轻度脑外伤军人抑郁发作情况及与认知功能受损的关系

目的研究有轻度颅脑损伤轻度颅脑损伤（mTBI）史的军队人员的抑郁发生情况及对认知功能的影响，为mTBI人员制定相应生理、心理干预措施提供依据。方法研究对象为解放军324医院2008年4月-2011年5月期间执行过国际维和、急重救灾任务或其他非战争军事行动后返回营区的战士、军官和军队文职人员，其中有mTBI史者106例（病例组），无mTBI史者79例（对照组）。利用DSM-IV-TR轴I障碍用临床定式检查（SCID-I／P）和简易精神状态检查表（MMSE）进行抑郁发作及认知功能评定。结果（1）病例组的抑郁发生率及认知功能受损率均显著高于对照组（20．75％VS7．59％，P〈0．05；16．04％vs3．80％，P〈0．01）；（2）在病例组中，抑郁患者的认知功能受损主要表现为定向力、记忆力、注意力和计算力、回忆能力的显著下降（P〈0．05或P〈0．01），语言功能无明显差异；（3）mTBI患者认知功能受损与抑郁症状中的“情绪低落”、“睡眠障碍”、“激越或迟滞”、“疲倦或精力减退”、“无价值感”、“思考、注意、记忆差”和“有自杀意向”显著相关（P〈0．01）。结论对有mTBI史的军人应及早检查抑郁和认知功能情况，并探索有效的生理、心理干预措施，以提高军队战斗力和军人生活质量。

Correlation between depression and damage of cognitive function in soldiers with mild traumatic brain injury

Objective To explore the status of depression in military personnel with mild traumatic brain injury （mTBI） and its effects on their cognitive function, and to provide basis for making physiological and mental intervention measures among these personnel. Methods The subjects were 106 soldiers,officers and civil servants from the hospital 324 of PLA who had carried out tasks of international peace keeping,emergent disaster relief and other non - war military actions from April 2008 to May 2011. Among them, there were 106 cases with mTBI history（ case group）and 79 ones without（ control group）. Their incidence of depression and cognitive function were evaluated with Structured Clinical Interview for DSM - IV - TR Axis I Disorders（ SCID - I/P）and Mini - Mental State Examination（MMSE）. Results （1）The incidences of depression and cognitive function damage in the case group were significantly higher than those in the control group（20.75% vs 7.59% ,P 〈0.05 ;16.04% vs 3.80% ,P 〈0.01 ）. （2）In the case group,the main manifestation of cognitive function damages were significant decrease in orientation, memory, attention, calculation, and recollection capabilities（P 〈 0.05 or P 〈 0.01 ）, and there was no significant difference in the language function. （5）The damage of cognitive function in the patients with mTBI was significantly correlated with the symptoms of depression such as low emotion, somnipathy, agitating or hysteresis, languor or decrease of vigor, sense of insignificance, bad thinking, attention and memory ability and intention of suicide（P 〈 0.01 ）. Conclusion For those military individuals with mTBI history, their status of depression and cognitive function should be examined as early as possible. Effective physiological and mental intervention measures should be explored in order to enhance their physical health and quality of life.