青少年重症抑郁症患儿执行功能的特点

目的探讨青少年重症抑郁症(MDD)患儿执行功能的特点。方法采用学龄儿童情感障碍和精神分裂症问卷-目前及终生版,儿童抑郁量表,中国韦氏智力测试中的数字广度分测验,Stroop色词关联测验以及剑桥神经心理自动化成套测试(CANTAB)中的空间工作记忆(SWM)测验、剑桥袜(SOC)测验、目标内外注意转换(IED)测验分别对36例首发未服药青少年MDD患儿(抑郁症组)和40例健康对照儿童的当前和既往精神疾病发作情况进行筛查,评估抑郁严重程度和执行功能,比较二组执行功能的区别。结果在数字广度分测验和Stroop色词关联测验中,抑郁症组与健康对照组比较差异均无统计学意义(Pa>0.05);在SWM测验中,抑郁症组的8个格子间隔错误数(20.27±12.51 vs 13.91±9.72)、策略分(34.79±3.35 vs 32.14±4.25)多于健康对照组,二组比较差异均有统计学意义(Pa<0.05);在SOC测验中,抑郁症组的4步平均移动步数(5.98±1.25 vs 5.33±0.96)多于健康对照组,二组比较差异有统计学意义(P<0.05);在IED测验中,抑郁症组的总尝试次数(60.74±37.45 vs 35.44±27.40)明显多于健康对照组,二组比较差异有统计学意义(P<0.05)。结论青少年MDD患者存在空间工作记忆、认知灵活性和计划等多个执行功能成分的损害,而语音工作记忆和抑制控制等执行功能成分的损害不突出。

Characteristics of Executive Function in Adolescents with Major Depressive Disorder

Objective To explore the characteristics of executive function in adolescents with major depressive disorder(MDD). Me-thods A total of 36 first-episode drug naive adolescents with MDD and 40 healthy controls were involved.The current and historical psychia-tric conditions were assessed with the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version.The depression severity was assessed with the children′s depression inventory.The executive function was measured in digit span test,Stroop color word test and cambridge neuropsychological test automated battery(CANTAB)[including spatial working memory(SWM),stockings of cambridge(SOC),intra-dimensional/extra-dimensional shifts(IED)].Performances on executive function were compared between the 2 groups. Results In digit span test and Stroop color word test,there was no significant difference between the 2 groups(Pa>0.05).In CANTAB,adolescents with major depression showed more SWM between errors(8 boxes)(20.27±12.51 vs 13.91±9.72),greater SWM strategy score(34.79±3.35 vs 32.14±4.25),more SOC mean moves(5.98±1.25 vs 5.33±0.96) and more IED total trials(60.74±37.45 vs 35.44±27.40) than those of healthy control group,there were significant differences between the 2 groups(Pa<0.05). Conclusions Adolescents with MDD showed deficits in spatial working memory,set-shifting and planning.Executive function impairments of verbal working memory and inhibitory control are not obvious.