首發(fā)與復(fù)發(fā)抑郁癥患者記憶功能改善的比較

謝新鳳 鄧書(shū)祿 李詩(shī)燕 易蕓 楊晶雪 蘭寒菊

【摘 ?要】目的：比較計(jì)算機(jī)認(rèn)知矯正治療對(duì)首發(fā)與復(fù)發(fā)性抑郁癥患者記憶功能的改善。方法：50例于2017年5月至2018年12月在廣西腦科醫(yī)院就診的抑郁癥急性發(fā)作期的患者按發(fā)病次數(shù)分為首發(fā)組與復(fù)發(fā)組，兩組患者均接受藥物草酸艾司西酞普蘭+計(jì)算機(jī)認(rèn)知矯正治療（CCRT）治療4周，分別在治療前 、治療 4周后進(jìn)行臨床記憶量表（CMS）的評(píng)估，評(píng)價(jià)兩組患者治療前后記憶功能的改善。結(jié)果：治療前兩組患者的臨床記憶量表（CMS）各項(xiàng)指標(biāo)方面比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）;與同組治療前相比，兩組患者治療后CMS各項(xiàng)指標(biāo)均顯著改善，差異均具有統(tǒng)計(jì)學(xué)意義（t指向記憶 2.226，2.640;t聯(lián)想學(xué)習(xí)4.410，3.936;t圖像記憶4.521，2.718;t圖像再認(rèn)2.242，2.232;t人像特點(diǎn)回3.836，3.596;t記憶商數(shù)7.717，4.945; P<0.05）;經(jīng)治療4周后，首發(fā)組患者CMS各項(xiàng)評(píng)分指標(biāo)顯著優(yōu)于復(fù)發(fā)組，差異均具有統(tǒng)計(jì)學(xué)意義（t指向記憶2.498，t聯(lián)想學(xué)習(xí)2.724，t圖像記憶2.399，t圖像再認(rèn)2.614，t人像特點(diǎn)回憶2.968，t記憶商數(shù)2.459， P<0.05）。結(jié)論： CCRT能改善抑郁癥患者的記憶功能，而且首發(fā)患者效果更好。

【關(guān)鍵詞】首發(fā)與復(fù)發(fā)抑郁癥;計(jì)算機(jī)認(rèn)知矯正治療;記憶功能

【中圖分類號(hào)】R749.4+1 ? ?【文獻(xiàn)標(biāo)識(shí)碼】A ? ? ?【文章編號(hào)】1672-3783（2020）07-0033-02

【Abstract】Objective：To compare the improvement of memory function in patients with first and recurrent depression treated by computer cognitive correction. Methods：The 50 patients at the stage of acute depression were divided into the first episode group and the recurrence group according to the attack times in Guangxi Brain Hospital from May 2017 to December 2018.Patients in both groups were be treated by esitalopram oxalate and computer cognitive correction therapy （CCRT） for 4 weeks， the clinical memory scale （CMS） was used to evaluate the improvement of memory function before and after treatment. Results：there was no significant difference in the clinical memory scale （CMS） between the two groups （P > 0.05） before treatment. Compared with the same group before treatment， all indicators of CMS in the two groups were significantly improved after treatment， and the differences were statistically significant （tpoint to memory ?2.226 and2.640 ， tassociative learning 4.410 and 3.936，timage memory 4.521 and 2.718，timage recognition 2.242 and 2.232，tportrait feature recall 3.836 and3.596，tmemory quotient 7.717and 4.945，P < 0.05）; After 4 weeks of treatment， the CMS scores of the first-episode group were significantly better than those of the relapse group， with statistically significant differences （t Point to memory 2.498， t associative learning 2.724， t image memory 2.399， t image recognition 2.614， t portrait feature recall 2.968， t memory score 2.459， P < 0.05）. Conclusion：CCRT can improve the memory function of patients with depression， and the effect is better in the first episode patients.

【Key words】First episode and recurrent depression;Computer cognitive correction therapy; Memory function

抑郁癥被列為全球疾病負(fù)擔(dān)最重病癥之一[1]，是一種以情緒低落、興趣減退、思維遲緩、認(rèn)知功能損害為主要特征的情感障礙性疾病[2]。當(dāng)前認(rèn)為多數(shù)抑郁癥患者存在顯著的記憶障礙[3]，其中，記憶功能受損顯著作用于抑郁癥的康復(fù)，甚至降低康復(fù)后的生活質(zhì)量。臨床研究表明計(jì)算機(jī)認(rèn)知矯正治療系統(tǒng)（Computerized cognitive remediation therapy ， CCRT）對(duì)精神分裂癥的認(rèn)知功能受損具有明確療效[4-6]，國(guó)內(nèi)部分研究也認(rèn)為，CCRT能有效改善抑郁癥患者的認(rèn)知功能，并影響其記憶功能。故本研究旨在探討CCRT對(duì)抑郁癥患者的記憶功能改善的效果，以及比較CCRT對(duì)首發(fā)與復(fù)發(fā)性抑郁癥患者記憶功能改變的差異。