Nakano Yoshiyuki, Baba Hajime, Maeshima Hitoshi, Kitajima Akiyoshi, Sakai Yoshie, Baba Kanako, Suzuki Toshihito, Mimura Masaru, Arai Heii
Department of Psychiatry, Juntendo University, School of Medicine, Tokyo, Japan.
J Affect Disord. 2008 Nov;111(1):46-51. doi: 10.1016/j.jad.2008.01.027. Epub 2008 Mar 4.
Past neuropsychological studies on depression have documented executive dysfunction and it has been reported that some dysfunction persists even after depressive symptoms disappear. Studies have shown a correlation between cerebrovascular lesions and executive dysfunction in depression among the elderly. The aim of the present study was to focus on executive functions in remitted major depressive disorder (MDD) patients, and to investigate whether remitted young and elderly patients show different patterns of executive dysfunction, and to ascertain the relationships with vascular lesions.
Subjects were 79 inpatients with MDD and 85 healthy controls. Each subject received Wisconsin Card Sorting Test (WCST), Stroop test, and Verbal Fluency Test (VFT) in a remitted state. Both the MDD and control groups were divided into young and elderly groups, and the performances between 4 groups were compared.
For Stroop test, the scores of the MDD group were significantly lower than controls. In addition, as for VFT, the scores for the elderly MDD group were significantly lower than the other groups. Multiple regression analysis showed that VFT scores were affected by the presence of vascular lesions.
The results of the present study demonstrated that executive dysfunction remained even in a remitted state in MDD patients, but the patterns of impairment were different between young and elderly patients. The results also suggested that vascular lesions affect executive dysfunction, particularly in elderly depressive patients.
过去关于抑郁症的神经心理学研究记录了执行功能障碍,并且有报道称即使抑郁症状消失,一些功能障碍仍然存在。研究表明,老年人抑郁症患者的脑血管病变与执行功能障碍之间存在关联。本研究的目的是关注缓解期重度抑郁症(MDD)患者的执行功能,调查缓解期的年轻和老年患者是否表现出不同的执行功能障碍模式,并确定与血管病变的关系。
研究对象为79例MDD住院患者和85名健康对照者。每位受试者在缓解期接受威斯康星卡片分类测验(WCST)、斯特鲁普测验和言语流畅性测验(VFT)。MDD组和对照组均分为年轻组和老年组,比较4组之间的表现。
在斯特鲁普测验中,MDD组的得分显著低于对照组。此外,在言语流畅性测验中,老年MDD组的得分显著低于其他组。多元回归分析表明,言语流畅性测验得分受血管病变的影响。
本研究结果表明,MDD患者即使在缓解期仍存在执行功能障碍,但年轻和老年患者的损害模式不同。结果还表明,血管病变会影响执行功能障碍,尤其是老年抑郁症患者。