【摘要】：目的:比較雙相I型障礙(BD)患者緩解期與抑郁發(fā)作期的神經(jīng)認(rèn)知功能。方法:選取符合美國精神障礙統(tǒng)計與診斷手冊第4版(DSM-IV)診斷標(biāo)準(zhǔn)的BD緩解期患者29例、BD抑郁發(fā)作期患者30例及健康對照27例,使用精神分裂癥認(rèn)知功能成套測驗-共識版(MCCB),對三組的持續(xù)注意、學(xué)習(xí)、記憶、精細動作、社會認(rèn)知、執(zhí)行功能及信息處理速度7個領(lǐng)域的神經(jīng)認(rèn)知特點進行比較。歸納BD緩解期組和抑郁發(fā)作期組的首次抑郁發(fā)作年齡、終生抑郁發(fā)作次數(shù)、首次躁狂發(fā)作年齡、終生躁狂發(fā)作次數(shù)、家族史及臨床用藥等臨床指標(biāo)的特征;用漢密頓抑郁量表(HAMD)、大體功能評定量表(GAF)評定抑郁和功能情況。結(jié)果:BD緩解期組HAMD得分低于BD抑郁發(fā)作期組[(4.1±2.9)vs.(17.6±3.3),P0.01],而GAF得分高于BD抑郁發(fā)作組[(70.6±14.0)vs.(57.8±11.2),P0.01]。BD緩解期和BD抑郁發(fā)作期患者的MCCB記憶、精細動作、執(zhí)行功能及總體認(rèn)知功能得分低于健康對照組[(46.8±4.7)vs.(49.7±4.3),(45.4±6.0)vs.(49.7±4.3);均P0.05];BD緩解期患者的詞語記憶測驗得分低于BD抑郁發(fā)作期患者[(45.6±9.3)vs.(51.4±8.3),P0.05],溝槽釘板非利手測驗得分高于BD抑郁發(fā)作組[(44.5±10.9)vs.(37.6±12.4),P0.05];兩組其他認(rèn)知測驗結(jié)果差異無統(tǒng)計學(xué)意義。結(jié)論:BD緩解期及抑郁發(fā)作期患者均存在認(rèn)知功能受損,BD緩解期患者詞語記憶能力比抑郁發(fā)作期患者差,非利手精細運動能力優(yōu)于抑郁發(fā)作期患者,提示神經(jīng)認(rèn)知功能缺損可能是BD的素質(zhì)性指標(biāo)之一。
[Abstract]:Objective: to compare the neurocognitive function between remission and depression in patients with biphasic type I disorder (BD). Methods: 29 patients with remission of BD, 30 patients with BD depression and 27 healthy controls were selected according to the diagnostic criteria of American Mental Disorder Statistics and Diagnostic Manual (DSM-IV). The continuous attention, learning, memory, fine action and social cognition of the three groups were studied by cognitive function test-consensus version (MCCB),. The neurocognitive characteristics of executive function and information processing speed were compared. The age of first depressive attack, the number of lifelong depressive attack, the age of first manic attack, the number of lifelong manic attack, family history and clinical medication were summarized in BD remission group and depressive attack group, and depression and function were evaluated by Hamilton depression scale (HAMD), gross function rating scale (GAF). Results: the score of HAMD in BD remission group was lower than that in BD depression attack group [(4.1 鹵2.9) vs. (17.6 鹵3.3), P 0.01], while the GAF score in BD depression attack group was higher than that in BD depression attack group [(70.6 鹵14.0) vs. (57.8 鹵11.2), P 0.01]. MCCB memory and fine movement in BD remission stage and BD depression attack group. The scores of executive function and overall cognitive function in the control group were lower than those in the healthy control group [(46.8 鹵4.7) vs. (49.7 鹵4.3), (45.4 鹵6.0) vs. (49.7 鹵4.3)]. The scores of word memory test in BD remission stage were lower than those in BD depression attack group [(45.6 鹵9.3) vs. (51.4 鹵8.3), P 0.05], and the score of grooving nailboard non-use hand test was higher than that in BD depression attack group [(44.5 鹵10.9) vs. (37.6 鹵12.4), P 0.05]. There was no significant difference in other cognitive tests between the two groups. Conclusion: cognitive impairment exists in patients with BD in remission stage and depression attack stage. The ability of word memory in patients with BD remission stage is worse than that in patients with depression attack stage, and the fine motor ability of non-use hand is better than that in patients with depression attack stage, suggesting that neurocognitive deficit may be one of the prime indexes of BD.
【作者單位】： 北京大學(xué)第六醫(yī)院;北京大學(xué)精神衛(wèi)生研究所;衛(wèi)生部精神衛(wèi)生學(xué)重點實驗室(北京大學(xué));
【基金】：北京市科委首都特色臨床應(yīng)用研究Z121107001012040
【分類號】：R749.4

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相關(guān)期刊論文 前2條

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本文編號：2502751