本文選題：抑郁障礙　切入點(diǎn)：認(rèn)知功能損害　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的本研究旨在明確抑郁障礙患者認(rèn)知功能損害的特點(diǎn),并在此基礎(chǔ)上探究認(rèn)知功能損害與臨床癥狀的關(guān)系。方法首先以數(shù)據(jù)庫中484例抑郁障礙患者和194例正常對照為研究對象,采用重復(fù)性成套神經(jīng)心理狀態(tài)測驗(yàn)(Repeatable Battery for the Assessment of Neuropsychologital Status,RBANS)、stroop色詞測驗(yàn)等評估患者及正常對照的認(rèn)知功能,分析患者認(rèn)知功能損害的特點(diǎn);采用漢密爾頓抑郁量表(Hamilton Depression Scale-17,HAMD)、漢密爾頓焦慮量表(Hamilton Anxiety Scale,HAMA)等評估患者的臨床癥狀,分析臨床癥狀與認(rèn)知功能損害的關(guān)系。另選取60例抑郁障礙患者為調(diào)查對象進(jìn)行3個(gè)月的調(diào)查,分別于基線、2周末、4周末、6周末、8周末、3個(gè)月時(shí)評估HAMD、HAMA,于基線、6周末、3個(gè)月時(shí)進(jìn)行RBANS、stroop色詞測驗(yàn)評估,分析臨床癥狀與認(rèn)知損害的關(guān)系。依據(jù)3個(gè)月時(shí)HAMD得分將抑郁障礙患者分為臨床治愈組(HAMD≤7)、未臨床治愈組(HAMD7),分析患者認(rèn)知功能損害的特點(diǎn)。另收集9名抑郁障礙患者,進(jìn)行訪談和病例資料收集,了解抑郁障礙患者認(rèn)知功能損害的特點(diǎn)。結(jié)果1.抑郁障礙患者與正常對照在認(rèn)知功能方面存在顯著差異(t=2.85,p=0.004)。人口學(xué)變量中受教育年限(B=0.416,t=9.49,p0.001),年齡(B=-0.121,t=-2.76,p=0.006)共同解釋RBANS22.4%的變異量。2.6周末(t=-5.76,p0.001)、3個(gè)月(t=-2.34,p=0.024)的RBANS與基線水平的差異均有統(tǒng)計(jì)學(xué)意義。3個(gè)月時(shí),臨床治愈組與未臨床治愈組在RBANS上的差異沒有統(tǒng)計(jì)學(xué)意義(Z=-1.22,p=0.231)。3.抑郁障礙患者睡眠障礙因子(B=-0.233,t=-4.85,p0.001)、軀體化焦慮因子(B=-0.118,t=-2.57,p=0.011)共解釋RBANS8%的變異量。4.基線水平的焦慮因子解釋3個(gè)月時(shí)RBANS21.5%的變異量(B=0.414,F=12.32,p=0.001)�；�水平的軀體性焦慮解釋3個(gè)月的即刻記憶10.1%的變異量(B=-0.317,F=5.03,p=0.030),基線水平的精神性焦慮解釋3個(gè)月的視覺廣度11.6%的變異量(B=0.340,F=5.88,p=0.019)。結(jié)論1.抑郁障礙患者普遍存在認(rèn)知功能損害。人口學(xué)變量(受教育年限、年齡)可以預(yù)測認(rèn)知功能損害。2.抑郁障礙患者在癥狀恢復(fù)后仍然存在認(rèn)知功能受損。3.抑郁障礙臨床癥狀與認(rèn)知功能存在一定的關(guān)系。睡眠障礙、軀體化焦慮預(yù)測了認(rèn)知功能水平。4.基線的焦慮因子得分可以預(yù)測3個(gè)月之后的認(rèn)知功能�；�水平的軀體性焦慮可以預(yù)測3個(gè)月之后的即刻記憶,基線水平的精神性焦慮可以預(yù)測3個(gè)月之后的視覺廣度。
[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，

本文編號：1568520