摘要
目的探讨青少年重性抑郁障碍(抑郁),双相情感障碍抑郁相(双相抑郁)、躁狂相(双相躁狂)的临床症状、认知功能以及认知-症状网络差异。方法本研究共入组175例青少年健康对照,380例患者(包括146例抑郁、131例双相抑郁、103例双相躁狂)。比较各组焦虑、抑郁、精神病性症状、轻躁狂、躁狂、非自杀性自伤、失眠、快感缺失、儿童期虐待、认知损害等差异;采用网络结构不变性测试,分析三组网络结构差异。结果在轻躁狂(HCL-32)、躁狂(MDQ)症状方面,三组患者严重程度呈现“梯度”差异:抑郁组<双相抑郁组<双相躁狂组(Ps<0.05);在认知功能方面,双相躁狂组较其它组认知损害更显著(Ps<0.05)。双相躁狂组较抑郁组(M=0.562,P=0.028)、及双相抑郁组(M=0.584,P=0.028)网络结构存显著差异。结论双相躁狂组轻躁狂、躁狂症状及认知损害重;症状-认知网络结构与其它诊断不同。抑郁与双相抑郁组的症状、认知损害重叠大,症状-认知网络结构亦相似;探寻更多可鉴别抑郁与双相抑郁的可靠的评估工具尤为重要。
Objective Exploring clinical symptoms,cognitive functions,and cognitive-symptom network differences in adolescents with major depressive disorder,depressive phase of bipolar disorder,and manic phase of bipolar disorder.Methods This study enrolled 175 healthy controls and 380 patients(146 with depression,131 with bipolar depression,and 103 with bipolar mania).Differences among groups were compared in terms of clinical symptoms and cognitive impairment.Network structure invariance testing was used to analyze differences in network structures among the three groups.Results In terms of hypomania(HCL-32)and manic symptoms(MDQ),the severity of symptoms showed a"gradient"difference across the three groups:depression group<bipolar depression group<bipolar mania group(Ps<0.05).In cognitive function,the bipolar mania group exhibited more significant cognitive impairment compared to the other groups(Ps<0.05).The network structure of the bipolar mania group significantly differed from that of the depression group and the bipolar depression group.Conclusion The bipolar mania group exhibited more severe hypomanic and manic symptoms,as well as greater cognitive impairment.Their symptom-cognitive network structure also differed from the other diagnostic groups.The symptoms and cognitive impairments of the depression and bipolar depression groups overlapped significantly.Therefore,it is crucial to explore more reliable assessment tools to differentiate between depression and bipolar depression.
出处
《国际精神病学杂志》
2025年第2期351-355,共5页
Journal Of International Psychiatry
基金
国家科技创新2030重大项目(编号:2021ZD0202000)
湖北省技术创新计划重大科技项目(编号:2024BCA003)
湖北省卫生健康委重点项目(编号:WJ2023Z003)
湖北省自然科学基金(编号:2024AFB751)
孝感市自然科学计划项目(编号:XGKJ2024010061,XGKJ2024010062,XGKJ2024010063)
武汉大学大学生创新训练计划项目(编号:202510486145,W202510486380)。
关键词
青少年
重性抑郁障碍
双相情感障碍
认知功能
网络结构
Adolescent
Major depressive disorder
Bipolar disorder
Cognitive function
Network structure
