| BackgroundDepressive episode is a common mental disease involving many aspects of sensory,emotional and activities,which presents the characteristics of high prevalence,high recurrence rate and high mortality rate,which seriously affects the physical and mental health of patients.In the past,single antidepressant therapy was used.But some studies showed that antidepressants could effectively relieve the clinical symptoms of patients,while it is not obvious to improve cognitive function,even most patients can not regain cognitive function before the disease,seriously affecting the life-quality and prognosis.So clinicans began to abandon the single drug therapy model,to choose the combined therapy to treat depressibe episode,focus on clinical symptoms of depressive episode and the double improvement of cognitive impairment,and improve the prognosis.ObjectiveTo understand and study the effect of Computerized Cognitive Remediation Therapy(CCRT)on efficacy and cognitive function in depression episode.MethodsIn this study,84 depressive episode patients who were hospitalized at PLA 91 st central hospital from October 2016 to October 2017 were divided in study group and control group by random digital table method.Study group(43 cases)were treated with Computerized Cognitive Remediation Therapy combined with SNRIs antidepressant drug(venlafaxine hydrochloride sustained-release tablets),the control group(41 cases)were treated with single SNRIs antidepressant drug(venlafaxine hydrochloride sustained-release tablets).Antidepressant therapy in study group and control group began on the first day of admission.According to the drug instructions,the starting dose is 75 mg per day,once a day,in the moring or at night,with food.Take it as a whole and avoid breaking,crushing,chewing and soaking.Addition of 75 mg daily at intervals of 4 to 7 days,with maximum dose not exceeding 225 mg.In both groups,the treatment period around hospitalization 4 was selected,during which a single drug was used to avoid combination of drugs,especially antidepressants.In the event of severe sleep disorder,the hypnotic drug benzodiazepine maybe given orally temporarily.The entire treatment process was carried out by 2 special trained,middle-level or above professional psychiatrists.The study group received systematic Computerized Cognitive Remediation Therapy 5 days after admission,2 days recuperate,5 times a week for 4 weeks,lsating 45 minutes each time,a total of 20 sessions.The treatment is carried out by professionals skilled in the operation of equipment.In addition,40 cases were selected as normal group.Based on the design,the evaluvtion work of the study group,control group and normal group was carried out.Hanilton Depression scale was used to evaluate clinical sympyoms in depressive episode patients;the cognitive function of patients with depressive episode was assessed by MATRICS Consensus Coginitive Battery and Event Related Potentials P300;the social function status of patients with depressive episode was assessed by using Social Function Deficiency Screening Scale;assessment of possible adverse drug reactions during treatmeng of patients with depressive episode by Treatment Emergent Symptom Scale.By using SPSS18.0 statistical software,statistical analysis was carried out by the methods of card inspection,T inspection and repeated variance analysis.The statistical significance is analyzed by P<0.05orP<0.01.Results1.There were no ststistical differences in age,sex and years of education among the study group,control group and normal group(P?0.05),There was no ststistical difference in the course of disease between the study group control group(P?0.05);2.The results of variance analysis of repeated tests showed that the study group was superior to the control group in HAMD score changes,and there was a statistical difference between the two groups(P<0.01).Further comparison showed that the HAMD score of the study group and the control group at 2 weekend,4 weekend was lower than that of the groups when entered the group(P<0.01);The HAMD score of the study group and the control group at 4 weekend was lower than that of the groups at 2 weekend(P<0.01).Effective and curative results showed that 16 cases were cured by the research group at the end of the 4th weekend,and 36 cases were effective,accounting for 37.2 % and 83.7 % respectively;In the control group,10 cases were cured,and 25 cases were effective,accounting for 24.4 % and 61.0 % respectively.The total effective rate and cure rate of the study group at 4 weekend were higher than those of the control group,with statistical differences(P<0.05);3.The scores of the study group and the control group when entered the group were lower than the normal group in the connection test,symbol coding,language memory,space breadth,maze test,visual memory,verbal fluency,and continuous operation score,and there was a statistical difference(P<0.05 or P<0.01),while there was no statistical difference in the score of the numerical sequence and mood management compared with the normal