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[老年单相重度抑郁症患者的执行功能损害:精神运动迟缓的影响]

[Impairment of executive function in elderly patients with major unipolar depression: influence of psychomotor retardation].

作者信息

Baudic Sophie, Benisty Sarah, Dalla Barba Gianfrano, Traykov Latchezar

机构信息

INSERM U-792, Hôpital Ambroise Paré, Boulogne.

出版信息

Psychol Neuropsychiatr Vieil. 2007 Mar;5(1):65-71.

Abstract

The results from several studies assessing the executive function in depressed patients compared to control subjects varied from significant impairment to normal performance. To assess the executive impairment in elderly patients with major unipolar depression and to evaluate the influence of psychomotor retardation and severity of depression in the executive deficits, the performance of 15 elderly patients with unipolar depression was compared to that of 15 elderly control subjects on executive tasks. The severity of depression was evaluated by the Montgomery and Asberg depressive scale and that of psychomotor retardation by the Widlöcher's scale. In depressed patients, deficits were found on tasks assessing cognitive flexibility (Modified card sorting test (MCST) and Trail making test B), planification and elaboration of strategies (cognitive estimates), motor initiation (graphic sequences), categorisation and hypothesis making (MCST) and interference resistance (Stroop test). However, depressed patients performed normally on the Hayling test assessing the inhibition processes. Intensity of psychomotor retardation was not correlated to the performance of executive tasks. Conversely, severity of depression was related to the scores of MCST (number of errors and perseverations), Stroop and Hayling tests (time taken to complete the end of the sentence). Unipolar depressed patients showed deficits in most tasks assessing executive function. However, inhibition processes appeared to be intact in depressed patients although their implementation was difficult. The severity of depression but not that of psychomotor retardation was associated with executive deficits.

摘要

与对照组相比,多项评估抑郁症患者执行功能的研究结果各不相同,从显著受损到表现正常都有。为了评估老年单相抑郁症患者的执行功能损害,并评估精神运动迟缓及抑郁严重程度对执行功能缺陷的影响,将15例老年单相抑郁症患者与15例老年对照受试者在执行任务方面的表现进行了比较。抑郁严重程度通过蒙哥马利和阿斯伯格抑郁量表评估,精神运动迟缓程度通过维德洛赫尔量表评估。在抑郁症患者中,发现他们在评估认知灵活性(改良卡片分类测试(MCST)和连线测验B)、策略的计划与细化(认知估计)、运动启动(图形序列)、分类与假设形成(MCST)以及抗干扰能力(斯特鲁普测验)的任务中存在缺陷。然而,抑郁症患者在评估抑制过程的海林测验中表现正常。精神运动迟缓的程度与执行任务的表现无关。相反,抑郁严重程度与MCST(错误和持续错误的数量)、斯特鲁普测验和海林测验(完成句子末尾所用时间)的得分相关。单相抑郁症患者在大多数评估执行功能的任务中存在缺陷。然而,尽管抑郁症患者在执行抑制过程时存在困难,但其抑制过程似乎是完整的。与执行功能缺陷相关的是抑郁严重程度,而非精神运动迟缓的程度。

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