目的 探讨伴焦虑症状的抑郁症患者认知功能的特点及其影响因素.方法 对458名首发抑郁症患者使用汉密尔顿焦虑量表(HAMA)评定焦虑程度,根据量表得分划分为无焦虑症状组(n=76)和伴焦虑症状组(n=266),并使用威斯康星卡片分类测验(WCST)、Stroop色-词关联测验、可重复性成套神经心理状态测验(RBANS)评定其认知功能.结果 (1)无焦虑症状组在完成分类数、学习到学会、即刻记忆、视觉广度、注意、延时记忆上的得分[分别为(2.88±2.14)分,(64.16±24.20)分,(81.78±17.16)分,(84.08±15.41)分,(106.45±20.72)分,(86.12± 13.06)分]高于伴焦虑症状组[分别为(2.07±1.98)分,(54.33±27.05)分,(70.47±17.61)分,(79.76±14.63)分,(98.25±17.11)分,(79.97±16.10)分],差异有统计学意义(P<0.01或P<0.05);无焦虑症状组在在错误应答数、持续错误百分比、单色时间、字义干扰时、颜色干扰时上的得分[分别为(61.21±21.50)分,(17.11±6.10)分,(19.04±6.57)分,(15.01±9.11)分,(2.79±2.82)分]低于伴焦虑症状组[分别为(67.20±21.87)分,(19.21±7.18)分,(21.03±7.69)分,(17.92±10.64)分,(3.86±5.61)分],差异有统计学意义(P<0.05).(2)受教育年限、年龄、躯体性焦虑、精神性焦虑共同解释了即刻记忆28.1%的变异量(F=25.015,P<0.01);受教育年限和精神性焦虑共同解释了延时记忆19.8%的变异量(F=31.625,P<0.01);年龄和精神性焦虑共同解释了字义干扰时13.6%的变异量(F=20.293,P<0.01).结论 伴焦虑症状的抑郁症在执行功能、认知加工速度、记忆及注意上的损伤比无焦虑症状的抑郁症更为严重,受教育年限、年龄、精神性焦虑及躯体性焦虑是其影响因素.
Objective To investigate the cognitive impairment in depression with anxiety symptom and its influencing factors.Methods 458 first-episode depression patients were assessed with Hamilton Anxiety Scale (HAMA).According to the score of HAMA,the patients with depression were divided into with anxiety symptom group (n=266) and without anxiety symptom group (n=76).Using Wisconsin Card Sorting Test (WCST),Stroop Color-Word Test,Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to assess neuropsychological function.Results (1)The group without anxiety symptom had higher scores on categories completed (2.88 ± 2.14),learning to learned (64.16 ± 24.20),immediately memory(81.78± 17.16),visual span(84.08± 15.41),attention(106.45±20.72) and delayed memory (86.12 ±13.06) than the group with anxiety symptom had ((2.07± 1.98),(54.33±27.05),(70.47± 17.61),(79.76± 14.63),(98.25± 17.11),(79.97± 16.10) respectively),and all these differences were significant (P〈0.01or P〈0.05).The group without anxiety symptom had lower scores on response error(61.21±21.50),perseverative error percentage(17.11±6.10),monochrome time (19.04±6.57),time of meaning interference (15.01 ±9.11) and time of color interference (2.79 ± 2.82) than the group with anxiety symptom had ((67.20 ±21.87),(19.21±7.18),(21.03±7.69),(17.92± 10.64),(3.86±5.61) respectively),and all these differences were significant (P〈0.05).(2)The combination of educational years,age,somatic anxiety and psychic anxiety explained the 28.1% variances of immediately memory(F=25.015,P〈0.01);the combination of educational years and psychic anxiety explained the 19.8% variances of delayed memory(F=31.625,P〈0.01);and the combination of age and psychic anxiety explained the 13.6% variances of time of meaning interference (F=20.293,P〈0.01).Conclusion Depression with anxiety symptom has more severe