CAJ | 학술논문

目的：比较青少年双相障碍Ⅱ型和单相抑郁症之间认知功能的差异。方法对54例青少年双相障碍Ⅱ型和83例青少年单相抑郁症患者在抑郁发作时作认知功能测验，包括：中国韦氏成人智力量表（WAIS- RC）、连线测验（TMT）、持续操作测验（CPT）、韦氏记忆量表（WMS- RC）、词语流畅性测验（VF）、威斯康星卡片分类测验-改良版（WCST），并与50例健康对照组比较。经过6周治疗后，对抑郁症状缓解（HAMD≤7分）患者重复上述认知功能测验。结果入组时双相障碍Ⅱ型和单相抑郁两组在认知功能方面广泛受损，表现为TMT- A、WAIS- RC数字符号、CPT、WAIS- RC数字广-倒背、WAIS- RC视觉再生、VF、WCST和TMT- B项目上与健康人群相比明显成绩差，差异均有统计学意义（均P＜0.01），但双相障碍Ⅱ型和单相抑郁两组间比较差异无统计学意义（P＞0.05）。治疗6周后，对两组临床痊愈的患者重复测验，发现两者在WAIS- RC数字符号和WAIS- RC视觉再生方面存在持续性损伤，与健康对照组比较差异均有统计学意义（P＜0.05）。双相障碍Ⅱ型患者在CPT项目上存在损伤，与健康对照组比较差异有统计学意义（P＜0.05）。而单相抑郁症患者表现为VF和TMT- B项目上存在损伤，与健康对照组比较差异有统计学意义（P＜0.05）。结论双相障碍Ⅱ型和单相抑郁在抑郁状态时，认知功能广泛受损，两者比较无统计学差异。在抑郁症状缓解后，双相障碍Ⅱ型表现为持续性注意功能障碍，而单相抑郁表现为执行功能障碍。
목적：비교청소년쌍상장애Ⅱ형화단상억욱증지간인지공능적차이。방법대54례청소년쌍상장애Ⅱ형화83례청소년단상억욱증환자재억욱발작시작인지공능측험，포괄：중국위씨성인지역량표（WAIS- RC）、련선측험（TMT）、지속조작측험（CPT）、위씨기억량표（WMS- RC）、사어류창성측험（VF）、위사강성잡편분류측험-개량판（WCST），병여50례건강대조조비교。경과6주치료후，대억욱증상완해（HAMD≤7분）환자중복상술인지공능측험。결과입조시쌍상장애Ⅱ형화단상억욱량조재인지공능방면엄범수손，표현위TMT- A、WAIS- RC수자부호、CPT、WAIS- RC수자엄-도배、WAIS- RC시각재생、VF、WCST화TMT- B항목상여건강인군상비명현성적차，차이균유통계학의의（균P＜0.01），단쌍상장애Ⅱ형화단상억욱량조간비교차이무통계학의의（P＞0.05）。치료6주후，대량조림상전유적환자중복측험，발현량자재WAIS- RC수자부호화WAIS- RC시각재생방면존재지속성손상，여건강대조조비교차이균유통계학의의（P＜0.05）。쌍상장애Ⅱ형환자재CPT항목상존재손상，여건강대조조비교차이유통계학의의（P＜0.05）。이단상억욱증환자표현위VF화TMT- B항목상존재손상，여건강대조조비교차이유통계학의의（P＜0.05）。결론쌍상장애Ⅱ형화단상억욱재억욱상태시，인지공능엄범수손，량자비교무통계학차이。재억욱증상완해후，쌍상장애Ⅱ형표현위지속성주의공능장애，이단상억욱표현위집행공능장애。
Objective To compare the cognitive function in adolescents with bipolar disorder- Ⅱ and those with u-nipolar depression. Methods Fifty four adolescents with bipolar disorder- Ⅱ (bipolar group), 83 adolescents with unipolar de-pression (unipolar group) and 50 healthy adolescents (control) were enrol ed in the study. Wechsler Adult Intel igence Scale (WAIS- RC), Trail Making Test(TMT), Continuous Performance Test (CPT), Wechsler Memory Scale(WMS- RC), Verbal Fluency(VF) and Wisconsin Card Sorting Test (WCST) were performed in al subjects, the tests were performed again after 6 weeks of treat-ment and patients experienced remission(HAMD≤7), Results Before treatment the TMT- A, WAIS- RC numerical symbols, CPT, WAIS- RC digit span subtest, WAIS- RC visual reproduction, VF, WCST and TMT- B scores in patients were worse than those in healthy controls (P<0.01). However, there were no significant differences between bipolar and unipolar groups (P>0.05). After six- week treatment, there was stil significant difference in WAIS- RC numerical symbols and WAIS- RC visual reproduction be-tween patients and healthy groups(P<0.05). The bipolar patients had difficulty in CPT, compared to healthy group(P<0.05), while the abilities of VF and TMT- B in unipolar patients were stil lower compared to healthy group(P<0.05). Conclusion The cognitive function in adolescents with bipolar disorder- Ⅱ or unipolar depression is general y damaged. At the remission of the disease bipolar patients have difficulty in sustained attention, while unipolar patients show the decline of executive function.