抑郁和焦虑情绪在癫痫患者客观认知功能和主观记忆间的中介作用

The mediating effect of depression and anxiety between objective cognitive function and subjective memory in patients with epilepsy

目的探讨癫痫患者客观认知功能和主观记忆的关系, 以及抑郁和焦虑的内在作用机制。方法共纳入123例癫痫患者, 收集其基本信息及临床资料, 采用癫痫患者生活质量评定量表-89记忆子量表、贝克抑郁量表第二版、贝克焦虑量表和重复成套神经心理状态测验分别评估癫痫患者的主观记忆、抑郁状态、焦虑状态和客观认知功能。采用SPSS 25.0进行双变量Spearman相关分析和多元回归分析, PROCESS V3.5宏程序进行Bootstrap中介效应检验。结果相关性分析表明, 癫痫患者客观认知功能评分与抑郁评分(r=-0.392, P<0.01)、焦虑评分(r=-0.310, P<0.01)均呈显著负相关、与主观记忆评分(r=0.388, P<0.01)呈显著正相关;主观记忆与抑郁评分(r=-0.436, P<0.01)、焦虑评分(r=-0.395, P<0.01)呈显著负相关。中介效应分析表明, 癫痫患者客观认知功能可以通过抑郁和焦虑的中介作用间接对主观记忆造成影响, 其中介效应分别占总效应的33.87%, 17.93%。结论癫痫患者客观认知功能、抑郁、焦虑与主观记忆密切相关, 抑郁和焦虑在癫痫患者客观认知功能和主观记忆之间起中介作用。

Objective To explore the relationship between objective cognitive function and subjective memory in patients with epilepsy and the mediating effect of depression and anxiety.Methods A total of 123 patients with epilepsy were included,and their basic information and clinical data were collected.The quality of life in epilepsy inventory-89 memory subscale,Beck depression inventoryⅡ,Beck anxiety scale and repeatable battery for the assessment of neuropsychological status were used to evaluate the subjective memory,depression,anxiety and objective cognitive function of patients with epilepsy.SPSS 25.0 software was used for bivariate correlation analysis and multiple regression analysis,and PROCESS V3.5 macro program was used for Bootstrap mediating effect test.Results(1)Correlation analysis showed that the objective cognitive function score of patients with epilepsy was negatively correlated with depression score(r=-0.392,P<0.01)and anxiety score(r=-0.310,P<0.01),while positively correlated with subjective memory score(r=0.388,P<0.01).Subjective memory score was significantly negatively correlated with depression score(r=-0.436,P<0.01)and anxiety score(r=-0.395,P<0.01).(2)The mediating effects analysis showed that objective cognitive function of patients with epilepsy could affect the subjective memory through the mediating effects of depression and anxiety indirectly.The mediating effect accounted for 33.87%and 17.93%of the total effects respectively.Conclusion Objective cognitive function,depression and anxiety are closely related to subjective memory in patients with epilepsy.Depression and anxiety play a mediating role between objective cognitive function and subjective memory in patients with epilepsy.