目的探讨首发抑郁症的认知功能损害特点。方法对112例首发抑郁症患者和47例正常对照采用韦氏成人智力量表、韦氏记忆量表、威斯康星卡片分类测验(WCST)进行检测。采用汉密尔顿抑郁量表(HAMD)对抑郁症患者进行抑郁状态评估。结果抑郁症组的心智、图片、再认、再生、联想、理解、背数、记忆商数、言语智商数、操作智商数、智商数均明显低于对照组(P〈0.05)。抑郁症组的WCST完成分类数明显低于对照组,总测验数明显高于对照组,差异均有统计学意义(P〈0.05)。相关分析显示,HAMD总分和心智、图片、再认、再生、联想、触觉、理解、背数、记忆商数、言语智商、操作智商、智商和完成分类数呈负相关(P〈0.05);焦虑/躯体化因子和再认、再生、背数呈负相关(P〈0.05);体重因子和图片、触觉呈负相关(P〈0.05);认识障碍因子和图片、再生、联想、触觉、背数、完成分类数呈负相关(P〈0.05);阻滞因子和心智、图片、再生、联想、理解、背数、记忆商数、言语智商、完成分类数呈负相关(P〈0.05);睡眠障碍因子和心智、图片、再认、再生、联想、触觉、理解、背数、记忆商数、言语智商、操作智商、智商、完成分类数、概念化水平、百分数呈负相关(P〈0.05)。结论首发抑郁症患者可能存在比较严重的全面认知功能损害,范围比较广,且抑郁症症状能够影响患者的认知能力。
Objective: To investigate the damaging traits of cognitive function and the related factors in first - episode patients with major depressive disorder. Methods: One hundred and twelve patients with major depressive disorder and 47 normal controls were measured with Wechsler adult intelligence scale ( WAIS), Wechsler memory scale (WMS) and Wisconsin card sorting test (WCST). The depressive symptoms were assessed with Hamilton depression scale (HAMD). Results:In the patient group, the memory quotient (MQ) score, verbal quotient (VIQ)score , practical quotient (PIQ)score , IQ score and the score of the total trials, preservative errors and random errors in the WCST were significanltly lower than that of the control group ( P 〈 0.01 or P 〈 0. 05 ). Pearson correlation analysis showed that the scores of arithmetic, figure, recognition, regeneration, association, tactual performance test, comprehension, digit span, MQ, VIQ, PIQ, IQ and correct categories were negatively correlated with the HAMD total score(P 〈 0.05). The scores of recognition, regeneration and digit span were negatively correlated with anxiety somatization factor score ( P 〈 0.05 ). The figure and tactual performance test score were negatively correlated with weigh factor score ( P 〈 0.05 ). The scores of figure, regeneration, association, tactual performance test, digit span and correct categories were negatively correlated with cognitive disturbance factor score ( P 〈 0.05 ). The scores of arithmetic, figure, regeneration, association, comprehension, digit span, MQ, VIQ and correct categories were negatively correlated with retardation factor score ( P 〈 0.05 ). The scores of arithmetic, figure, recognition, regeneration, association, comprehension, taetual performance test, digit span, MQ, VIQ, PIQ, IQ, correct categories and conceptual level were negatively correlated with sleep disterbance factor score ( P 〈 0.05 ). Conclusion : There may be cognitive dysfunctions in p