强迫症患者前瞻记忆缺损程度对SSRIs疗效的预测作用

Predictive role of the degree of prospective memory impairment on treatment response to SSRIs in patients with obsessive-compulsive disorder

目的探究强迫症患者前瞻记忆缺损程度对选择性5-羟色胺再摄取抑制剂(SSRIs)疗效的预测作用。方法选择符合《精神障碍诊断与统计手册(第4版)》修订版(DSM-IV-TR)强迫症诊断标准的30例强迫症患者为研究对象,对患者进行为期4周的SSRIs药物治疗。采用耶鲁布朗强迫症状量表(Y-BOCS)评定患者治疗前后强迫症状的严重程度,以Y-BOCS总评分减分率评定疗效,并比较患者治疗前后基于事件、基于时间和基于活动的前瞻记忆任务正确率。结果治疗后,强迫症患者Y-BOCS总评分低于治疗前[(27.07±4.63)分vs.(24.87±5.93)分,F(1,29)=4.984,P=0.033],基于事件和基于时间的前瞻记忆任务正确率高于治疗前[(0.78±0.21)vs.(0.88±0.11),F(1,29)=9.022,P=0.005;(0.81±0.17)vs.(0.91±0.11),F(1,29)=9.063,P=0.005],患者基线基于事件的前瞻记忆任务正确率与Y-BOCS总评分减分率呈正相关(r=0.478,P=0.014),基线基于事件的前瞻记忆水平可正向预测SSRIs疗效(β=0.441,P=0.014)。结论强迫症患者基线基于事件的前瞻记忆水平可预测SSRIs疗效,前瞻记忆水平越高,SSRIs疗效越好。

Objective To explore the predictive role of the degree of prospective memory impairment on the treatment response to Selective Serotonin Reuptake Inhibitors(SSRIs)in patients with obsessive-compulsive disorder.Methods A total of 30 patients with obsessive-compulsive disorder who met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders,fourth edition,text revision(DSM-IV-TR)were selected,and all patients were treated with SSRIs for 4 weeks.The severity of obsessive-compulsive symptom was assessed using Yale-Brown Obsessive Compulsive Scale(Y-BOCS),and the efficacy was evaluated by the reduction rate of Y-BOCS score.Moreover,the performance of event-based,time-based and activity-based prospective memory tasks were compared before and after treatment.Results After treatment,the total Y-BOCS score of patients was lower than before treatment[(27.07±4.63)vs.(24.87±5.93),F(1,29)=4.984,P=0.033],meantime,the performance of event-and time-based prospective memory tasks was improved[(0.78±0.21)vs.(0.88±0.11),F(1,29)=9.022,P=0.005;(0.81±0.17)vs.(0.91±0.11),F(1,29)=9.063,P=0.005].Correlation analysis showed that the performance of event-based prospective memory at baseline was positively correlated with the reduction of Y-BOCS score(r=0.478,P=0.014).The event-based prospective memory performance at baseline could positively predict the treatment response to SSRIs treatment in patients(β=0.441,P=0.014).Conclusion The event-based prospective memory function of patients with obsessive-compulsive disorder can positively predict SSRIs treatment outcome,and patients with better prospective memory performance yield better treatment responses.