广泛性焦虑障碍住院患者与健康对照者的认知功能比较研究

Comparative Study of Cognitive Function in Inpatients with Generalized Anxiety Disorder and Healthy Controls

背景广泛性焦虑障碍(GAD)是常见的慢性精神疾病,常伴有不同程度的认知功能损害,严重影响患者的生活质量及社会功能。目的比较GAD住院患者与健康对照者认知功能的差异。方法选取2018年8月至2020年1月在南方医科大学南方医院住院治疗的GAD患者为GAD组(n=30),同期通过广告在南方医科大学南方医院住院患者陪护人员中招募年龄、性别相匹配的健康志愿者为健康对照组(n=30)。使用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)和Beck自杀意念量表中文版(BSI-CV)进行心理测评,采用精神运动警觉性任务(PVT)、Go/No-go联想任务、N-back任务分别评估认知功能的注意、抑制及工作记忆功能。比较两组一般情况、量表测评总分及认知功能差异,进一步采用多因素Logistic回归分析探究GAD住院患者和健康对照者的认知功能差异。结果GAD组HAMA、HAMD总分和最严重情况时BSI-CV总分及最严重情况时存在自杀意念者所占比例高于健康对照组(P<0.05)。N-back任务:GAD组1-back击中目标率(NBACK1a)、2-back击中目标率(NBACK2a)低于健康对照组,1-back击中目标的平均反应时(NBACK1b)长于健康对照组(P<0.05)。多因素Logistic回归分析结果显示,NBACK1a〔OR=0.946,95%CI(0.898,0.997),P=0.038〕、NBACK1b〔OR=1.007,95%CI(1.000,1.014),P=0.042〕是GAD的影响因素。结论与健康对照者相比,GAD住院患者的工作记忆较差,需要临床关注。

Background Generalized anxiety disorder is a common chronic psychiatric disorder,which leads to cognitive impairment and seriously affects the quality of life and social function of patients.Objective To compare the differences in cognitive function between GAD inpatients and healthy controls.Methods From August 2018 to January 2020,GAD patients hospitalized in Nanfang Hospital,Southern Medical University were selected as the GAD group(n=30).At the same time,age-and gender-matched healthy volunteers were recruited from the escorts of inpatients in Nanfang Hospital,Southern Medical University as the healthy control group(n=30).The Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD)and Beck scale for suicide ideation-Chinese Version(BSI-CV)were used for psychological evaluation.Psychomotor vigilance task(PVT),Go/No-go association task and N-back task were used to evaluate the cognitive function of attention,inhibition and working memory separately.The differences in general conditions,psychological characteristics,and cognitive function between two groups were compared.Multivariate Logistic regression analysis was further used to compare the differences in cognitive function between GAD inpatients and healthy controls.Results The total scores of HAMA and HAMD,the total scores of BSI-CV at the most severe condition and the proportion of the patients with suicidal ideation at the most severe condition in GAD group were higher than those in control group(P<0.05).N-back task:the percentage of hitting targets at 1-back(NBACK1a)and 2-back(NBACK2a)in GAD group were both significantly lower than that in control group(P<0.05);the average reaction time of hitting targets at 1-back(NBACK1b)in GAD group was significantly longer than that in control group(P<0.05).Multivariate Logistic regression analysis showed that NBACK1a〔OR=0.946,95%CI(0.898,0.997),P=0.038〕and NBACK1b〔OR=1.007,95%CI(1.000,1.014),P=0.042〕were the influencing factors of GAD.Conclusion GAD inpatients perform worse than healthy controls mainly in working memory,which deserves more clinical attention.