抑郁发作和双相情感障碍住院患者自知力与认知功能关系研究

Relationship between insight and cognitive function in inpatients with depressive episode and bipolar disorder

目的分析抑郁发作和双相情感障碍住院患者自知力与认知功能的关系。方法选取40例抑郁发作患者(A组),80例双相情感障碍患者,其中40例双相障碍抑郁发作患者作B组,40例双相障碍狂躁发作患者作C组;同时选取同期入院体检的40名健康者作对照组,以汉密尔顿抑郁量表(HAMD)对患者病情状况进行评定,并以自知力与治疗态度问卷(ITAQ)、重复性成套神经心理状态测验(RBANS)分别评定四组自知力及认知功能。结果A组、B组、C组和对照组ITAQ及RBANS评分比较差异均有统计学意义(P<0.05)。进一步两两比较结果显示,A组ITAQ总分及对疾病认知、对用药态度的认知因子分和RBANS总分及即刻记忆因子分均低于对照组(P<0.05),B组ITAQ总分及各因子分和RBANS总分及即刻记忆、延时记忆因子分均低于对照组(P<0.05),C组ITAQ、RBANS总分及各因子分均低于对照组(P<0.05);A组、B组ITAQ、RBANS总分及各因子分均高于C组(P<0.05)。A组ITAQ中对病情复发及求助方法的认知与RBANS中语言功能呈正相关(P<0.05),ITAQ中对用药态度的认知与RBANS中注意呈正相关(P<0.05)。B组ITAQ总分及对住院认知与HAMD中迟缓均呈正相关(P<0.05)。C组ITAQ中对病情复发及求助方法的认知和对用药态度的认知与RBANS中注意均呈正相关(P<0.05)。结论抑郁发作患者和双相情感障碍住院患者在自知力以及认知功能方面均有缺陷,且患者的认知功能及其自知力还存在相关性。

Objective To explore the relationship between insight and cognitive function in inpatients with depressive episode and bipolar disorder.Methods A total of 40 patients with depressive episode(group A),80 patients with bipolar disorder divided into 40 patients with bipolar disorder of depressive episode(group B)and 40 patients with bipolar disorder of manic episode(group C)and 40 healthy controls in control group were selected and assessed with Hamilton Depression Scale(HAMD),Insight and Treatment Attitudes Questionnaires(ITAQ)and Repeatable Battery for the Assessment of Neuropsychological Status(RBANS).Results There existed significant differences in the total scores of ITAQ and RBANS among group A,group B,group C and control group(P<0.05).In group A,the total score and factor scores of disease cognition,attitude to medication of ITAQ and the total score and factor score of immediate memory of RBANS were all significantly lower than those in control group(P<0.05).In group B,the total score and all factor scores of ITAQ and the total score and factor scores of immediate memory and delayed memory of RBANS were all significantly lower than those in control group(P<0.05).In group C,the total scores and all factor scores of ITAQ,RBANS were all significantly lower than those in control group(P<0.05).The total scores and all factor scores of ITAQ,RBANS in group A and group B were all significantly higher than those in group C(P<0.05).In group A,the cognition of disease recurrence and help-seeking methods in ITAQ was positively correlated with language function in RBANS(P<0.05)and cognition of medication attitudes in ITAQ was positively correlated with attention in RBANS(P<0.05).In group B,the total score and hospitalization cognition in ITAQ were positively correlated with the delay in HAMD(P<0.05).In group C,the cognition of disease recurrence and help-seeking methods and cognition of medication attitudes in ITAQ were positively correlated with attention in RBANS(P<0.05).Conclusion There exist defects in self-insight and cognitive function in patients with depressive episode and inpatients with bipolar disorder,and there is a correlation between their cognitive function and self-insight.