Electrophysiological Study Of Three Different Subtypes Of Depressive Disorder

ObjectiveTo explore the differences of clinical symptoms and electrophysiological indexes between the baseline and follow-up period of patients with melancholic,atypical,and anxious depression,so as to find the objective index factors of symptoms and electrophysiology that can distinguish the subtypes of depressionMethodThe patients in this study were screened by mini,and then matched to Mel group,ATY group and anx group according to DSM-V diagnostic standard.HAMD-17,IDS-30 and QIDS-16 were used to evaluate the depression,QOL-6 was used to evaluate the quality of life.Auditory P300,visual P300 and mismatched negative wave MMN were used to evaluate the cognitive function.Patients in MEL group received fluoxetine single drug intervention;patients in ATY group received fluvoxamine single drug intervention;patients in anx group received mirtazapine single drug intervention.Follow up evaluation was performed at baseline and 12 weeks after treatment.All data were statistically analyzed using SPSS 21.0.p < 0.05 was considered statistically significant.The statistical methods mainly involved in this study were paired samples t-tests,ANVOA and Wilcoxon rank sum test.Results1.61 patients with depression were enrolled into the group,including 27 in MEL group,14 in ATY group and 20 in anx group.The differences of sleep factor,body anxiety factor and cognitive impairment factor in HAMD among the three groups at baseline were statistically significant(F = 4.064,P< 0.05,f = 10.562,P < 0.05,f = 4.852,P < 0.05);the differences of emotional / cognitive factors in IDS were statistically significant(f = 6.680,P < 0.05).2.24 patients were followed up,10 in MEL group,6 in ATY group and8 in anx group.After 12 weeks of treatment,the scale scores of the three groups were decreased in varying degrees.Compared with the baseline scores,the total scores of HAMD and QIDS in MEL group and ATY group were significantly different in the follow-up period.The total score of HAMD in anx group was significantly different in the follow-up period.3.The electrophysiological examination in baseline period showed that in auditory P300 task,there were significant differences in C3 and PZ leads among the three groups(F = 3.433,P < 0.05,f = 3.228,P < 0.05);in MMN task,there were significant differences in FZ and FCZ leads among the three groups(F = 3.255,P < 0.05,f = 3.464,P < 0.05).4.After 12 weeks of treatment,there were significant differences in leads C4,CP1 and CP2 in MEL group(t =-3.282,P < 0.05,t =-2.852,P <0.05,t =-2.378,P < 0.05).In MMN task,there was significant difference in F4 lead in ATY group(t =-2.759,P < 0.05).ConclusionThere are significant differences in clinical symptoms among different subtypes of depression.Depression patients have serious emotional and sleep problems,atypical patients also have serious emotional problems,anxiety depression patients have serious physical symptoms.After targeted antidepressant treatment,most of the patients with depression will get relief of clinical symptoms.The three subtypes of depression patients have quality of life problems,including physical conditions,mental and psychological conditions and interpersonal relationships.Through targeted antidepressant treatment,the quality of life of patients will be improved.At baseline,there were differences in P300 and MMN latencies in different subtypes of depression.After receiving antidepressant drugs,there were changes in P300 latencies and amplitude in depression patients.