重复经颅磁刺激对不同心理理论能力抑郁症患者情绪和认知水平的影响

朱琦; 盖琼; 沈妃; 丁卓颖; 潘友让; 李松涛

doi:10.16766/j.cnki.issn.1674-4152.004092

重复经颅磁刺激对不同心理理论能力抑郁症患者情绪和认知水平的影响

doi: 10.16766/j.cnki.issn.1674-4152.004092

朱琦¹,
盖琼²,
沈妃¹,
丁卓颖³,
潘友让⁴,
李松涛^5, ,

1.
绍兴市第七人民医院精一病区，浙江绍兴 312000
2.
绍兴市第七人民医院精四病区
3.
绍兴市第七人民医院门急诊
4.
绍兴市第七人民医院心身障碍一病区
5.
绍兴市第七人民医院精二病区

基金项目:

浙江省医药卫生科技计划项目 2024KY1735

绍兴市卫生健康科技计划项目 2022KY057

详细信息

通讯作者:
李松涛，E-mail：402493476@qq.com

中图分类号: R454.1 R749.05
计量
- 文章访问数: 5
- HTML全文浏览量: 3
- PDF下载量: 0
- 被引次数: 0
出版历程
- 收稿日期: 2024-11-28
- 网络出版日期: 2025-10-25

The effect of repetitive transcranial magnetic stimulation on emotion and cognitive level of depression patients with different theory of mind

1.
The First Psychiatric Ward, Shaoxing Seventh People's Hospital, Shaoxing, Zhejiang 312000, China

摘要

摘要: 目的探讨重复经颅磁刺激(rTMS)对具有不同心理理论能力(TOM)的抑郁症患者在情绪和认知水平上的改善作用。方法选取2023年6月—2024年6月绍兴市第七人民医院收治的154例抑郁症患者，按照随机数表法分为干预组(86例)和对照组(68例)，将干预组进一步以患者心理理论故事图片任务(ToM-PST)评分中位数为界限分为低TOM组44例和高TOM组42例。对照组给予口服草酸艾司西酞普兰药物治疗，干预组在此基础上联合rTMS治疗，干预4周。干预后比较低TOM组、高TOM组和对照组患者总有效率，并比较3组患者间抑郁、认知水平改善情况。结果高TOM组(76.19%，32/42)总有效率高于低TOM组(50.00%，22/44)和对照组(38.24%，26/68)，差异有统计学意义(χ²=15.078，P=0.001)。在抑郁水平改善方面，高TOM组“躯体化/焦虑”“迟缓”和“睡眠障碍”优于对照组。低TOM组“迟缓”“睡眠障碍”优于对照组，差异有统计学意义(P < 0.05)。在认知改善方面，高TOM组“注意”高于低TOM组与对照组；高TOM组、低TOM组“延迟回忆”优于对照组，差异有统计学意义(P < 0.05)。结论重复经颅磁刺激对药物治疗的不同心理理论能力抑郁症患者的情绪及认知均具有一定的辅助改善作用。
- 重复经颅磁刺激 /
- 抑郁症 /
- 心理理论能力 /
- 情绪 /
- 认知
Abstract: Objective To explore the effect of repetitive transcranial magnetic stimulation (rTMS) on the improvement of emotional and cognitive levels in patients with depression with different theories of mind (TOM). Methods A total of 154 patients with depression admitted to Shaoxing Seventh People's Hospital from June 2023 to June 2024 were selected and divided into an intervention group (86 cases) and a control group (68 cases) according to the random number table method. The intervention group was further divided into a low TOM group (44 cases) and a high TOM group (42 cases) according to the median of the theory of mind picture-sequencing task (ToM-PST) score. The control group was treated with oral escitalopram oxalate, and the intervention group was treated with rTMS on this basis. The intervention period was 4 weeks. After the intervention, the total effective rate of patients in the low TOM group, the high TOM group, and the control group was compared, and the improvement of depression and cognitive level among the three groups was compared. Results The total effective rate of the high TOM group (76.19%, 32/42) was higher than that of the low TOM group (50.00%, 22/44) and the control group (38.24%, 26/68), and the difference was statistically significant (χ²=15.078, P=0.001). In terms of the improvement of depression level,'somatization/anxiety ','retardation ', and'sleep disorder'in the high TOM group were better than those in the control group. The'retardation'and'sleep disorder'in the low TOM group were better than those in the control group, and the difference was statistically significant (P < 0.05). In terms of cognitive improvement, the'attention'of the high TOM group was higher than that of the low TOM group and the control group; the'delayed recall'of the high TOM group and the low TOM group was better than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion Repetitive transcranial magnetic stimulation has a certain auxiliary improvement effect on the emotion and cognition of patients with depression with different psychological theory abilities.
- Repetitive transcranial magnetic stimulation /
- Depression /
- Theory of mind ability /
- Emotional /
- Cognition

