Study On The Characteristics And Influencing Factors Of Cognitive Impairment In Patients With Liver Depression Type Depression

Objective:To explore the characteristics of changes in cognitive function and social function of patients with depression in liver stagnation,and analyze the influencing factors,compare the differences between syndromes of deficiency and empirical type,identify cognitive impair me nt in patients with depression early,and prevent dementia.Methods:This study is a cross-sectional study.According to the inclusion and exclusion criteria,200 depressive patients were collected,and 30 healthy adults were collected as a control group.The enrolled persons filled out the general situation questionnaire to collect personal information.The syndrome types,the degree of depression,the degree of anxiety,cognitive function,social function were assessed by using the Syndrome Observation Scale,the Hamilton Depression Scale(HAMD),the Hamilton Anxiety Scale(HAMA),the Montreal Intelligence Scale(MoCA)and the Social F unction Defect Screening Scale(SDSS).The above scale adopts the method of independent evaluation of two people,and the average is divided into the final score.SPSS 23.0 was used for statistical analysis of data.The statistical methods used include T test,One Way ANOVA analysis,Welch’s t test,Kruskal-Wallis H test,Mann-Whitney U test,χ2 test,binary or multiple logistics regression analysis.The above statistical methods all have significant statistical difference with P<0.05.Result:1.There were no differences in the gender,age,marriage,occupation,education,economic status,residence,smoking and alcohol preference between the liver stagnation and blood stasis group,the liver stagnation and spleen deficiency group,the normal group;There were differences in social interaction,hobbies,family relationships,exercise frequency and family history of mental illness.2.A total of 97 patients in the liver stagnation and blood stasis group were included in this study,including 7 people without anxiety,15 people may have anxiety,29 people must have anxiety,26 people must have significant anxiety,20 people may have severe anxiety.A total of 103 patients in the liver stagnation and spleen deficiency group were included in this study,including 6 people without anxiety,16 people may have anxiety,28 people must have anxiety,34 people must have obvious anxiety,19 people may have severe anxiety.A total of 30 cases in the normal group were included in this study,including 3 people may have anxiety,27 people have no anxiety.The liver stagnation and blood stasis group,liver stagnation and spleen deficiency group were different from the normal group in terms of mental anxiety factor,physical anxiety factor and total score of HAMA(all P<0.05),the average values were higher than the normal group.There was no difference between the group of liver stagnation and blood stasis and the group of liver stagnation and spleen deficiency.3.According to the analysis of the MoCA results,there were 28 cases of normal cognition and 2 cases of mild cognitive impairment in the normal group.In the liver stagnation and blood stasis group,51 cases had normal cognition,33 cases had mild cognitive impairment,and 13 cases had moderate cognitive impairment.In the gnation and spleen deficiency group,47 cases had normal cognition,40 cases had mild cognitive impairment,and 16 cases had moderate cognitive impairment.The liver stagnation and blood stasis group and the liver stagnation and spleen deficiency group were different from the normal group in visual space and executive ability,attention,language,delayed recall and MoCA total score(P<0.05),but no differences in naming,abstraction and orientation(P>0.05).There was no difference between the group of liver stagnation and blood stasis and the group of liver stagnation and spleen deficiency.The scores of normal group were higher than those of liver stagnation and blood stasis group,liver stagnation and spleen deficiency group.In terms of influencing factors analysis,visual space and executive ability factors were related to age,education,and total score of HAMA;attention factors were related to disease course and total score of HAMA;language factors were related to age and total score of HAMA;delayed recall factors were related to age and HAMD total scores;MoCA total scores were related toage,education level,HAMA total score,and HAMD total score.4.There were 30 cases of normal social function in the normal group;23 cases of normal social function in the liver stagnation and blood stasis group,and 74 cases of social disability;21 cases of normal social function in the liver stagnation and spleen deficiency group,and 82 cases of social disability.The liver stagnation and blood stasis group and the liver stagnation and spleen deficiency group were different from the normal group in occupation and work factor,marriage function factor,parent function factor,social withdrawal factor,social activity factor outside the family,family activity factor,family function factor,the interest and care factors for the outside world,responsibility and planning factors and the total score of SDSS(all P<0.05).There were no differences in personal life self-care factors(P>0.05).All scores of depression were higher than the normal group.In terms of influencing factors analysis,SDSS total score was correlated with HAMD total score,HAMA total score,MoCA total score,and positively correlated with HAMD total score,HAMA total score and negatively correlated with MoCA total score.The total score of SDSS had no correlation with gender,age,course of disease and education level.Conclusion:1.Cognitive impairment is common in depression patients,mostly mild to moderate,mainly in visual space and executive ability,attention,language and delayed recall.In terms of syndrome comparison,there was no significant difference between the liver stagnation and blood stasis group and the liver stagnation and spleen deficiency group.Among depressed patients,advanced age,accompanied by anxiety symptoms,and severe depression are risk factors for cognitive impairment,and high education level is a protective factor for cognitive impair me nt.2.Most patients with depression have social dysfunction,mainly manifested in occupation and work,marriage function,parental function,social withdrawal,social activities outside the family,activities within the family,family functions,care and interest in the outside world,responsibility and planning.The social function of liver stagnation and blood stasis group is equivalent to that of liver stagnation and spleen deficiency group.Severe depression and anxiety symptoms are risk factors for social dysfunction,and high cognitive level is a protective factor for social dysfunction.