晚发抑郁症患者抑郁程度与神经认知功能的相关性研究

Correlation analysis of depression severity and neurocognitive function in patients with late-onset depression

目的探究晚发抑郁症患者抑郁严重程度与神经认知功能的相关性。方法选取2015年2月—2017年12月金华市第二医院收治的晚发抑郁症患者,根据汉密尔顿抑郁量表(HAMD-17)评估抑郁严重程度,并分为轻度、中度和重度组,同期≥60岁健康体检人员纳入对照组,采用威斯康星卡片分类测验(WCST)、词语流畅性测验(VFT)和Stroop字色干扰测验评估神经认知功能,比较4组研究对象的3项测验结果差异,分析HAMD-17评分与3项测验结果的相关性。结果轻度、中度、重度和对照组分别纳入32、28、35和35人。与对照组比较,轻度、中度和重度组患者的WCST错误应答数、持续性应答数、持续性错误数均增加,概念化水平应答百分数减少(均P<0.05);轻度、中度和重度组3组比较,错误应答数、持续性应答数、持续性错误数和持续性错误百分数均依严重程度递增,概念化水平应答百分数依严重程度递减(均P<0.05)。重度组患者的Stroop测验一致组正确数、VFT正确数均少于对照组、轻度组和中度组(均P<0.05),而轻度组和中度组患者与对照组差异均无统计学意义(P>0.05)。HAMD-17量表评分与Stroop测验一致组正确数(r=-0.448,P<0.001)、VFT正确数(r=-0.401,P<0.001)呈负相关,与WCST持续应答数呈正相关(r=0.784,P<0.001)。结论晚发抑郁症患者抑郁严重程度加重,其神经认知功能损伤也随之加重。

Objective To explore the correlation between depression severity and neurocognitive function in patients with late-onset depression.Methods The patients with late-onset depression treated in Jinhua Second hospital from February2015to December2017were assigned into the mild,moderate and severe groups according to the severity of depression assessed by the Hamilton Depression Scale-17(HAMD-17).At the same time,some healthy persons were selected as the control group.Wisconsin Card Sorting Test(WCST),Verbal Fluency Test(VFT)and Stroop Test were carried out,and the scores of these tests were compared in the four groups.The correlations of WCST,VFT,Stroop Test and HAMD-17scores were analyzed.Results There were32,28,35and35subjects involved in the mild,moderate,severe and control group,respectively.The subjects of the mild group,moderate group and severe group had more total errors,perseverative responses and perseverative errors than the control group,and less percent conceptual level responses than the control group(all P<0.05).The total errors,perseverative responses,perseverative errors and percent perseverative errors increased and the percent conceptual level responses decreased gradually with the severity of depression(all P<0.05).The correct numbers of Stroop-consistent group and VFT in the severe group were less than those in the control,mild and moderate group(all P<0.05),which was significantly different between the mild,moderate and control group(P>0.05).The HAMD-17scores were negatively correlated with the correct numbers of Stroop congruent group(r=-0.448,P<0.001)and VFT(r=-0.401,P<0.001),and were positively correlated with perseverative responses in the WCST(r=0.784,P<0.001).Conclusion The neurocognitive impairment in patients with late-onset depression aggravated with the severity of depression.