成人抑郁症患者儿童期受虐对神经系统软体征的影响

目的:研究抑郁症患者儿童期受虐待对神经系统软体征的影响. 方法:对103例抑郁症患者行儿童受虐问卷、神经系统软体征、汉密尔顿抑郁量表、自杀意念量表以及Beck绝望量表评定.结果:①儿童受虐患者较未受虐者额叶有更多的软体征(2.51±1.61,1.77±1.25,P＜0.01).有情感忽视患者额叶软体征也明显高于无情感忽视者(2.53±1.63,1.80±1.25,P＜0.05)；有躯体忽视者额叶较无躯体忽视者软体征明显增多(2.41±1.63,1.65±1.00,P＜0.01)；有性虐待患者软体征明显高于无性虐待者(6.29±1.83,4.28±2.82,P＜0.01).②受虐总分与额叶和颞叶评分呈明显正相关(r=0.29,P＜0.01;r=0.24,P＜0.05)；情感受虐待、情感被忽视及躯体虐待与额叶评分呈明显正相关(r=0.284,0.345,0.218,P＜0.01或0.05).③HAMD与神经系统软体征总分及各脑叶均呈明显正相关；自杀意念量表评分与神经系统软体征总分及额叶、顶叶、颞叶软体征评分呈明显正相关. 结论:抑郁症患者儿童期受虐对大脑有不利影响,不同虐待可对不同脑区产生损害,主要在额叶.

Affect of the child abuse to the soft neurological signs in depressive patients

Objective:To investigate the effects of child abuse on the soft neurological signs (SNS) in depressive patients.Method:103 depressive patients were tested by childhood trauma questionnaire(CTQ),24-item Hamiltom rating scale for depression (HAMD),self-rating idea of suicide scale (SIOSS) and Beck helpless rating scale (BHS) to evaluate the severity of symptoms.Patients were divided into abuse group (total score ≥55 or subscale score ≥13) and no-abuse group (<55 or <13) in terms of CTQ score.Results:①The child abuse group have much more SNS than no-abuse group in frontal lobe(2.51±1.61 vs 1.77±1.25,P<0.01).The emotion neglect group have much more SNS in frontal lobe than no emotion abuse group (2.53±1.63 vs 1.80±1.25,P<0.05).The Body abuse group have much more SNS in frontal lobe than no body abuse (2.41±1.63 vs.1.65±1.00,P<0.01).The sexual abuse group have much more SNS in temporal lobe than no sexual abuse group (6.29±1.83 vs 4.28±2.82,P<0.01).②The SNS of frontal and temporal lobe were significantly associated with the child abuse (r=0.29 P<0.01;r=0.24,P<0.05).The emotion abuse,emotion neglect and body abuse were significantly associated with the SNS of frontal lobe(r=0.284,P<0.01;r=0.345,P<0.01;r=0.218,P<0.05).③HAMD were significantly associated with the SNS of total and each brain lobe;SIOSS were significantly associated with SNS of total frontal parietal and temporal lobe.Conclusion:The child abuse can negatively influence the brain in depressive patients.Different kinds of abuses affect different lobes,especially the frontal lobe.