首发与复发性抑郁症患者认知功能的比较

目的对首发与复发性抑郁症及正常对照进行认知功能测定,探讨首发抑郁症和复发性抑郁症认知功能特点。方法43例首发抑郁症患者、48例复发抑郁症患者和45例正常对照为研究对象。采用汉密尔顿抑郁量表测定抑郁严重程度,采用事件相关电位P300波幅及潜伏期、韦氏记忆量表、威斯康星卡片分类测验测定认知功能。抑郁症患者给予SSRIs类抗抑郁药治疗8周,进行治疗前后的上述指标的比较。结果（1）治疗前首发组,除瞬时记忆和N2波幅外,其他各项指标均较对照组差;复发组各项认知功能指标均较对照组差（P〈0.05）;N2潜伏期首发组低于复发组,分类数和WMS各项指标首发组高于复发组（P〈0.05）。（2）治疗后首发组,除长时记忆分、瞬时记忆分、分类数、P3波幅和N2波幅外,其他指标均与对照组有统计学差异（P〈0.05）;复发组除瞬时记忆分外,各项指标均较对照组为差（P〈0.05）;首发组与复发组比较,除N2波幅无差别外,其余各项均优于对照组（P〈0.05）。（3）治疗后,无论是首发组还是复发组,其HAMD17评分及认知功能的指标均有显著性改善。结论（1）首发与复发性抑郁症患者均存在记忆、执行功能的损害;与首发抑郁症患者相比,复发性抑郁症患者的记忆、执行功能损害更为严重。（2）药物治疗后,首发、复发性抑郁症患者的记忆、执行功能均有一定程度的恢复;复发性抑郁症患者的认知功能损害仍较为严重。

The comparison of cognitive functions between first-episode and recurrent depression

Objective To evaluate the cognitive functions of first-episode, recurrent depression and normal control, so as to explore the features of cognitive functions in first-episode and recurrent depression.Methods 43 first-episode depressive patients, 48 recurrent depressive patients and 45 normal persons were enrolled. The severity of depression was evaluated by Hamilton Depression Scale-17 (HAMD-17). The amplitude and latency of P300, Wechsler Memory Scale and Wisconsin Card Sorting Test were used to measure the cognitive functions. The depressive patients were treated by antidepressive drugs (SSRIs) for 8 weeks. The cognitive functions were compared with that of pretherapy.Results (1)There were significant differences in all items except immediate memory and N2 amplitude between untreated first-episode depression and control group(P<0.05). All the items of untreated recurrent group were worse than those in the control group(P<0.05). The latency of N2 was shorter in first-episode group compared with recurrent group (P<0.05). The completed categories and items of WMS in first-episode group were higher than those of recurrent group(P<0.05). (2)There were significant differences in all the other items between first-episode group and control after treatment(P<0.05) except long-term memory, immediate memory, completed categories, the amplitude of P3 and N2. Almost all the items in recurrent group were worse than those in control group(P<0.05), except the immediate memory. But between first-episode group and recurrent group, there were significant differences in all items except the amplitude of N2 (P<0.05).(3)Significant improvement was found in HAMD17 and all items of cognitive functions after treatment in first-episode and recurrent group(P<0.05).Conclusions (1)There are impairments of memory and executive functions in both first-episode and recurrent group. To compare with first-episode group, the impairment of cognitive functions in recurrent group is more severe. (2)The memory and executive functions of the two depressive groups are repaired partly after drug treatment, but the improvement of cognitive functions in first-episode depression is better than in recurrent depression.