Abstract:Objective To analyze the working memory impairment in patients with different degrees of depressive disorder and its influencing factors, so as to provide the basis for the clinical evaluation of cognitive function in patients with depressive disorder. Methods From January 2019 to November 2020, the patients with depressive disorder were selected in the psychiatry and clinical psychology departments of a tertiary hospital. Demographic information, disease course and medication were collected. Depression subscale ( DEP ) of Mental Health Inventory ( PHI ) was used to measure the degree of depressive disorder. N-back tasks were used to test working memory, with error rate and reaction time as experimental variables to compare the working memory impairment of patients with different degrees of depressive disorder. The multivariate linear regression model was used to analyze the influencing factors for working memory impairment in patients with depressive disorder. Results A total of 75 patients with depressive disorder were included, including 45 mild cases and 30 moderate and severe cases. The error rates of mild cases and moderate and severe cases in the 3-back task were ( 27.47±20.59 )% and ( 39.60±25.95 )%, the response time between the two groups in 0-back, 1-back, 2-back and 3-back task were ( 458.29±104.19 ) ms and ( 527.90±99.58 )ms,( 499.87±85.46 ) ms and ( 574.57±126.25 ) ms, ( 567.44±114.86 ) ms and ( 675.37±137.54 ) ms, ( 663.76±167.99 ) ms and ( 753.27±152.06 ) ms, the differences between two groups were significant ( P<0.05 ). The multivariate linear regression analysis showed that the severity of depressive disorder was correlated with the response time of 0-back to 3-back tasks and the error rate of 3-back task; whether patients took medicine or not was depressive disorder correlated with the 0-back task response time ( all P<0.05 ). Conclusion There are differences in working memory impairment among patients with different degrees of depressive disorder and the severity of impairment is correlated with the severity of depressive disorder and the use of antidepressant drugs.
[1] BADDELEY A.The fraction of working memory[J].PNAS,1996,93(24):134-138. [2] 孙丽君,王希林,黄悦勤.抑郁障碍患者缓解期认知功能损害研究[J].预防医学,2016,28(7):658-661,665. [3] 王雪. 大学生抑郁情绪对工作记忆影响的研究[D].大连:大连海事大学,2017. [4] STEVAN N,TAN Y Y,SCHWAAB A,et al.An investigation of working memory deficits in depression using the n-back task:a systematic review and meta-analysis[J].J Affect Disord,2021,284:1-8. [5] 鲍枫,潘伟刚,毛佩贤,等.中重度晚发抑郁症患者的神经认知功能损害[J].中国心理卫生杂志,2017,31(6):442-446. [6] LEE R S C,HERMENS D F,PORTER M A,et al.A meta-analysis of cognitive deficits in first-episode Major Depressive Disorder[J].J Affect Disord,2012,140(2):113-124. [7] 美国精神医学学会.精神障碍诊断与统计手册(案头参考书)[M].5版.北京:北京大学出版社,2014:25-27. [8] 宋维真,莫文彬.心理健康测查表(PHI)的编制过程[J].心理科学,1992(2):38-42,67. [9] 段敬利,潘伟盟,穆俊林,等.不同程度抑郁症患者认知功能及事件相关电位P300的研究[J].临床精神医学杂志,2017,27(5):327-330. [10] LI M,FENG L,LIU X W,et al.Emotional working memory in patients with major depressive disorder[J].J Int Med Res,2018,46(5):1734-1746. [11] NOORT M,BOSCH P,KUEPPENBENDER N,et a1.Verbal working memory capacity in patients with chronic schizophrenia,chronic depression,and healthy participants[J].Eur Psychiatry,2010,25(10):222-231. [12] 帕丽扎提·木合塔尔,买合甫来提·坎吉,徐向东,等.抑郁症患者工作记忆容量不足研究[J].中国神经精神疾病杂志,2017,43(3):180-184. [13] HARVEY P O,BASTARD G L,POCHON J B.Executive functions and updating of the contents of working memory in unipolar depression[J].J Psychiatr Res,2010,189(8):100-111. [14] WATTERS A J,CARPENTER J S,HARRIS A W F,et al.Characterizing neurocognitive markers of familial risk for depression using multi-modal imaging,behavioral and self-report measures[J].J Affect Disord,2019,253:336-342. [15] WANG X L,DU M Y,CHEN T L,et al.Neural correlates during working memory processing in major depressive disorder[J].Prog Neuropsychopharmacol Biol Psychiatry,2015,56:101-108. [16] LE T M,BORGHI J A,KUJAWA A J,et al.Alterations in visual cortical activation and connectivity with prefrontal cortex during working memory updating in major depressive disorder[J]. Neuroimage Clin,2017,14:43-53. [17] SMITH J,BROWNING M,CONEN S,et al.Vortioxetine reduces BOLD signal during performance of the N-back working memory task:a randomised neuroimaging trial in remitted depressed patients and healthy controls[J].Mol Psychiatry,2018,23(5):1127-1133. [18] 简炜颖,关力杰,黄建伟,等.难治性抑郁症与首发抑郁症患者认知功能的对比研究[J].天津医药,2017,45(12):1275-1278. [19] 刘治港,赵晓峰,张会杰,等.反复发作抑郁症患者认知功能损害研究[J].中华行为医学与脑科学杂志,2019,28(7):636-641. [20] 娄乐. 抑郁症患者认知功能损害及其影响因素初步研究[D].杭州:浙江理工大学,2015. [21] 谢慧,罗跃嘉,张丹丹.基于N-back任务的抑郁群体工作记忆更新研究进展和展望[J].心理学通讯,2019,2(1):43-49.