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表 1 3组抑郁症患者一般资料比较

Table 1. Comparison of general data of three groups of patients with depression

组别	例数	年龄[M(P₂₅, P₇₅), 岁]	性别[例(%)]		受教育年限[M(P₂₅, P₇₅), 年]	病程[M(P₂₅, P₇₅), 年]^c	首发[例(%)]
组别	例数	年龄[M(P₂₅, P₇₅), 岁]	男性	女性	受教育年限[M(P₂₅, P₇₅), 年]	病程[M(P₂₅, P₇₅), 年]^c	是	否
低TOM组	44	31.50(26.00，37.75)	13(29.55)	31(70.45)	13.00(12.00，16.00)	3.00(1.00，5.75)	16(36.36)	28(63.64)
高TOM组	42	31.00(27.00，39.25)	14(33.33)	28(66.67)	12.00(9.00，15.25)	2.00(1.38，4.50)	14(33.33)	28(66.67)
对照组	68	31.00(27.00，37.75)	22(32.35)	46(67.65)	12.00(11.00，16.00)	2.00(1.00，4.00)	29(42.65)	39(57.35)
统计量		0.547^a	0.158^b		3.020^a	0.823^a	1.052^b
P值		0.761	0.924		0.221	0.663	0.591
注：^a为H值, ^b为χ²值; ^c病程中非整年部分，如超出6个月，记作0.5年，未超出记作0年。

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表 2 3组抑郁症患者HAMD-17量表各因子评分改善情况比较[M(P₂₅, P₇₅)，分]

Table 2. Comparison of improvement in each factor score of the HAMD-17 scale among three groups of patients with depression[M(P₂₅, P₇₅), points]

组别	例数	焦虑/躯体化	体质量减轻	认知障碍	迟缓	睡眠障碍
低TOM组	44	-2.00(-3.75，0.00)	0.00(0.00，0.00)	-3.00(-5.00，0.00)	-3.00(-4.00，-1.25)^a	-2.00(-2.00，-0.25)^a
高TOM组	42	-3.00(-5.00，-0.75)^a	0.00(0.00，0.00)	-2.00(-5.00，0.00)	-3.00(-5.00，-1.00)^a	-1.50(-2.25，-0.75)^a
对照组	68	-1.00(-3.00，0.00)	0.00(0.00，0.00)	-1.50(-6.00，0.00)	-2.00(-3.00，-1.00)	-1.00(-1.75，0.00)
H值		8.720	1.178	0.099	9.367	10.222
P值		0.013	0.555	0.952	0.009	0.006
注：与对照组比较，^aP＜0.05。

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表 3 3组抑郁症患者MoCA量表各因子评分改善情况比较[M(P₂₅, P₇₅)，分]

Table 3. Comparison of improvement in each factor score of MocA scale among three groups of patients with depression[M(P₂₅, P₇₅), points]

组别	例数	视空间/执行功能	命名	注意	语言	抽象	延迟回忆	定向
低TOM组	44	0.00(0.00，0.00)	0.00(0.00，0.00)	0.00(0.00，1.00)	0.00(0.00，0.00)	0.00(0.00，0.00)	1.00(0.00，2.00)^a	0.00(0.00，1.00)
高TOM组	42	0.00(0.00，1.00)	0.00(0.00，0.00)	1.00(0.00，2.00)^ab	0.00(0.00，1.00)	0.00(0.00，0.00)	1.00(0.00，2.00)^a	0.00(0.00，1.00)
对照组	68	0.00(0.00，1.00)	0.00(0.00，0.00)	0.00(0.00，1.00)	0.00(0.00，0.00)	0.00(0.00，0.00)	0.00(0.00，1.00)	0.00(0.00，1.00)
统计量		1.459	0.337	10.756	2.513	2.942	10.573	2.291
P值		0.482	0.845	0.005	0.285	0.230	0.005	0.318
注：记忆评估因不计分，不纳入本研究内容；与对照组比较，^aP＜0.05；与低TOM组比较，^bP＜0.05。

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