未服药的双相抑郁患者执行功能的对照研究

A control study about the characteristics of executive function in untreated patients with bipolar depression

目的:探讨未服药双相抑郁(BP)患者执行功能状况,以及伴有焦虑症状对其执行功能的影响。方法:根据汉密尔顿焦虑量表(HAMA)评分,将46例BP患者(BP组)分为BP伴焦虑症状亚组(BP-A组:HAMA>14分,27例)和不伴焦虑症状亚组(BP-NA组:HAMA≤14分,19例);收集入组者的一般资料,使用Stroop色词测验(CWT)、威斯康星卡片分类测验(WCST)评估执行功能;结果与46名一般情况相匹配的健康对照者(NC组)比较。结果:BP组职业状态与NC组比较差异有统计学意义(χ~2=6.624,P=0.032),CWT中正确数和遗漏数、WCST中总应答数和测验完成时间与NC组比较差异有统计学意义(P<0.05或P<0.01);BP-A组、BP-NA组和NC组间年龄、婚姻状态、职业状态差异有统计学意义(P<0.05或P<0.01);BP-A组CWT中遗漏数明显高于NC组(SE=2.547,P=0.033),BPNA组WCST中完成分类数(CC)明显低于NC组,不能维持完整分数(FM)明显高于NC组(P均<0.05)。结论:未服药的BP患者执行功能受损,BP-A患者在压力性任务中执行功能表现更差,而BP-NA患者在非压力性任务中执行功能更差。

Objective： To investigate the characteristics of executive function in untreated patients with bipolar depression（ BP） and the influence of with anxiety symptoms on executive cognition. Method： According to the score of Hamilton rating scale for anxiety（ HAMA）,46 untreated BP patients were divided into the BP with anxiety symptoms group（ BP-A group： HAMA 14,27 cases） and without anxiety symptoms group（ BP-NA group： HAMA≤14,19 cases）. The clinical data of the patients were collected. The executive function were assessed by Stroop color-word test（ CWT） and Wisconsin card sorting test（ WCST）. The results were compared with 46 normal controls（ NC group）. Results： The occupational status between BP group and NC group showed significant difference（ χ~2= 6. 624,P = 0. 032）. The numbers of correct and missing of CWT and total number of responses and complete time of WCST between the BP group and NC group had significant differences（ P 0. 05 or P 0. 01）. The age,marital and occupational status were significantly different among the BP-A,BP-NA and NC groups（ P 0. 05 or P 0. 01）. Compared to NC group,the number of missing of CWT in BP-A was significantly higher（ SE = 2. 547,P = 0. 033）; the number of categories completed（ CC） of WCST was significantly lower and failure to maintain categories（ FM） of WCST was significantly higher in BPNA（ all P 0. 05）. Conclusion： Executive cognition in untreated BP patients presents impairment. BP-A patients performe worse in stress related tasks,and BP-NA patients performe worse in non-stress related tasks.