抑郁症首次发病患者睡眠障碍与认知功能的关系

The relationship between sleep disorders and cognitive function in the patients with first-episode of depression

目的:探讨首发抑郁症患者睡眠障碍和认知功能损害的关系。方法:采用17项汉密尔顿抑郁量表(HAMD-17)评估378例首发抑郁症患者的抑郁症状,根据是否伴有睡眠障碍分为睡眠障碍组(HAMD总分≥14分且睡眠因子分≥4分)253例和非睡眠障碍组(HAMD总分≥14分且睡眠因子分≤3分)125例;采用重复性成套神经心理状态测验(RBANS)、威斯康星卡片分类测验(WCST)、Stroop色-词关联测验评估两组认知功能并进行比较。结果:睡眠障碍组RBANS即刻记忆(t=-4.309)、视觉广度(t=-2.321)、注意因子(t=-4.555)、延时记忆(t=-2.282)得分及总分(t=-2.549)、WCST完成分类数(t=-3.459)、学习到学会(t=-2.406)得分显著低于非睡眠障碍组(P<0.05或P<0.001);错误应答数(t=3.621)、持续性错误百分比(t=3.753)、Stroop色-词关联测验单色时间(t=2.010)、字义干扰反应时(t=2.168)、颜色干扰反应时(t=3.089)显著高于非睡眠障碍组(P<0.05或P<0.001)。结论:首发抑郁症患者的睡眠障碍与认知功能损害有一定关联;伴睡眠障碍者较不伴睡眠障碍者认知功能损害更严重。

Objective：To explore the relationship between sleep disorders and cognitive function in the patients with first-episode of depression. Method：The seventeen Hamilton depression scale（ HAMD-17 ）was used to assess the depressive symptoms of 378 patients with first-episode depression. They were divided into sleep disorder group（ HAMD~〉 14 and sleep factor score I〉4,253 cases） and non-sleep disorder group（ HAMD ≤ 14 and sleep factor score ≤3,125 cases） according to whether they were accompanied by sleep disorders. The two groups of cognitive functions were evaluated and compared using the he repeatable battery for the assess- mentof neuropsychological status （ RBANS）, Wisconsin card sorting test （WCAT） and Stroop color-wordassocia- tion test. Results：The scores of immediate memory（t = -4. 309） ,visual span（t = -2. 321 ） ,attention factor （ t = - 4. 555 ） , delayed memory（ t = - 2. 282 ） score and total score （ t = - 2. 549 ） of RBANS in sleep disorder group were lower than those of non-sleep disorder group（ P 〈 0.05 or P 〈 0. 001 ）. The sleep disorder group had lower scores on categories completed （ t = - 3. 459 ） , learningtolearned （ t = - 2. 406 ） of WCAT than non-sleep disorder group. The sleep disorder group had higher scores on response error（ t = 3. 621 ） and perseverative error- percentage （ t = 3. 753 ） than non-sleep disorder group; There were significant differences in the time of monochro- matic （ t = 2. 010 ）, semantic interference （ t = 2. 168 ） and color interference （ t = 3. 089 ） in the Stroop color- word association test between the two groups （ P 〈 0.05 or P 〈 0.001 ）. Conclusion： The sleep disorder have a certain relationship with cognitive impairment in the patients with first-episode of depression; patients with sleep disorders have more seriou scognitive dysfunction than those without sleep disorders.