A Study On Cognitive Function And Quality Of Life In Patients With Primary Insomnia

Objective:(1) To explore the characteristics of cognitive function impairment and its influencing factors in the patients with primary insomnia(PI), so we can provide the neuropsychological basis for the study of cognitive function of PI patients.(2) To explore the quality of life(QOL) and its influencing factors in patients with primary insomnia, so we can provide scientific evidence for improving the quality of life of PI patients.Methods:(1) Neuropsychological tests including Wechsler memory scale(digital accumulation, visual recall, visual reproduction, associative learning), digit span, digit cancellation, trail-marking test(TMT), Wisconsin card sorting test(WCST) were used to evaluate the attention, memory and executive function in 46 PI patients(PI group) and 40 healthy controls(HC group);(2) The WHOQOL-BREF was used to assessed the quality of life in 50 PI patients and 40 healthy controls;(3) The severity of insomnia and its accompanying anxiety or depression symptoms in PI patients were separately assessed by Pittsburgh sleep quality index(PSQI), Self-rating anxiety sale(SAS) and Self-rating depression sale(SDS).Results:(1) The cognitive function and its influencing factors in PI patients: j Compared with the healthy controls, the achievements of digit accumulation, visual recall, visual reproduction, associative learning, digit span backward, the error rate of digit cancellation test, trail-marking test B and B-A and Wisconsin card sorting test(WCST) were significantly worse in the PI patients except the correct responses of WCST. k In the PI patients, the SDS score was positively correlated with PSQI and SAS score; the digital accumulation score was negatively correlated with the course; the associative learning score was negatively correlated with PSQI, the time of trail marking test B and B-A were positively correlated with the course and the Rpe% of WCST was positively correlated with SDS score.(2) The impairment of quality of life and its influencing factors in PI patients: jCompared with the healthy controls, the WHOQOL-BREF in the physical, psychological, independent, social relationships, environment domains and the overall QOL were significantly worse in the PI patients. kIn PI patient, the overall QOL of severe group was lower than moderate group; the overall QOL in the anxiety depression co-morbid group was lower than those without corresponding emotional symptoms. lIn the PI patients, the SAS score was negatively correlated with all the domains and the overall QOL except the spiritual domain; the SDS score was negatively correlated with all the domains and the overall QOL; the PSQI score was negatively correlated with the physical, psychological, independent, spiritual domains and the overall QOL. l Multiple regression analyses indicated that the depression symptom, severity of insomnia and family history were significant predictors of impairment of quality of life in PI patients.Conclusions:(1) There is generally cognitive impairment in the PI patients, including attention, memory, and executive function.(2) The course of the disease, severity of insomnia, anxiety and depression symptoms are the correlative factors leading to the cognitive impairment.(3) In PI patients, the quality of life in the physical, psychological, independent, social relationships, environment domains and the overall QOL were impaired.(4) The severity of insomnia, family history, anxiety and depressive symptoms are the important factors resulting in impairment of quality of life in PI patients.