抑郁障碍患者认知功能损害及与临床症状的关系研究

发布时间：2018-03-05 03:19

  本文选题：抑郁障碍　切入点：认知功能损害　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的本研究旨在明确抑郁障碍患者认知功能损害的特点,并在此基础上探究认知功能损害与临床症状的关系。方法首先以数据库中484例抑郁障碍患者和194例正常对照为研究对象,采用重复性成套神经心理状态测验(Repeatable Battery for the Assessment of Neuropsychologital Status,RBANS)、stroop色词测验等评估患者及正常对照的认知功能,分析患者认知功能损害的特点;采用汉密尔顿抑郁量表(Hamilton Depression Scale-17,HAMD)、汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)等评估患者的临床症状,分析临床症状与认知功能损害的关系。另选取60例抑郁障碍患者为调查对象进行3个月的调查,分别于基线、2周末、4周末、6周末、8周末、3个月时评估HAMD、HAMA,于基线、6周末、3个月时进行RBANS、stroop色词测验评估,分析临床症状与认知损害的关系。依据3个月时HAMD得分将抑郁障碍患者分为临床治愈组(HAMD≤7)、未临床治愈组(HAMD7),分析患者认知功能损害的特点。另收集9名抑郁障碍患者,进行访谈和病例资料收集,了解抑郁障碍患者认知功能损害的特点。结果1.抑郁障碍患者与正常对照在认知功能方面存在显著差异(t=2.85,p=0.004)。人口学变量中受教育年限(B=0.416,t=9.49,p0.001),年龄(B=-0.121,t=-2.76,p=0.006)共同解释RBANS22.4%的变异量。2.6周末(t=-5.76,p0.001)、3个月(t=-2.34,p=0.024)的RBANS与基线水平的差异均有统计学意义。3个月时,临床治愈组与未临床治愈组在RBANS上的差异没有统计学意义(Z=-1.22,p=0.231)。3.抑郁障碍患者睡眠障碍因子(B=-0.233,t=-4.85,p0.001)、躯体化焦虑因子(B=-0.118,t=-2.57,p=0.011)共解释RBANS8%的变异量。4.基线水平的焦虑因子解释3个月时RBANS21.5%的变异量(B=0.414,F=12.32,p=0.001)。基线水平的躯体性焦虑解释3个月的即刻记忆10.1%的变异量(B=-0.317,F=5.03,p=0.030),基线水平的精神性焦虑解释3个月的视觉广度11.6%的变异量(B=0.340,F=5.88,p=0.019)。结论1.抑郁障碍患者普遍存在认知功能损害。人口学变量(受教育年限、年龄)可以预测认知功能损害。2.抑郁障碍患者在症状恢复后仍然存在认知功能受损。3.抑郁障碍临床症状与认知功能存在一定的关系。睡眠障碍、躯体化焦虑预测了认知功能水平。4.基线的焦虑因子得分可以预测3个月之后的认知功能。基线水平的躯体性焦虑可以预测3个月之后的即刻记忆,基线水平的精神性焦虑可以预测3个月之后的视觉广度。
[Abstract]:Objective to investigate the characteristics of cognitive impairment in patients with depression. On this basis, the relationship between cognitive impairment and clinical symptoms was explored. Methods 484 patients with depression and 194 normal controls were selected as subjects. The repetitive Battery for the Assessment of Neuropsychologital status test was used to evaluate the cognitive function of patients and normal controls, and the characteristics of cognitive impairment were analyzed. Hamilton Depression Scale-17 Hamd and Hamilton Anxiety scale were used to evaluate the clinical symptoms and analyze the relationship between clinical symptoms and cognitive impairment. 60 patients with depressive disorder were investigated for 3 months. Hamd Hama was evaluated at 3 months, and RBANS stroop color word test was performed at baseline 6 weeks and 3 months, respectively, at baseline 2 weekends, 4 weekends, 6 weekends, 6 weekends, 8 weekends, 3 months, respectively. The relationship between clinical symptoms and cognitive impairment was analyzed. According to the HAMD score of 3 months, depressive disorder patients were divided into two groups: clinical cured group (Hamd 鈮，

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