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目的探讨青少年重症抑郁症(MDD)患儿执行功能的特点。方法采用学龄儿童情感障碍和精神分裂症问卷-目前及终生版,儿童抑郁量表,中国韦氏智力测试中的数字广度分测验,Stroop色词关联测验以及剑桥神经心理自动化成套测试(CANTAB)中的空间工作记忆(SWM)测验、剑桥袜(SOC)测验、目标内外注意转换(IED)测验分别对36例首发未服药青少年MDD患儿(抑郁症组)和40例健康对照儿童的当前和既往精神疾病发作情况进行筛查,评估抑郁严重程度和执行功能,比较二组执行功能的区别。结果在数字广度分测验和Stroop色词关联测验中,抑郁症组与健康对照组比较差异均无统计学意义(Pa>0.05);在SWM测验中,抑郁症组的8个格子间隔错误数(20.27±12.51 vs 13.91±9.72)、策略分(34.79±3.35 vs 32.14±4.25)多于健康对照组,二组比较差异均有统计学意义(Pa<0.05);在SOC测验中,抑郁症组的4步平均移动步数(5.98±1.25 vs 5.33±0.96)多于健康对照组,二组比较差异有统计学意义(P<0.05);在IED测验中,抑郁症组的总尝试次数(60.74±37.45 vs 35.44±27.40)明显多于健康对照组,二组比较差异有统计学意义(P<0.05)。结论青少年MDD患者存在空间工作记忆、认知灵活性和计划等多个执行功能成分的损害,而语音工作记忆和抑制控制等执行功能成分的损害不突出。
Objective To investigate the executive function of children with major depression (MDD). Methods The questionnaire of affective disorder and schizophrenia in school-age children-current and lifetime version, children’s depression scale, digital breadth test in China’s Wechsler Intelligence Test, Stroop Color Word Association Test and Cambridge Neuropsychological Automated Test (CANTAB) SWM test, SOC test and IED test were used to evaluate the current and past status of 36 children with MDD (depression group) and 40 healthy controls Mental illness seizures were screened to assess the severity of depression and executive function, the difference between the two executive functions. Results There was no significant difference between the depression group and the healthy control group in the digital breadth test and the Stroop color word association test (Pa> 0.05). In the SWM test, 20.27 ± 12.51 vs 13.91 ± 9.72), and the score of strategy (34.79 ± 3.35 vs 32.14 ± 4.25) was more than that of healthy control group (P <0.05). In SOC test, (P <0.05). In the IED test, the total number of attempts in the depression group (60.74 ± 0.05) was significantly higher than that in the healthy controls (5.98 ± 1.25 vs 5.33 ± 0.96) 37.45 vs 35.44 ± 27.40) were significantly more than healthy control group, the difference between the two groups was statistically significant (P <0.05). Conclusion Adolescents with MDD suffer from impairment of multiple executive functional components, such as spatial working memory, cognitive flexibility and planning, while impairment of executive functional components such as voice working memory and suppression control is not conspicuous.