难治性抑郁症与首发抑郁症注意偏向的相关研究

Investigation of attentional bias between treatment resistant depression and fist episode depression

目的比较和分析首发抑郁症(FED)与难治性抑郁症(TRD)患者的注意偏向特点。方法以26例FED患者(FED组)和27例TRD患者(TRD组)作为研究对象,以41例健康志愿者作为正常对照(Heathy controls,HC)。采用汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)评估临床严重程度,采用中文情绪词Stroop任务进行注意偏向测试,并进行3组组间比较和分析。结果①TRD组与FED组在HAMD、SDS量表得分方面差异均无统计学意义;②注意偏向测试显示FED组[(1 213.07±391.28)ms,(1 128.73±318.39)ms,(1 184.90±386.40)ms]与TRD组[(1 403.28±345.34)ms,(1 333.71±331.38)ms,(1 325.92±300.16)ms]在负性词、中性词、正性词的反应时均高于HC组[(754.08±212.88)ms,(763.43±209.01)ms,(763.45±192.69)ms],差异有统计学意义(F=39.679,P=0.000;F=36.065,P=0.000;F=35.440,P=0.000);③TRD组在负性词错误数方面高于HC组,差异有统计学意义(F=5.596,P=0.021);④TRD组在负性词、中性词、正性词的反应时均高于FED组,差异有统计学意义(F=39.679,P=0.000;F=36.065,P=0.000;F=35.440,P=0.023)。结论 TRD与FED均存在明显的注意偏向方面和执行功能方面的损伤,与FED患者相比,TRD症患者的执行功能损害更为严重。SDS、HAMD量表评估并不能反映TRD的临床严重程度,对消极词汇的注意偏向可能是TRD的特征性表现。

Objective To investigate and compare the attentional bias between first episode depression （FED）and treatment resist-ant depression （TRD）.Methods Twenty-six patients with FED （FED group）and 27 patients with TRD （TRD group）were enrolled,and another 41 healthy volunteers were served as healthy control group （HC）.The disease severity was evaluated with Hamilton Depression Scale （HAMD）and Self-Rating Depression Scale（SDS）.The attentional bias was assessed with Chinese Emotional Stroop Task,and comparison was conducted among groups.Results （1 ）There was no significant difference in the scores of HAMD and SDS between TRD group and FED groups.（2）The assessment of attentional bias demonstrated that the reaction time of negative-,neutral-and positive-related words of Chinese Emotional Stroop Task in FED group [（1213.07 ±391.28）ms,（1128.73 ±318.39）ms,（1184.90 ±386.40）ms]group and TRD group [（1403.28 ±345.34）ms,（1333.71 ±331.38）ms,（1325.92 ±300.16）ms]were significantly lower than those in HC group （F=39.679, P=0.000;F=36.065,P=0.000;F=35.440,P=0.000）.（3）The error number of the negative-related words in TRD group was worse than that of HC group,and the difference between two groups was statistically significant（F=5.596,P=0.021）.（4）The comparison be-tween FED and TRD group in the reaction time of negative-,neutral-and positive-related words was significant（F=39.679,P=0.000;F=36.065,P=0.000;F=35.440,P=0.023）.Conclusion There are impairments of attentional bias and executive functions in both FED and TRD group.Compared with FED group,the impairment of executive functions in TRD group is more severe.Clinical evaluation of disease severity by HAMD,SDS can not reflect the characteristics of TRD.The impairment of attentional bias in negative-related words is character-ized in TRD.