舍曲林与帕罗西汀治疗抑郁症首次发病患者认知功能的相关研究

目的 比较舍曲林与帕罗西汀对抑郁症首次发病患者认知功能的影响及其相关因素.方法 将符合国际疾病分类第10版关于抑郁发作诊断标准、17项汉密尔顿抑郁量表(HAMD17)评分≥17分、年龄18～65岁的100例首次发病的门诊患者,按照随机数字表法分为舍曲林组(51例,剂量范围25～150 mg/d)和帕罗西汀组(49例,剂...

The cognitive functioning after sertraline and paroxetine treatment in first-episode major depression patients

Objective To compare the effects of sertraline and paroxetine on cognitive function in first-episode major depressed patients,and to explore the related factors of cognitive function.Methods In this 12-week randomized open study,patients who met ICD-10 criteria for major depression,aged 18-65years old,scored HAMD17 ≥ 17,signed in informed consent form were recruited and assigned to sertraline (n =51 ) or paroxetine treatment group (n =49).Hamilton Depression Scale ( 17 item,HAMD17 ) were valuated at the baseline and endpoint of treatment,and neuropsychological assessments (WAIS-RC,WCST,Stroop) were performed twice to valuate cognition function.Result The patients had significant improvement in HAMD17 score and neuropsychological tests score after treatment.The patients with sertraline treatment had significantly reduced in Stroop card-CC time (67.59 ± 15.48 ) s,card-CC errors (3.66 ±4.03 ),card-CW errors (5.68 ± 5.02 ),SIE time2 ( 35.86 ± 13.74) s and SIE errors2 ( 3.18 ± 3.34) after treatment.The patients with paroxetine treatment had significantly reduced scores in WCST persistent errors (61.52 ± 11.07 ) and Stroop card-CC time ( 73.02 ± 16.45 ) s,card-CW errors ( 3.90 ± 4.12 ),card-CC errors (6.00±5.01),SIE time2 (39.24 ± 14.21 ) s and SIE errors2(3.48 ±3.79),had significantly improved in WCST correct answerings ( 26.55 ± 22.51 ) and conceptualization ( 0.74 ± 0.23 ) after treatment.There was no statistic difference on neuropsychological test score between the two groups,but the mean score of Stroop and WAIS was better in sertraline than paroxetine group.The amendment of Stroop card-CW errors had relation with the improvement degree of depressed symptom ( r =0.25,P ＜ 0.05 ),the amendment of Stroop card-SIE errors had relation with the deduction of body weight ( r =0.27,P ＜ 0.05 ),the amendment of WCST categories,total answering,persistent errors,random errors,conceptualization,and Stroop card-CC errors had relation with the deduction of cognitive disturbance( r =0.28,0.37,0.38,0.26,0.38,0.37,P ＜ 0.05 ).Conclusion Cognitive function including attention,executive capacity,and intelligence of first-episode major depression patient could improve after antidepressants treatment.The amendment of cognitive function have relation with the improvement of depressed symptom.