摘要目的 探讨抑郁症首次发病患者治疗前后错误相关负电位(error related negativity,ERN)的变化及其不同临床特征对ERN的影响.方法 对80例首次发病未治疗的抑郁症患者(抑郁症组),根据HAMD17总分将其分为重度抑郁组(34例)和中度抑郁组(46例),根据HAMA总分将其分为重度焦虑组(43例)和中度焦虑组(37例),根据HAMD17中的阻滞因子总分将其分为重度阻滞组(30例)和中度阻滞组(50例),于艾司西酞普兰(10～20 mg/d)单药治疗前和治疗8周后分别检测各组ERN,比较抑郁症组与健康对照(对照组,60名)、抑郁症组治疗前后及抑郁症不同临床特征亚组间ERN的差异.结果 (1)抑郁症组基线ERN波幅-5.38(-4.62,-8.14)μV]高于对照组[-4.26(-3.01,-6.23)μV,Z=-2.081,P＜0.05];(2)抑郁症组治疗前后ERN潜伏期和波幅差异均无统计学意义;(3)重度抑郁组、中度抑郁组和对照组间ERN波幅差异有统计学意义(Z=7.648,P＜0.05),重度焦虑组、中度焦虑组和对照组间ERN波幅差异有统计学意义(Z=8.097,P＜0.05),重度迟滞组、中度迟滞组和对照组间ERN潜伏期和波幅差异有统计学意义(F=7.437,Z=7.896,P＜0.05).结论 抑郁症患者的ERN波幅增高,焦虑和迟滞症状的严重程度可能影响ERN的变化情况.

abstractsObjective To investigate the variations of error related negativity (ERN)in first episode depression (FED) after treatment and the effect of different clinical features on ERN in FED patients.Methods 80 FED patients were divided into different subgroups according to their severity of depression,anxiety and retardation.According to the total score of Hamilton Depression Rating Scale,they were divided into severe depression subgroup (n=34)and moderate depression subgroup (n=46).According to the total score of Hamilton Anxiety Rating Scale,they were divided into severe anxiety subgroup (n=43)and moderate anxiety subgroup (n=37).According to the retardation factor score of Hamilton Depression Rating Scale,they were divided into severe retardation subgroup (n=30)and moderate retardation subgroup (n=50).Their ERN were tested before and after single treatment of escitalopram 10-20 mg per day for 8 weeks,and the differences of ERN indexes were compared between FED patients and healthy controls (HC),between FED patients before and after their treatment,and among subgroups of FED patients with different clinical features.Results The baseline ERN amplitudes of FED group were significantly higher than those of HC group (Z =-2.081,P＜0.05).There was no significantly variation in ERN latency and amplitude of FED patients after treatment (t=-0.094,P＞0.05;Z =-1.456,P＞0.05).There were significant differences on ERN amplitude among severe depression subgroup,moderate depression subgroup and HC group (Z=7.648,P＜ 0.05),there were significant differences on ERN amplitude among severe anxiety subgroup,moderate anxiety subgroup and HC group (Z=8.097,P＜0.05),there were also significant differences on ERN latency and amplitude among severe retardation subgroup,moderate retardation subgroup and HC group (F=7.437,P＜0.05;Z=7.896,P＜0.05).Conclusions The increased ERN amplitude in first episode depression is a possible trait mark.The variations of ERN indexes in depressive disorder are probably related with the severity of anxiety and retardation.