抑郁症患者急性期空间工作记忆与症状缓解期社会功能的关系

The relationship between spatial working memory in acute phase of depression and functional outcomes of remitted patients

目的:探索抑郁症患者急性期空间工作记忆与症状缓解期社会功能的关系。方法:纳入95例抑郁症患者,分别采用剑桥神经心理自动化成套测试(CANTAB)空间工作记忆测试(SWM)、汉密尔顿抑郁量表17项(HAMD-17)、社会功能筛选量表(SDSS)评估急性期空间工作记忆、抑郁症状、缓解期社会功能。进行组间差异比较、相关性分析、回归分析、路径分析。结果:症状缓解期有社会功能受损的患者SWM测试的总组内搜索错误数、4标志模式组内搜索错误数、8标志模式组内搜索错误数、总双重错误数、4标志模式双重错误数、6标志模式双重错误数较无社会功能受损患者更多(P<0.05或P<0.01);症状缓解期SDSS总分与SWM测试中总组内搜索错误数、4标志模式组内搜索错误数、8标志模式组内搜索错误数、总双重错误数、4标志模式双重错误数、HAMD睡眠障碍因子分正相关(P<0.05或P<0.01)。回归分析显示SWM总双重错误数(系数=0.162,P=0.028)、4标志模式双重错误数(系数=2.859,P<0.001)可预测症状缓解期SDSS总分;路径分析发现HAMD睡眠障碍因子分对SDSS总分的标准化直接效应为0.219(P=0.026)。结论:抑郁症患者急性期空间工作记忆及睡眠障碍症状分别与症状缓解期社会功能存在关联,空间工作记忆可能是症状缓解期社会功能的重要预测因素。

Objective:To explore the relationship between spatial working memory in acute phase of depression and functional outcomes of remitted patients.Method:Ninty-five patients with Major Depressive Disorder(MDD) were included,their spatial working memory was assessed during acute episodes by spatial working memory test(SWM) of Cambridge Neuropsychological Test Automated Battery(CANTAB).Depression severity was assessed by 17-item Hamilton Depression Rating Scale(HAMD).The social function was assessed by Social Disability Screening Schedule(SDSS) during symptomatic remission.Comparison of differences between groups,correlation analysis,regression analysis,and path analysis were performed.Results:The patients with impaired social function made significantly more SWM within errors,SWM within errors(4 boxes),SWM within errors(8 boxes),SWM double errors,SWM double errors(4 boxes),and SWM double errors(6 boxes)(P<0.05 or P<0.01 respectively).The SDSS score was significantly positively correlated with SWM within errors,SWM within errors(4 boxes),SWM within errors(8 boxes),SWM double errors,SWM double errors(4 boxes),and the HAMD sleep disturbance score(P<0.05 or P<0.01 respectively).Regression analysis suggested that the SWM double errors(coefficient=0.162,P=0.028)and SWM double errors(4 boxes)(coefficient=2.859,P<0.001)could predict the SDSS score during symptomatic remission.Path analysis showed a standardized direct effect of the HAMD sleep disturbance score on the SDSS score of 0.219(P=0.026).Conclusion:The spatial working memory and sleep disturbance during acute episodes in MDD patients are associated with social function during symptomatic remission,respectively.Spatial working memory may be a significant predictor of social functioning during symptom remission.