group(P>0.05).The results of repeated measurement variance analysis showed that the study group was superior to the control group in connection tests,symbol coding,language memory,spatial breadth,maze tests,visual memory,speech fluency,and continuous operation sub-measurement changes,and there was a statistical difference(P<0.05orP<0.01),while there was no statistical difference in the changes of the number sequence and mood management score(P>0.05);Further comparison showed that the score of the study group on the maze test and the continuous operation test at 2 weekend was higher than when enterd the group,there was a statistical difference(P<0.05).while there was no statistical difference from the score of the connection test,symbol coding,language memory,spatial breadth,visual memory,verbal fluency to the scores when entered the group(P>0.05).the score of the control group on the connection test,symbol coding,language memory,space breadth,maze test,visual memory,verbal fluency,and continuous operation at 2 weekend were no statistical difference to the scores when entered the group(P>0.05).The scores of the study group and the control group in the connection test,symbol coding,language memory,spatial breadth,maze test,visual memory,verbal fluency and continuous operation at 4 weekend were higher than that when entered the group,and there was no statistical difference(P<0.05);The scores of the study group and the control group in the connection test,symbol coding,language memory,spatial breadth,maze test,visual memory,verbal fluency and continuous operation at 4 weekend were higher than the scores at 2 weekend,and there was no statistical difference(P<0.05);4.The amplitude of P300 in the study group and the control group were lower than that of the normal group when enterd group,and there was statistical difference(P<0.01),while there was no statistical difference between the study group and the control group(P?0.05).The results of repeated measurement variance analysis showed that the study group was superior to the control group in the variation of P300 amplitude in 4 weekend treatment,and there was statistical difference(P<0.05);Further comparison showed that at the 2 weekend the amplitude of P300 in the study group was higher than the amplitude when entered the group,and there was statistical difference(P<0.05);at the 2 weekend the amplitude of P300 in the control group was not statistical difference with the amplitude when entered the group(P?0.05);at 4 weekends the amplitude of P300 of the study group and the control group were higher than the amplitude when entered the group,there was statistical difference(P<0.01);at 4 weekends the amplitude of P300 of the study group and the control group were higher than the amplitude at 2 weekend,there was statistical difference(P<0.01).The incubation period of P300 of the study group and the control group was higher than that of the normal group,there was statistical difference(P<0.01),while there was no statistical difference between the study group and the control group(P?0.05).The results of repeated measurement variance analysis showed the study group was superior to the control group in the incubation period of P300 at 4 weekend treatment,and there was statistical difference(P<0.05);Further comparison showed that at 2 weekend there was no statistical difference from the incubation period scores of the study group and the control group to the incubation period when entered the group(P?0.05);at 4 weekends the incubation period scores of P300 of the study group and the control group were lower than the incubation period scores when entered the group,there was statistical difference(P<0.05);at 4 weekends the incubation period scores of P300 of the study group and the control group were lower than the incubation period scores at 2 weekend,there was statistical difference(P<0.05).5.There was no statistical difference in SDSS scores between the study group and the control group when entered the group(t=0.5030,P>0.05),there was statistical difference in SDSS scores between the study group and the control group at 4 weekends(t=2.1687,P<0.05),the SDSS score of the study group was lower than the score of the control group at follow-up of 6 months(t=3.3918,P<0.01);6.There were no serious adverse drug reaction in the study group and control group.4 weekend the study group showed 12 cases,accounting for 27.9% of the total,while the control group showed 11 cases,accounting for 26.8% of the total.There was no ststistically significant differentce in adverse drug reactions between the study group and the control group with the 2 and 4 weekend(P>0.05);Conclusion1.Computer cognitive correction therapy effectively improve the clinical symptoms of patients with depressive episodes and improve the efficacy of the patients with depression.2.Computer cognitive correction therapy effectively improve the cognitive function of patients with depressive episodes,improve social function,and safe and reliable... |
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