双相障碍Ⅱ型抑郁发作患者神经认知功能损害的研究

Cognitive impairment in bipolar disorder patients with type Ⅱ depressive episode

目的探讨双相障碍Ⅱ型抑郁发作患者神经认知功能损害的临床特征。方法对45例符合DSM—Ⅳ—R双相障碍Ⅱ型抑郁发作患者(病例组)和45例健康者(对照组)采用威斯康星卡片分类测验(WCST)、彩色连线测验(TMT)、STROOP卡片测验(CWT)以及持续操作测验(CPT)进行认知功能评估,并对两组测试结果进行分析。结果在WCST分类测验方面,两组间正确反应数、错误总数、持续错误数、完成分类数比较差异均有统计学意义(均P<0.01),且病例组较对照组差。在CPT测验中,病例组在错误次数1和第2次按键数中较对照组差(P<0.01),其他指标第1次按键、错误次数2、第3次按键、错误次数3两组间比较差异均无统计学意义(均P>0.05)。在TMT和CWT测验方面,病例组TMTA分测验较对照组差(P<0.05),CWT卡片B和卡片C分测验中两组间有统计学差异(P<0.01),且病例组较对照组差。结论双相障碍Ⅱ型抑郁发作患者认知功能存在明显损害,主要表现为大脑执行功能、注意力、记忆力及信息的处理速度能力障碍。

Objective To determine the characteristics of cognitive function in bipolar disorder patients with type vI depression episode. Methods Forty five bipolar disorder patients with type Ⅱdepressive episode meeting DSM-IV-R criteria （patient group ） and 45 healthy subjects （control group） were enrolled in the study. Wisconsin Card Sorting Test （WCST）, Color of Attachment Test （TMT）, STR^OP card Test （CWT） and Continuous Performance Test （CPT） were applied to assess the cognitive function of two groups. Results There were no significant difference in the gender, age, education years, marriage between two groups （P 〉0.05）. The scores in the WCST, number of correct reaction, the total number of errors, continuous error number, completed the classification number were lower in patient group than those in control group （P〈0.01）. And the CPT, the wrong number 1 and number of the second button were lower in patient group than those in control group （P〈0.01）. However, there was no significant difference in the first time button, error number 2, the third time button, error number 3 between two groups（P 〉0.05）. In TMT, CWT tests TMT card A and in CWT test card B and card C of patients were worse than those of control group （P〈0.01）. Conclusion The patients with bipolar Ⅱdepressive episode have cognitive deficits in executive function, attention, memory and information processing speed, compared with healthy controls.