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共病广泛性焦虑障碍对抑郁症患者执行功能的影响:多中心回顾性病例对照研究

耿文奇 段艳平 蒋静 李涛 张克让 朱刚 于欣 史丽丽 魏镜

耿文奇, 段艳平, 蒋静, 李涛, 张克让, 朱刚, 于欣, 史丽丽, 魏镜. 共病广泛性焦虑障碍对抑郁症患者执行功能的影响:多中心回顾性病例对照研究[J]. 协和医学杂志, 2021, 12(2): 221-226. doi: 10.3969/j.issn.1674-9081.2020.00.020
引用本文: 耿文奇, 段艳平, 蒋静, 李涛, 张克让, 朱刚, 于欣, 史丽丽, 魏镜. 共病广泛性焦虑障碍对抑郁症患者执行功能的影响:多中心回顾性病例对照研究[J]. 协和医学杂志, 2021, 12(2): 221-226. doi: 10.3969/j.issn.1674-9081.2020.00.020
GENG Wen-qi, DUAN Yan-ping, JIANG Jing, LI Tao, ZHANG Ke-rang, ZHU Gang, YU Xin, SHI Li-li, WEI Jing. Effects of Comorbidity of Generalized Anxiety Disorder on Executive Functions of Patients with Major Depressive Disorder: A Multi-center Retrospective Case-control Study[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(2): 221-226. doi: 10.3969/j.issn.1674-9081.2020.00.020
Citation: GENG Wen-qi, DUAN Yan-ping, JIANG Jing, LI Tao, ZHANG Ke-rang, ZHU Gang, YU Xin, SHI Li-li, WEI Jing. Effects of Comorbidity of Generalized Anxiety Disorder on Executive Functions of Patients with Major Depressive Disorder: A Multi-center Retrospective Case-control Study[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(2): 221-226. doi: 10.3969/j.issn.1674-9081.2020.00.020

共病广泛性焦虑障碍对抑郁症患者执行功能的影响:多中心回顾性病例对照研究

doi: 10.3969/j.issn.1674-9081.2020.00.020
基金项目: 

国家重点基础研究发展计划“重度抑郁症遗传与神经生物学基础及干预研究” 2013CB531300

详细信息
    通讯作者:

    史丽丽  电话:010-69156061, E-mail: shill@pumch.cn

  • 中图分类号: R749.4

Effects of Comorbidity of Generalized Anxiety Disorder on Executive Functions of Patients with Major Depressive Disorder: A Multi-center Retrospective Case-control Study

Funds: 

National Key Basic Research Program of China: Basic and Interventional Research of Genetics and Neurobiology of Major Depressive Disorder 2013CB531300

