Studies Of Long-term Cognitive Impairment In Post-traumatic Stress Disorder

Objective: To investigate the long-term cognitive impairment characteristics and mechanisms on post-traumatic stress disorder(PTSD), and association between cognitive impairment and dementia.Methods: We selected 40 PTSD patients consistent with DSM-IV Axis diagnosis coming to Hebei Medical University- Institute of Mental Health from January 2004 to December 2005, and selected the same period another 40 patients with generalized anxiety disorder, 40 cases of depression and 40 healthy people from January 2012 to December 2013 be the control group. All patients enrolled should be given neuropsychological investigation, including the Hamilton anxiety Scale(HAMA), Hamilton depression Scale(HAMD), post-traumatic stress diagnostic Scale(PDS), PTSD Check List-Civilian Version(PCL-C), Wisconsin Card(WCST), Wechsler Adult Intelligence Scale Revised(WAIS-RC),Wechsler Memory Test(WPS-R), and Event-Related Potentials(ERP). According to SPSS17.0 statistical analysis, the enumeration data were analyzed to find the differences between PTSD group, depression group and the control group, and the relationship between memory function with memory impairment.Results:1 In terms of sex, age, mean years of schooling, there is no significant difference in the four groups(P>0.05).2 The scores of HAMA and HAMD in patients with anxiety and depressed are higher than the PTSD group and the control group, while the scores of PTSD group are higher than that of the control group, the differences are statistically significant(P<0.05); HAMA score in anxiety group is higher than that of the depression group, while HAMD score in anxiety group is lower than that of the depression group, the differences are statistically significant(P<0.05).3 WAIS-RC scores of PTSD group are significantly lower than in the normal group, depression and anxiety group, the difference was statistically significant(P<0.05); WAIS-RC scores of depression and anxiety group group were significantly lower than in the normal group, the differences are statistically significant(P<0.05); There is no significant difference in WAIS-RC scores between depression and anxiety group group(P>0.05).4 PCL-C score of PTSD patients was higher than in depression and anxiety group, and the differences are statistically significant(P<0.05); The scores of depression and anxiety group are significantly higher than in the normal group(P<0.05), and there is no significant difference between depression and anxiety group(P>0.05).5 C, R, DC, DR scores of PTSD patients are higher than in depression and anxiety group, and the differences are statistically significant(P<0.05); The scores of C, R, DC, DR in depression and anxiety group are significantly higher than in the normal group(P<0.05), and there is no significant difference between depression and anxiety group(P>0.05).6 The response number(Ra) and error response number(Re) in PTSD group are significantly higher than in control, depression and anxiety group(P<0.05), while there is no significant difference between three groups(P>0.05) Re. There is no significant difference in number of responses, completed the classification number(Cc), the number of correct answers(Rc), persistent errors(Rpe), non- persistent errors(n Rpe), required to complete the first category(Rf) between each group( P>0.05).7 Compared with depression group, anxiety group and control group, event related potential P300 latency in PTSD patients is longer, but with lower amplitude, the differences are statistically significant(P<0.05).8 Cognitive dysfunction in PTSD patients is significantly more serious than in control group, depression and anxiety group, the differences are statistically significant(P<0.05); While there is no statistically difference between three groups(P>0.05).Conclusion:1 Major trauma is the leading cause to memory impairment in patients with PTSD, and the more severe trauma symptoms, the more severe of memory impairment.2 PTSD patients have severe frontal lobe damage and memory ability of abstract thinking, and executive dysfunction, executive dysfunction and no correlation with PTSD symptoms, which prompted that executive dysfunction in patients with PTSD is independent neural symptom.3 PTSD may be one of an important cause of decline in cognitive function in patients with damage, and reduced cognitive function damage is also a result of cognitive impairment in primary PTSD symptoms caused.4 PTSD patients have more severe memory impairment, including visual regeneration, understanding of memory, delayed memory and visual aplasia,except depression and anxiety disorder.