抑郁症首次发病患者情绪加工特征及抗抑郁剂治疗前后的变化

目的 探讨首次发病(以下简称首发)抑郁症情绪加工特征及抗抑郁剂治疗前后变化与症状改善的关联作用.方法 17例抑郁症首发患者治疗前后及22名对照者完成情绪词识别任务.患者组抗抑郁剂治疗9周,以汉密尔顿抑郁量表(17项,HAMD)评估疗效.结果 (1)患者组治疗有效率为88%,HAMD总分减分率75%.(2)情绪词识别任务:抑郁症组治疗前后正性词遗漏数[分别为(7.4±6.9)个和(4.1±5.3)个]均大于负性词遗漏数[分别为(3.2±3.3)个和(1.8±2.7)个;P＜0.05),治疗后正性词遗漏数小于治疗前(P=0.002),与对照组[(3.0±2.6)个]差异无统计学意义(P=0.44);治疗前后负性词遗漏数[分别为(3.2±3.3)个和(1.8±2.7)个]与对照组[(2.1±2.4)个],以及正负性词错判数与对照组差异均无统计学意义(P＞0.05);正性词平均反应时治疗后[(514±68)ms]短于治疗前[(550±75)ms;P=0.036],负性词平均反应时治疗前后[分别为(540±80)ms和(521±61)ms]差异无统计学意义(P=0.16).(3)治疗前正性词遗漏数与抑郁症状和负性思维评分正相关(r=0.36～0.50,P＜0.05).(4)治疗前后正、负性词遗漏数变化对HAMD分数变化有不同预测作用(r_( chang) ~2=0.45,P=0.002).结论首发抑郁症患者可能存在正性情绪加工缺陷,治疗后可恢复至正常水平;以负性情绪加工占优势的认知结构不因抑郁症状缓解而改变;正负性情绪加工变化与症状改善可能有不同的关联作用.

Processing of emotional information before and after antidepressants treatment in patients with first-episode major depression

Objective The purpose of this study was to explore the processing of emotional information in major depression and to examine whether the processing indices were associated with the symptomatic change.Methods Seventeen first-episode depressed patients and 22 age-,gender-,and education matched healthy controls were administered the visual recognition tasks of Chinese emotional words.After 9-week antidepressants treatment,17 patients were re-administered the tasks.The depressive symptoms were evaluated with the 17-item Hamilton Depression Scale(HAMD).Results (1)The response rate was 88%with 75%reduction rate of the HAMD score total after 9-week treatment.(2)On the tasks of Chinese emotional words,the depressed patients had more errors of omission during positive than negative block before and after treatment[positive:(7.4±6.9)vs.(4.1±5.3),negative:(3.2 ±3.3)vs.(1.8±2.7),respectively,P＜0.05 ).After treatment,fewer errors of omission were found during positive block relative to the initial time(P=0.002)in depressed patients.and no difierence was found on errors of omission during positive block compared to healthy controls[(3.0±2.6),P=0.44].No difference was found on errors of omission during negative block across time in depressed patients [(3.2±3.3)vs.(1.8±2.7)]nor across groups[controls(2.1±2.4),P＞0.05],and so was on distracter errors.(3)Depressed patients required less time to respond to positive after treatment[(514±68)ms]than at initial time[(550±75)ms,P=0.036],no significant difierence was observed for negative across time [(521±61)ms vs.(540±80)ms,P=0.16].(4)Errors of omission during positive were positively associated with the HAMD scores and negative thoughts(r=0.36-0.50,P＜0.05).(4)Change of errors of omission during positive and negative block predicted the change of HAMD scores(r_(chang) ~2=0.45,P=0.002).Conclusion Unmedicated first-episode depressed patients might display deficits of positive information processing,which are not obvious when symptom remitted.The preferential processing of negative information does not change with symptoms remitted.The change of the processing of emotional information might correlate with the change of symptoms.