中重度晚发抑郁症患者的神经认知功能损害分析

目的探讨中重度晚发抑郁症患者神经认知功能损害的特征。方法选取2017年2月至2019年2月我院收治的中重度晚发抑郁症患者50例作为观察组,采用重复性成套神经心理状态测验(RBANS)、词语流畅性测验(VFT)、威斯康星卡片分类测验(WCST)对神经认知功能损害情况予以评定,与同期收治的对照组50名健康体检者进行比较。采用汉密顿抑郁量表(HAMD-17)评估观察组抑郁严重程度,并分析它与认知损害的关系。结果在RBANS测验中,观察组晚期抑郁症患者即刻记忆、延时记忆、视觉广度、注意力、言语能力各维度评分均低于对照组,差异具有统计学意义(P<0.05);观察组VFT测验评分经评定低于对照组(P<0.05);在WCST测验中,两组完成分类数、完成第一分类所需应答数评分无差异(P>0.05),观察组错误应答数、持续性错误百分数、持续性错误数、持续性应答数评分均高于对照组,概念化水平应答百分数评分高于对照组(P<0.05);Spearman相关分析发现RBANS测验中的即刻记忆、延时记忆、视觉广度、注意力、言语能力各维度均与HAMD-17评分具正相关(r=0.39,0.42,0.45,0.38,0.40,P<0.05);VFT和WCST测验中的持续性应答因子与HAMD-17评分呈负相关(r=-0.43,-0.51,P<0.05)。结论中重度晚发抑郁症患者容易出现神经认知功能损害,认知功能损害与抑郁程度密切相关。

Neurocognitive impairment in patients with moderate to severe late-onset depression

Objective To explore the characteristics of neurocognitive impairment in moderate or severe late-onset depression patients. Methods 50 moderate or severe patients with late-onset depression were selected as observation group from February 2017 to February 2019. The control group consisted of 50 health examinees. The neurocognitive impairment was assessed by repetitive neuropsychological state test(RBANS),verbal fluency test(VFT)and Wisconsin Card Sorting Test(WCST). Hamilton Depression Scale(HAMD-17)was used to assess the severity of advanced depression in the observation group. Results In the RBANS test,the scores of immediate memory,delayed memory,visual span,attention and speech ability in the observation group were lower than those in the control group(P<0.05). The scores of VFT test in the observation group were lower than those in the control group(P<0.05). In the WCST test,the scores of error response,persistent error percentages,persistent error percentages and persistent response percentages in the observation group were higher than those in the control group,and the scores of conceptual level response percentages were higher than those in the control group(P<0.05). Spearman correlation analysis found that the dimensions of immediate memory,delayed memory,visual span,attention and speech ability in RBANS test were positively correlated with HAMD-17 score(r=0.39,0.42,0.45,0.38,0.40,P<0.05). The persistent response factors in VFT and WCST test were negatively correlated with HAMD-17 score(r=-0.40,P<0.05). Conclusion The moderate or severe patients with late-onset depression had neurocognitive impairment. Cognitive impairment is closely related to the degree of depression.