The Characteristics Of Cognitive Function And Soft Neurological Signs In Patients With First-episode Agitated And Retarded Major Depressive Disorder

Objective:⑴To study the characteristics of cognitive function in patients withfirst-episode agitated and retarded major depressive disorder;⑵To investigate the traitsof soft neurological signs in these patients;⑶and to explore the correlation between softneurological signs and cognitive impairment in them.Methods:There were88patients with first-episode major depressive disorder in allwho were grouped three classes according to the scores of retardation and agition inHAMD17，including retarded group(27)，agitated group(23), non-interactive group(38)，compared with40normal controls and36schizophrenic patients. All subjects weretested by neuropsychological tests(consist of STROOP,WCST,CPT,WMS) and CNI inthe first there days and at the eighth weeked after they were recruited. In the sametime,the patients underwent clinical assessment respectively (HAMA,HAMD andMADRS for depression patients;PANSS for schizophrenics),recorded relevant drugdosis.The datas were conducted statistics analysis.Results:⑴There were wide cognitive impairment in depression patients，whichwere less severity than those of schizophrenics (P<0.05～P<0.01);⑵Part of markers ofSTROOP(WT,CT,CWT),all indexes of WCST, CPT parameters(number of cancel,number of commission, mean reaction time) and WMS indexes (memory quotient,short-term memory, immediate memory) in agitated and retarded groups weresignificantly different compared non-interactive ones(P<0.05～P<0.01);⑶There wereobvious diversities between agitated and retarded groups including correct errors of CTin STROOP, non-preservative errors of WCST, mean reaction time of CPT, short-termmemory of WMS(P<0.05～P<0.01);⑷No significant correlation was found betweenmost of parameters and clinical symptoms or the amounts of psychotropicdrugs(imipramine-equivalent dose of anti-depressants，diazepam-equivalent dose of sedatives，chlorpromazine-equivalent dose of antipsychotics)(P>0.05);⑸After therapyfor8weeks,the cognitive dysfunction of each depressive subtype has been improved indifferent levels，but not to recovery normally.There were some testing results of agitatedand retarded patients not as good as those of non-interactives ones(P<0.05～P<0.01);⑹Depressive patients had more soft neurological signs with significant difference,including rhythm tapping test， primitive reflexes, repetitive movement,seneoryintegration and total score.Besides rhythm tapping test, other abnormalities were lighterthan those of schizophrenia(P<0.05~P<0.01);⑺Agitated patients’primitive reflexesscores was most in depressive groups(P<0.05),other items with no significant difference;⑻Age presented a positive correlations with repetitive movement and total score.Negative relevance was found between education level and rhythm tapping test，repetitive movement,total score(P<0.05~P<0.01);⑼Therewere significant relevancebetween CNI and the majority of neuropsychological test results(P<0.05~P<0.01).Depressive subtypes emphasised on different aspects;⑽There were significantcorrelations between CNI and a part of clinical symptoms(P<0.05~P<0.01);⑾After8weeks,the presentation of soft neurological signs in depressive patients almostrecoveried nomally,agitated and non-interactives patients presented significantdifference on repetitive movement.Conclusion:⑴The cognitive dysfunction of depressive patients with psychomotordisorders was more serious and recovered more slowly;⑵The cognitive dysfunction ofagitated depression patients was not the same as those of retarded ones entirely, whichsupplied a positive evidence for the heterology of major depressive disorder;⑶Theclinical performance of soft neurological signs was in substantial agreement indepressive patients with or without psychomotor disorders;⑷Soft neurological signscorrelated with neuropsychological impairment,which presented differently for agitatedand retarded depression.