认知功能对抑郁症住院患者治疗反应的预测

Cognitive function predicts treatment response of inpatients with major depressive disorder

目的探讨抗抑郁药物治疗反应中的认知预测因子。方法采用汉密尔顿抑郁量表(HAMD-17)和焦虑量表(HAMA)及数字符号编码测验(DSCT)和简易视觉空间记忆测验-修订版(BVMT-R)评估60例抑郁症住院患者的临床症状和认知功能。结果治疗应答组的基线HAMD-17评分(P=0.005)、HAMA评分(P=0.013)均较治疗无应答组低。临床缓解组的基线HAMD-17评分(P<0.001)、HAMA评分(P=0.013)及HAMA评分≥14的患者比例(P=0.022)均较临床未缓解组低,而首次发作患者比例高于临床未缓解组(P=0.019)。治疗无应答组的基线DSCT(P=0.004)及BVMT-R T3评分(P=0.042)明显高于治疗应答组。多元线性回归结果显示,首次发作(β=-2.750,P=0.028)、基线HAMD-17评分(β=0.841,P<0.001)以及DSCT评分(β=0.180,P=0.003)对治疗后HAMD-17评分有预测作用。结论抑郁症住院患者的基线认知功能对其抗抑郁药物的治疗反应有预测作用。

Objective To explore the cognitive predictors of response to antidepressant treatment.Methods We used the Hamilton Depression Rating Scale(HAMD-17),the Hamilton Anxiety Rating Scale(HAMA),the Digit Symbol Coding Test(DSCT),and the Brief Visuospatial Memory Test-Revised(BVMT-R)to evaluate 60 inpatients with major depressive disorder(MDD).Results The results showed the baseline HAMD-17 scores(P=0.005)and HAMA scores(P=0.013)of the responders were lower than those of the nonresponders.Compared with the non-remission group,the baseline HAMD-17 scores(P<0.001),HAMA scores(P=0.013),and the proportion of patients with HAMA scores≥14 in the remission group were lower,while the proportion of first depressive episode(P=0.019)was higher.The baseline DSCT scores(P=0.004)and BVMT-R T3 scores(P=0.042)of the non-responders were higher than those of the responders.The results of multiple linear regression revealed that the first episode(β=-2.750,P=0.028),baseline HAMD-17 scores(β=0.841,P<0.001),and baseline DSCT scores(β=0.180,P=0.003)significantly predicted post-treatment HAMD-17 scores in MDD patients.Conclusion The baseline cognitive function of MDD inpatients has a predictive effect on their response to antidepressant treatment.