A Comparative Study of the Cognitive Function in Patients with Different Degrees of Depression
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摘要:
目的 基于云南是边疆少数民族偏远地区，比较认知功能在不同程度抑郁症患者中的差异。 方法 采用韦氏成人智力量表，瑞文标准推理测验分别评定100名2019年8月至2019年12月期间在云南省精神病医院住院治疗的符合ICD-10诊断标准的抑郁症患者（入院时和入院治疗后6周）和100名健康人的认知功能状况。并采用汉密尔顿抑郁量表17项评定病情严重程度（在抑郁症患者入院时和入院治疗后6周），分为重度抑郁症组，中度抑郁症组和轻度抑郁症组。数据采用SPSS统计软件包进行分析。 结果 （1）正常组，RIQ与FIQ差异无统计学意义（P > 0.05）；抑郁症组，无论是入院时还是入院抗抑郁治疗后6周，FIQ均明显高于RIQ， P < 0.05；（2）正常组，抑郁症组入院和6周RIQ，VIQ，PIQ，FIQ的比较结果为，抑郁症组入院时 < 治疗后6周 < 正常对照组， P < 0.05；（3）抑郁症组入院和6周RIQ，VIQ，PIQ，FIQ的比较结果为，重度抑郁 < 中度抑郁 < 轻度抑郁， P < 0.05。 结论 （1）正常组韦氏智商和瑞文智商差异不明显，但抑郁症组韦氏智商明显高于瑞文智商，而瑞文智商与操作智商有关，故抑郁症患者操作智商受损更明显；（2）抑郁症患者存在认知功能损害，经抗抑郁治疗后，认知功能有改善，但仍不能达到正常水平；（3）抑郁程度越重，无论是在入院时，还是在治疗后6周，认知功能损害越明显。 Abstract:Objective Based on the fact that Yunnan is a remote and bordering area with multiple ethnic minorities, Wechsler intelligence Scale and Raven standard Reasoning test were used to compare the difference of cognitive function in patients with different degrees of depression. Methods The cognitive function of 100 ICD-10 patients with depression （at admission and 6 weeks after admission） and 100 healthy individuals admitted to Yunnan Psychiatric Hospital from August 2019 to December 2019 were assessed using Raven Standard Reasoning Test and Wechsler Adult Intelligence Scale. Seventeen items of the Hamilton Depression Scale were used to assess the severity of depression （at the time of admission and 6 weeks after admission）, and the patients were divided into 3 groups: severe, modest and mild groups. The data were analyzed by SPSS17.0 statistical software package. Results （1） In normal group, there was no significant difference between RIQ and FIQ （P > 0.05）. In the depression group, FIQ was significantly higher than RIQ both at admission and 6 weeks after admission of antidepressant treatment （ P < 0.05）. （2） The results of RIQ, VIQ, PIQ and FIQ at 6 weeks of admission between control group, depression group and the normal control group were as follows: The depression group had the lowest score at admission, followed by the 6-weeks after treatment, and the normal control group had the highest score （ P < 0.05）. （3） The comparison results of RIQ, VIQ, PIQ and FIQ between the depression group admitted to hospital and the depression group at 6 weeks were: severe depression was the lowest, followed by moderate depression, and mild depression was the highest （ P < 0.05）. Conclusion （1） There was no significant difference between Wechsler's IQ and Raven's IQ in the normal group; however, in the depression group, Wechsler's IQ was significantly higher than Ravin's IQ, and Ravin's IQ was related to performance IQ, so the impairment of performance IQ was more obvious in depression patients. （2） The cognitive function of patients with depression was impaired. After antidepressant treatment, the cognitive function was improved, but still could not reach the normal level. （3） As the degree of depression increases, the severity of cognitive impairment also increase, both at the time of admission and six weeks after treatment, -
表 1 同一受试者RIQ、FIQ的比较[（
$\bar x \pm {{s}}$ ），分]Table 1. RIQ、FIQ comparison of the same subject[（
$\bar x \pm {{s}}$ ），scores]指标 RIQ FIQ t P 正常组 110.77±14.30 110.14±9.11 0.775 0.440 抑郁症组入院时 83.93±13.11* 96.13±10.91 −11.873 < 0.001 抑郁症组入院6周 97.22±14.00* 105.38±10.34 −8.916 < 0.001 与FIQ比较，*P < 0.05。 
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表 2 正常组和抑郁症组入院时，6周RIQ、VIQ、PIQ、FIQ的比较（
$\bar x \pm {{s}}$ ）Table 2. Comparison of 6-week RIQ、VIQ、PIQ、FIQ between normal group and depression group （
$\bar x \pm {{s}}$ ）指标 RIQ VIQ PIQ FIQ 正常组 110.77 ± 14.30 106.54 ± 7.26 102.19 ± 7.47 110.14 ± 9.11 抑郁症组入院时 83.93 ± 13.11* 99.10 ± 7.75* 89.91 ± 9.31* 96.13 ± 10.91* 抑郁症组入院6周 97.22 ± 14.00*# 103.38 ± 7.42*# 96.16 ± 8.42*# 105.38 ± 10.34*# F 94.399 24.924 53.011 49.282 P < 0.001 < 0.001 < 0.001 < 0.001 与正常组比较，*P < 0.05；与抑郁症组入院时比较， #P < 0.05。
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表 3 抑郁症患者入院时和6周不同抑郁程度RIQ、VIQ、PIQ、FIQ的比较（
$\bar x \pm {{s}}$ ）Table 3. Comparison of different depression levels of RIQ、VIQ、PIQ、FIQ in depression patients at admission and 6 week（
$\bar x \pm {{s}}$ ）指标 RIQ VIQ PIQ FIQ 时间点 入院时 入院后6周 入院时 入院后6周 入院时 入院后6周 入院时 入院后6周 轻度抑郁（n=22） 89.50±10.68 101.22±14.00 105.54±7.26 106.38±7.42 94.91±9.31 101.16±8.42 100.13±10.91 108.38±10.34 中度抑郁（n=43） 83.18±10.58* 94.18±13.58* 100.43±7.05* 104.43±7.05 91.26±8.93 98.26±8.93 97.82±10.27 104.82±10.27 重度抑郁（n=35） 81.60±9.03* 87.60±12.03*# 96.63±8.46*# 100.63±8.46*# 87.40±9.61* 94.40±9.61* 93.00±11.52* 100.40±11.52* F 4.403 7.366 5.743 4.339 4.579 3.986 3.355 3.920 P 0.015 0.001 0.018 0.017 0.013 0.022 0.039 0.023 与轻度抑郁比较，*P < 0.05；与中度抑郁比较， #P < 0.05。
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