伴攻击行为酒精依赖患者认知功能与情感症状相关性研究

Correlation between cognitive function and emotional symptoms in alcohol dependent patients with aggressive behavior

目的研究伴攻击行为酒精依赖患者认知功能与情感症状相关性。方法前瞻性选取2019年1月20日至2019年12月20日于湖南省脑科医院酒瘾网瘾科住院的160例酒精依赖患者,按照修正版外显攻击行为量表(MOAS)评分结果划分为攻击组与非攻击组,各80例;同期通过招募形式纳入80例健康人群作为对照组。采用认知功能量表(RBANS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、躁狂量表(BRMS)对3组研究对象进行评估,比较各组在认知功能各维度、抑郁、焦虑、躁狂等方面的差异性。结果攻击组与非攻击组即时记忆、视觉广度、言语功能、注意功能及延时记忆评分分别为(30.94±6.37)、(15.25±4.19)、(29.04±5.06)、(64.98±10.21)、(54.34±17.34)分和(37.99±6.28)、(16.43±4.75)、(29.48±5.81)、(70.21±10.48)、(58.01±13.75)分,均低于对照组[(49.60±4.78)、(18.29±4.05)、(31.88±5.49)、(76.79±10.64)、(67.84±11.97)分],差异均有统计学意义(P<0.05);攻击组即时记忆、注意功能评分低于非攻击组,差异均有统计学意义(P<0.05),2组视觉广度、言语功能、延时记忆比较,差异无统计学意义(P>0.05)。攻击组与非攻击组HAMD、HAMA评分分别为(9.19±6.97)、(15.20±7.91)分和(6.45±5.10)、(11.19±5.63)分,高于对照组[(3.13±2.24)、(3.01±2.76)分],且攻击组HAMD、HAMA评分高于非攻击组,差异均有统计学意义(P<0.05)。攻击组与非攻击组BRMS评分为(4.18±5.13)和(4.12±4.24)分,高于对照组[(2.23±2.38)分],差异均有统计学意义(P<0.05),但攻击组与非攻击组BRMS评分差异无统计学意义(P>0.05)。经Pearson相关性分析,酒精依赖患者伴攻击行为与即时记忆、注意功能、焦虑、抑郁呈正相关(P<0.05)。结论伴攻击行为酒精依赖患者相对于无攻击行为患者在即时记忆与注意功能方面损伤更严重,合并焦虑、抑郁等情绪时更易发生攻击行为。

Objective To investigate the correlation between cognitive function and emotional symptoms in alcohol dependent patients with aggressive behavior.Methods A total of 160 patients with alcohol dependent hospitalized in the Department of Alcoholism and Internet Addiction of Hunan Brain Hospital from January 20,2019 to December 20,2019 were selected;Patients were divided into two groups according to results of the Modified Overt Aggression Scale(MOAS),aggression group and non-aggression group,with 80 cases in each group.Meantime,another 80 healthy individuals were set as control group.All selected individuals were assessed using various scales,including Repeatable Battery for the Assessment of Neuropsychological Status(RBANS),Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),and Bech-Rafaelsen Melancholia Scale(BRMS).Then the cognitive function,depression,anxiety and mania were compared among three groups.Results The scores of immediate verbal memory,visuospatial/constructional abilities,language,attention,and delayed memory of aggression group and non-aggression group were(30.94±6.37),(15.25±4.19),(29.04±5.06),(64.98±10.21),(54.34±17.34)points,respectively and(37.99±6.28),(16.43±4.75),(29.48±5.81),(70.21±10.48),(58.01±13.75)points,which were significantly lower than those of control group[(49.60±4.78),(18.29±4.05),(31.88±5.49),(76.79±10.64),(67.84±11.97)points],the differences were statistically significant(P<0.05).The scores of immediate verbal memory and attention of aggression group were significantly lower than those of non-aggression group(P<0.05),while There was no statistically significant difference in the scores of visuospatial/constructional abilities,language,and delayed memory between the two groups(P>0.05).The HAMD and HAMA scores of the aggressive group and the non-aggression group were(9.19±6.97),(15.20±7.91)points and(6.45±5.10),(11.19±5.63)points,respectively,which were higher than those of the control group[(3.13±2.24),(3.01±2.76)points],and the scores of aggressive group were significantly higher than those of non-aggressive group,the differences were statistically significant(P<0.05).BRMS scores of the aggression group and non-aggression group were(4.18±5.13)and(4.12±4.24)points,which were higher than those of the control group[(2.23±2.38)points],and the differences were statistically significant(P<0.05),but BRMS scores of the aggression group and non-aggression group were not statistically significant(P>0.05).Pearson correlation analysis showed that aggressive behavior in alcohol-dependent patients was positively correlated with immediate verbal memory,attention function,anxiety and depression(P<0.05).Conclusion Patients with alcohol dependence with aggressive behaviors have more severe impairment in immediate verbal memory and attention than those without aggressive behaviors,and are more likely to engage in aggressive behaviors when combined with anxiety and depression.