抑郁症患者和正常人威斯康星卡片分类测验的比较研究

A comparative study of Wisconsin Card Sorting Test between depression patients and normal people

目的 探讨抑郁症患者认知功能障碍的特点。方法 对67例符合ICD-10抑郁症诊断标准的抑郁症患者和44例正常人进行威斯康星卡片分类测验(WCST),并对其中21例经过6周抗抑郁药治疗的患者进行治疗前后比较,观察WCST与HAMD评分变化的关系。结果 抑郁症患者WCST的总测验次数、持续错误数和随机错误数同正常人相比较均有显著差异(P<0.01);相关分析发现:WCST的总测验次数、持续错误数、随机错误数与年龄、HAMD总分及迟缓、日夜变化两因子分正相关(P<0.01),正确数和分类数与年龄、HAMD的迟缓因子分成负相关(P<0.05);WCST在两组按性别及文化程度再分组比较后发现:各组间无显著性差异,对21例患者治疗前后比较发现WCST随病情的好转而改善。而治疗前后WCST的总测验次数、持续错误数、随机错误数的减分率与HAMD减分率正相关(P<0.05)。结论 抑郁症患者存在认知功能缺损,其认知功能缺损与病情的严重程度及抑郁症的迟滞和日夜变化等症状有关,认知功能的降低可能反映病人额叶功能的缺损。

Objective To explore the cognitive function in depression. Methods 67 depression patients who met the ICD - 10 were measured with HAMD and Wisconsin Card Sorting Test(WCST) .21 of the 67 patients were retested after treated with antidepressant for 6 weeks,44 normal controls were tested with WCST. Results The depression patients performed significantly worse than control group in the total trials, preservative errors, random errors of WCST ( P < 0.01). Further significant positive correlations were found between the total score of HAMD, two factors scores of HAMD and the total trials preservative errors, random errors of WCST ( P < 0.01) , significant negative correlations were found between retardation of HAMD and corrects, categories completes of WCST (P < 0.05). Between ages and WCST were correlated, the older the worse ( P < 0.05 ) in both groups. The damping of total trial, preservative errors and random errors of WCST were correlated with the damping of the HAMD score in 21 patients after their treatment for 6 weeks with antidepressant ( P < 0.05). Conclusion The study suggests that cognitive dysfunction exists in depression patients and related with severity of symptoms of depression as well as their frontal dysfunction.