The Specialties Of Cognitive Function And Soft Neurological Signs In First-episode Depression And The Effect Of CBT

Objective:To explore the characteristics of cognitive dysfunction and soft neurological signs and analyze their correlation in patients with first-episode major depressive disorder. Based on this study, explore the effectiveness of the combined treatment of cognitive behavioral therapy on cognitive dysfunction and soft neurological signs.Methods:In this study,90patients with first-episode major depressive disorder and80normal controls were tested by neuropsychological tests, as WCST, Stroop, CPT, WMS scales, and Cambridge Neurological Inventory to explore the characteristics of cognitive dysfunction and soft neurological signs, and correlate with dosage of antipsychotics, clinical symptoms. Then56patients were recruited for the study interventions, and were randomly assigned to medication group and combined treatment group of cognitive behavioral intervention,28cases each. After8weeks, the efficacys of two treatment ways were evaluated with all scales. Compare the results by SPSS17.0statistical software to explore the effectiveness of cognitive behavioral intervention.Results:(1) All indexes of neuropsychological tests in first-episode depression groups were significantly different compared normal control ones (p<0.0\). Most of indexes did not influenced by psychotropic drugs, while some indexes correlated with HAMD results.(2) To compare normal control group, first-episode depression patients had more soft neurological signs with significant difference, including the total score of CNI, categorys of repetitive movement and primitive reflex, items of rhythm tapping and go no go stimulus (p<0.05or p<0.01). Positive correlations were found between the HAMD factor (anxiety/somatization) and repetitive movement, the total score of CNI. The rhythm tapping have significantly correlation with some items of the neuropsychological tests.(3) Comparing the differences before and after intervention, the combined treatment group in the factors of clinical symptoms and cognitive dissonance were significantly greater than the medication group (p<0.05or p<0.01). In combined treatment group, most indexes of neuropsychological tests and CNI improved significantly larger than the medication group (p<0.05). But on the whole, after intervention, all of indexes in the depression groups were still different compared normal control ones (p<0.05or p<0.01).Conclusions:(1) The first-episode major depressed patients have wide cognitive dysfunction, including in executive dysfunction, attention and memory dysfunction.But cognitive dysfunction couldn’t improve completely even after depression symptom remission.(2) The first-episode major depressed patients also have abnormal soft neurological signs. And there is significant correlation between the abnormal performances and cognitive dysfunction.(3) On the basis of cognitive behavior therapy do the medication therapy, not only improve the clinical symptoms, but also show a good effect in improving the patients cognitive impairment and abnormal soft neurological signs.