More Information
    Corresponding author: SHI Li-li   Tel: 86-10-69156061, E-mail: shill@pumch.cn
  • 摘要:   目的  探讨共病广泛性焦虑障碍(generalized anxiety disorder, GAD)及不同焦虑水平对抑郁症(major depressive disorder, MDD)患者执行功能的影响。  方法  回顾性收集并分析2014年2月至2016年1月北京协和医院、山西医科大学第一医院、中国医科大学附属第一医院招募的MDD患者及对照人群的临床资料。MDD患者均采用汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)对焦虑程度进行评定,并依据是否合并GAD,分为MDD+GAD组、MDD-GAD组。3组均采用MATRICS共识认知成套测验(MATRICS consensus cognitive battery, MCCB)评估其执行功能,包括动物流畅性测验(animal fluency test, AFT)、符号编码分测验(brief assessment of cognition in schizophrenia-symbolic coding, BACS-SC)、颜色连线测验(color trail test, CTT)、Stroop色词测验(Stroop color word test,SCWT)。比较3组及不同焦虑水平的MDD患者执行功能差异,采用Spearman法分析HAMA评分与MDD患者执行功能的相关性。  结果  共230例MDD患者及77名精神健康对照者入选本研究。其中MDD+GAD组86例、MDD-GAD组144例。MDD+GAD组和MDD-GAD组AFT、BACS-SC、SCWT正确数目均较对照组少,CTT完成时间较对照组长(P均<0.05);MDD+GAD组AFT正确数目多于MDD-GAD组(P<0.05),CTT、BACS-SC、SCWT结果与MDD-GAD组无显著性差异(P均>0.05)。轻度焦虑患者(7分<HAMA≤14分)AFT、BASC-CS、SCWT正确数目少于中度焦虑(14分<HAMA≤29分)及重度焦虑患者(HAMA>29分)(P均<0.05),中度焦虑与重度焦虑患者之间差异无统计学意义(P均>0.05)。Spearman相关分析结果表明,HAMA评分与AFT(rs=0.26, P<0.001)、BASC-CS(rs=0.26, P<0.001)、SCWT(rs=0.27, P<0.001)正确数目呈正相关,与CTT完成时间无线性相关(rs=-0.11, P=0.106)。  结论  共病GAD可能减轻MDD患者词语流畅功能损害;随焦虑程度加重,MDD患者的词语流畅度、信息处理速度、抑制等执行功能受损得到一定缓解。
    作者贡献:耿文奇负责数据录入、整理、分析及文章撰写;史丽丽负责指导研究思路及文章撰写;段艳平、李涛、蒋静参与临床诊断与评估;张克让、朱刚、魏镜负责督导研究进程并指导研究思路;于欣负责多中心协调工作。
    利益冲突:  无
  • 表  1  一般临床资料

    组别 性别[n(%)] 年龄[M(P25, P75),岁] 受教育年限[M(P25, P75),岁]
    男性 女性
    MDD+GAD组(n=86) 21(24.42) 65(75.58) 37.5(30, 47) 12(9, 16)
    MDD-GAD组(n=144) 37(25.69) 107(74.31) 38(29, 47) 12(9, 16)
    对照组(n=77) 21(27.27) 56(72.73) 33(25, 43) 16(15, 19)
    P 0.917 0.054 <0.001
    MDD:抑郁症;GAD:广泛性焦虑障碍
    下载: 导出CSV

    表  2  MDD+GAD组、MDD-GAD组与对照组执行功能比较

    组别 AFT(x±s, 个) BACS-SC(x±s, 个) CTT[M(P25, P75),s] SCWT(x±s, 个)
    MDD+GAD组(n=86) 20.53±6.20 51.52±14.64 34.50(23.75, 55.00) 36.62±11.35
    MDD-GAD组(n=144) 18.03±5.57 48.53±15.29 42.50(28.25, 68.00) 34.26±12.10
    对照组(n=77) 22.82±6.05 61.91±12.36 32.00(22.00, 52.00) 43.38±14.40
    P <0.001 <0.001 0.012 <0.001
    MDD、GAD:同表 1;AFT:动物流畅性测验;BACS-SC:符号编码分测验;CTT:颜色连线测验;SCWT:Stroop色词测验
    下载: 导出CSV

    表  3  不同焦虑水平的抑郁症患者执行功能差异比较

    组别 AFT(x±s, 个) BACS-SC(x±s, 个) CTT[M(P25, P75),s] SCWT(x±s, 个)
    轻度焦虑患者(n=41) 15.41±4.82 41.22±15.39 45(32, 84) 30.95±14.54
    中度焦虑患者(n=155) 19.32±5.85 50.54±14.54 37(25, 56) 35.77±10.94
    重度焦虑患者(n=34) 21.68±5.66 55.76±13.25 41(31, 62) 37.32±11.52
    P <0.001 <0.001 0.096 0.004
    HAMA:汉密尔顿焦虑量表;AFT、BACS-SC、CTT、SCWT:同表 2
    下载: 导出CSV
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出版历程
  • 收稿日期:  2019-08-28
  • 录用日期:  2020-01-10
  • 网络出版日期:  2020-12-17
  • 刊出日期:  2021-05-30

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