减少也明显减轻 ,而伴有焦虑的抑郁症病人在药物治疗后 ,尽管抑郁症状已明显减少或消失 ,但其认知障碍依然存在。结论 :伴有焦虑的抑郁症病人 ,认知障碍更突出、顽固。因而在治疗过程中 ,必须将药物和认知行为治疗相结合 ,这样才能获得长期的疗效并能预防复发。

Objective:To reveal the relationship between cognitive dysfunction and anxiety disorder in patients with major depression.Methods:Major depressive patients with and without severe anxiety disorders(24 and 21 cases respectively) were assessed with DAS、HAMD and BDI before and after routine medication.Results:The improvement of cognitive function showed some difference between the two groups.In depression without anxiety,the severity of the cognitive dysfunction was lessened with the remission of the depressive symptoms and most of the cognitive factors(D 1,D 3,D 6,D 7,D 8)improved significantly after treatment(P< 0.05);In contrast,the cognitive dysfunction remained after treatment in depression with anxiety even though the depressive symptoms had remitted.Conclusion :Cognitive dysfunction in depressive patients with anxiety is more prominent and persistent.And combined treatment with drugs and cognitive behavioral therapies is indicated,because it yields better results than drug therapy alone.