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抑郁症患者存在明显的记忆和注意力缺陷模式。

A distinct pattern of memory and attention deficiency in patients with depression.

机构信息

Department of Psychology, Tianjin Huanhu Hospital, Tianjin 300060, China.

出版信息

Chin Med J (Engl). 2013 Mar;126(6):1144-9.

Abstract

BACKGROUND

Depression related cognitive deficits are frequently considered as simple epiphenomena of the disorder. However, whether or not the depression might directly bring about cognitive deficits is still under investigation. This study was to investigate the distinct pattern of cognitive deficits in patients with depression by comparing the cognitive function before and after anti-depressive drug therapy.

METHODS

Sixty cases of patients, first-time diagnosed with depression, were assessed by 17-item Hamilton Rating Scale for Depression (HAMD17scale). The memory ability was tested by quantitatively clinical memory scale, while the attention ability by modified Ruff 2&7 Selective Attention Test. Forty-two healthy volunteers were recruited as controls. The depressive patients were treated with Venlafaxine (75 - 300 mg/d), Fluoxetine (20 - 40 mg/d), Paroxetine (20 - 40 mg/d), and Sertraline (50 - 150 mg/d). After 12 weeks treatment, patients were tested again by HAMD17scale, quantitatively clinical memory scale, and modified Ruff 2&7 selective attention test to assess the effect of anti-depressive drugs on cognitive deficits.

RESULTS

The memory quotient (MQ) was significantly lowered in depressive patients. The selection speed was also significantly decreased and the number of missing and error hits increased in the depression group as compared to control. However, there was no significant difference in clinical memory scale and Ruff 2&7 selective attention test between mild-to-moderate and severe depression group. Importantly, after anti-depressive drug therapy, the HAMD17 scale scores in depressive patients were significantly decreased, but the MQ, directional memory (DM), free recall (FR), associative learning (AL), and face recognition were comparable with those before the treatment. Furthermore, the selection speed and the number of missing and error hits were also not significantly different after anti-depressive drugs treatment.

CONCLUSIONS

Depressive patients suffer from short-term memory deficits, and attention extent, stability and rearrangement deficiency. Even though anti-depressive drugs sufficiently relieve the cardinal presentation of depression, they could not successfully alleviate the accompanying cognitive deficits. This might indicate a distinct pattern of cognitive deficits in patients with depression.

摘要

背景

抑郁相关的认知缺陷通常被认为是该疾病的简单伴随现象。然而,抑郁是否会直接导致认知缺陷仍在研究之中。本研究旨在通过比较抗抑郁药物治疗前后的认知功能,来探讨抑郁患者认知缺陷的独特模式。

方法

首次被诊断为抑郁症的 60 例患者,使用汉密尔顿抑郁量表 17 项(HAMD17scale)进行评估。使用定量临床记忆量表测试记忆能力,使用修改后的 Ruff 2&7 选择性注意测试评估注意力能力。招募 42 名健康志愿者作为对照组。抑郁患者接受文拉法辛(75-300mg/d)、氟西汀(20-40mg/d)、帕罗西汀(20-40mg/d)和舍曲林(50-150mg/d)治疗。治疗 12 周后,再次使用 HAMD17scale、定量临床记忆量表和修改后的 Ruff 2&7 选择性注意测试对患者进行评估,以评估抗抑郁药物对认知缺陷的影响。

结果

抑郁患者的记忆商数(MQ)显著降低。与对照组相比,抑郁组的选择速度明显降低,漏记和错误击中的次数增加。然而,在轻度至中度和重度抑郁组之间,临床记忆量表和 Ruff 2&7 选择性注意测试无显著差异。重要的是,抗抑郁药物治疗后,抑郁患者的 HAMD17 量表评分显著降低,但 MQ、定向记忆(DM)、自由回忆(FR)、联想学习(AL)和面孔识别与治疗前无差异。此外,抗抑郁药物治疗后选择速度和漏记及错误击中次数也无显著差异。

结论

抑郁患者存在短期记忆缺陷,注意力广度、稳定性和重新排列能力不足。即使抗抑郁药物充分缓解了抑郁的主要表现,也无法成功缓解伴随的认知缺陷。这可能表明抑郁患者存在独特的认知缺陷模式。

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