中国科学院心理健康重点实验室知识库

摘要： 目的 探讨抑郁症患者急性期治疗前后临床症状与工作记忆的变化及两者的相关性.方法 招募2017年7月至2019年12月就诊于首都医科大学附属北京安定医院门诊的抑郁症患者,均采用草酸艾司西酞普兰10～20 mg/d治疗,随访12周.基线及12周末采用自定顺序指示任务(SOPT)和延迟回忆任务评估工作记忆,采用汉密尔顿抑郁量表17项(HAMD-17)量表评估临床症状.采用χ2检验、Wilcoxon秩和检验及Spearman相关分析比较各指标的变化及两者的相关性.结果 共招募抑郁症患者139例,其中73例完成12周随访.基线工作记忆精度在K2负载条件下与焦虑症状具有相关性(r=-0.171,P<0.05).工作记忆容量与焦虑症状具有相关性(r=-0.189,P<0.05).12周末43例(58.9％)完全缓解;缓解组的HAMD-17减分值[16.00(12.00,19.00)分]与未缓解组[8.00(4.00,11.00)分]比较,差异有统计学意义(P<0.05).缓解组与未缓解组的抑郁症状[7.00(6.00,9.00)分比5.00(3.00,5.00)分]、焦虑症状[4.00(3.00,6.00)分比2.00(1.00,4.00)分]、睡眠症状[1.00(0,3.00)分比1.00(0,2.00)分]、躯体症状[2.00(1.00,3.00)分比1.00(0,3.00)分]的减分值比较,差异均有统计学意义(P<0.05);随访12周后,HAMD-17总分及各维度变化值与工作记忆各维度变化值无相关性(P>0.05).结论 抑郁症患者的焦虑症状与工作记忆相关,急性期治疗前后临床症状及工作记忆变化无相关性.

Objective To explore the changes of clinical symptoms and working memory in patients with depression before and after treatment in the acute phase and their correlation. Methods Patients with depression， who were admitted to the outpatient clinic of Beijing Anding Hospital affiliated to Capital Medical University from July 2017 to December 2019， were recruited， given 10-20 mg/d Escitalopram oxalate treatment per day， and followed up for 12 weeks. At baseline and the end of the 12th week， self-ordered pointing task （SOPT） and delayed recall task were used to evaluate working memory， and the HAMD-17 scale was used to evaluate clinical symptoms. Chi-square test， Wilcoxon rank sum test and Spearman correlation analysis were used to compare the changes of each index and the correlation between them. Results A total of 139 patients with depression were recruited， among which 73 patients completed 12 weeks follow-up. Anxiety symptoms are related to working memory accuracy under K2 load conditions （r=-0.171，P ＜ 0.05） and are related to working memory capacity （r=-0.89，P＜0.05）. At the end of the 12th week， 43 patients （58.9%） had a complete remission. There was a statistically significant difference in the decrease of HAMD-17 score between the remission group ［16.00 （12.00，19.00）］ and the non-remission group ［8.00 （4.00，11.00）］ （P＜0.05）. There was statistically significant difference in the depressive symptoms ［7.00（6.00，9.00） vs 5.00（3.00，5.00）］， anxiety symptoms［4.00（3.00，6.00） vs 2.00 （1.00，4.00）］， insomnia symptoms ［1.00（0，3.00） vs 1.00（0，2.00）］， and somatic symptoms ［2.00（1.00，3.00） vs 1.00 （0，3.00）］ between remission group and non-remission group （all P＜0.05）. After 12 weeks of follow-up， The total score of HAMD-17 and the change value of each dimension had no correlation with the change value of each dimension of working memory （P＞0.05）. Conclusions Anxiety symptoms of patients with depression are related to working memory. There is no correlation between clinical symptoms and working memory changes before and after treatment in the acute phase.