伴自伤行为青少年抑郁障碍患者认知功能与临床特征的相关性

Correlation of cognitive function and clinical characteristics in adolescent depressive disorder patients with self-injury behavior

目的研究伴自伤行为的青少年抑郁障碍患者认知功能与成瘾、冲动及快感缺失的相关性。方法纳入2021年9月至2022年10月在青岛市精神卫生中心门诊就诊的青少年抑郁障碍患者,根据有无自伤行为,分为自伤组及非自伤组,每组各60人,使用自编一般资料调查表、17项汉密尔顿抑郁量表(17 items Hamilton depression rating scale,HAMD-17)、渥太华自伤量表(Ottawa self-injury inventory,OSI)、Barratt冲动量表中文版(Chinese version of the Barratt impulsiveness scale,BIS-11)、愉快情绪体验量表(temporal experience of pleasure scale,TEPS)对两组进行评分,中国简版神经认知成套测验(Chinese brief cognitive test,C-BCT)对两组的认知功能进行评分,使用SPSS 26.0统计分析软件对数据进行t检验、χ^(2)检验、Pearson相关分析及多元线性回归分析等统计学处理。结果自伤组的OSI成瘾因子得分[(9.43±8.29)分]、BIS-11得分[(67.09±11.48)分]均高于非自伤组[OSI成瘾因子得分:0分,BIS-11得分:(53.70±7.12)分,t=6.22,5.91,均P<0.05],TEPS得分及C-BCT各维度得分均低于非自伤组(t=-2.93,-2.01,-2.88,-2.20,-5.35,均P<0.05);其中信息处理速度与BIS-11得分呈负相关(r=-0.296,P<0.05),注意力得分与OSI成瘾因子得分和BIS-11得分呈负相关(r=-0.303,-0.561,均P<0.05),与TEPS得分、期待性快感缺失分量表得分呈正相关(r=0.364,0.318,均P<0.05);工作记忆得分与OSI成瘾因子得分和BIS-11得分呈负相关(r=-0.312,-0.416,均P<0.05);综合能力+执行能力与OSI成瘾因子得分和BIS-11得分呈负相关(r=-0.308,-0.679,均P<0.05),与TEPS得分呈正相关(r=0.304,P<0.05)。多元线性回归分析显示BIS-11得分是C-BCT各维度的影响因素(β=-0.260,-0.592,-0.557,-1.797,t=-2.150,-3.314,-2.285,-5.165,均P<0.05)。结论伴自伤行为的青少年抑郁障碍患者认知功能与成瘾、冲动及快感缺失存在相关性,其中冲动是认知功能损害的危险因素。

Objective To investigate the correlation between cognitive function and addiction,impulsivity,and anhedonia in adolescent depressive disorder patients with self-injury behavior.Methods From September 2021 to October 2022,adolescents with depressive disorders who visited the outpatient department of the Qingdao Mental Health Center were enrolled and divided into self-injury group and non self-injury group based on the presence or absence of self-injury behaviors,each with 60 participants.A self-compiled general information questionnaire,the 17 items Hamilton depression rating scale(HAMD-17),the Ottawa self-injury inventory(OSI),the Chinese version of the Barratt impulsiveness scale(BIS-11),and the temporal experience of pleasure scale(TEPS)were used to evaluate both groups.The Chinese brief cognitive test(C-BCT)was used to assess cognitive function in both groups.SPSS 26.0 software was used for statistical analysis,including t-test,χ^(2) test,Pearson correlation analysis,and multiple linear regression analysis.Results The self-injury group had higher scores for OSI addiction factors(9.43±8.29)and BIS-11(67.09±11.48)compared to the non self-injury group(OSI addiction factor scores:0,BIS-11 scores:53.70±7.12,t=6.22,5.91,both P<0.05).TEPS score and C-BCT scores in various dimensions were lower in the self-injury group than those in the non self-injury group(t=-2.93,-2.01,-2.88,-2.20,-5.35,all P<0.05).Information processing speed was negatively correlated with BIS-11 score(r=-0.296,P<0.05),and attention score were negatively correlated with OSI addiction factor score and BIS-11 score(r=-0.303,-0.561,both P<0.05)and positively correlated with TEPS score(r=0.364,P<0.05),including a positive correlation with the scale of anticipatory anhedonia score(r=0.318,P<0.05).Working memory score was negatively correlated with OSI addiction factor score and BIS-11 score(r=-0.312,-0.416,both P<0.05).Comprehensive ability and executive function scores were negatively correlated with OSI addiction factor score and BIS-11 score(r=-0.308,-0.679,both P<0.05),and positively correlated with TEPS score(r=0.304,P<0.05).Multiple linear regression analysis showed that BIS-11 scores were influencing factors of C-BCT dimensions(β=-0.260,-0.592,-0.557,-1.797,t=-2.150,-3.314,-2.285,-5.165,all P<0.05).Conclusion In adolescent depressive patients with self-injury,cognitive function is correlated with addiction,impulsivity and anhedonia,among which impulsivity is a risk factor for cognitive function.