苯丙胺类兴奋剂所致精神障碍首次发病患者认知功能的研究

The cognition function in patients with first-episode mental disorders due to use of amphetamine-type stimulants

目的:探讨首次发病住院苯丙胺类兴奋剂(ATS)所致精神障碍患者的认知功能特点及其影响因素。方法:采用韦氏记忆量表(WMS-RC)、连续操作测验(CPT)、威斯康星卡片分类测验(WCST)评定80例首发ATS所致精神障碍患者(研究组)和80名健康人(对照组)的认知功能;采用简明精神病量表(BPRS)评定患者病情严重程度。对影响神经心理学测验成绩与BPRS进行逐步多元回归分析。结果:研究组WCST中的总应答数、持续错误数、随机错误数显著高于对照组(F=10.87～68.78,P<0.01或P<0.001);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、连续操作测验正确数均显著低于对照组(F=4.92～114.20,P<0.05或P<0.001)。研究组总应答数和持续错误数与BPRS总分呈正相关(β=0.26,P=0.01;β=0.20,P=0.02);随机错误数与敌对猜疑分呈正相关(β=0.23,P=0.02);正确应答数与思维障碍分呈负相关(β=-0.25,P=0.01);完成分类数与缺乏活力分呈负相关(β=-0.25;P=0.01);记忆商数和长时记忆与焦虑忧郁分呈负相关(β=-0.32,P=0.00;β=-0.25,P=0.00);短时记忆和瞬时记忆与缺乏活力分呈负相关(β=-0.36,P=0.00;β=-0.32,P=0.00);CPT正确数与BPRS总分呈负相关(β=-0.34,P=0.00)。结论:首发ATS所致精神障碍患者的记忆、注意和执行功能等明显减退,临床症状严重程度越大,认知功能损害越大。

Objective：To explore the cognition function features and the affecting factors in patients with first-episode mental disorders caused by amphetamine-type stimulants（ATS）. Method：Eighty mental disorder patients caused by ATS（study group）and 80 healthy controls（control group）were involved. The cognitive function was measured with a series of neuropsychological test,and the illness severity assessed with the brief psychiatric rating scale（BPRS）. Results：The scores of total responses,preservative errors,random errors in WCST in research group were higher than those in control group（F =10. 87 -68. 78;P ﹤0. 01 or P ﹤0. 001）. However,the scores of correct responses,number of categories completed,memory quotient,numeric accumulation,short-term and instantaneous memory,continuous performance test（CPT）correct number were significantly lower than those in control group（F =4. 92 -114. 20;P ﹤0. 02 or P ﹤0. 001）. The research group total responses and preservative errors were positively correlated to the BPRS total score（β =0. 26,P = 0. 01;β = 0. 20,P = 0. 02）,random errors were positively correlated to hostile suspicion score（β =0. 23,P =0. 02）,correct responses were negatively corre-lated to thought disorder score（β = -0. 22,P =0. 01）,number of categories completed were negatively correlated to lack of energy score（β = -0. 22,P =0. 01）,memory quotient and long-term memory were negatively correlated to anxiety depression score（β = -0. 32,P =0. 00;β = -0. 22,P = 0. 00）,short-term and instantaneous memories were negatively correlated to lack of energy score（β = - 0. 36,P = 0. 00;β = - 0. 32,P = 0. 00）,CPT correct number was negatively correlated to BPRS total score（β = - 0. 34,P = 0. 00）. Conclusion：The paitents with first-episode mental disorders caused by ATS have obvious impairments in memory,attention and execute function. The more severe the clinical symptoms is ,the greater the impairment on the cognitive function is.