Objective To explore the characteristics of cognitive impairment and its influence factors in first-epi⁃sode depression patients with sleep disorder. Methods Three hundred and eighteen patients with first-episode depres⁃sion and two hundreds and forty-three healthy controls were recruited. The patients were divided into two group accord⁃ing to the sleeping situation: 202 patients with sleep disorder and 116 patients without. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to evaluated the cognitive function of all subjects, including immediate memory, visual span, speech function, attention and delayed memory. The 17 item Hamilton Depression Scale (HAMD-17) was used to evaluate patients’symptoms. Results The scores of immediate memory, visual span, speech function, delayed memory and the whole scale in the depression patients with sleep disorder were significantly lower than the patients without sleep disorder and the controls (P<0.05). Compared with the controls, the patients without sleep disor⁃der had lower scores of immediate memory, language function, delayed memory and the whole scale (P<0.05). Multiple linear regression showed that in the depression patients with sleep disorder, the RBANS score was related with the cogni⁃tive factors in HAMD (β=6.29, P=0.04);immediate memory was related with age (β=-0.24, P=0.04);visual span was re⁃lated with sleeping factor in HAMD (β=2.33, P=0.01);speech function was related with marriage (β=-5.74, P=0.01) and sleeping factor in HAMD (β=-1.20, P=0.03). In the depression patients with sleep disorder, speech function of RBANS was related with age (β=-0.32, P=0.04);attention was related with retardation factor in HAMD (β=2.52, P=0.01). Con⁃clusion The first-episode depression patients with sleep disorders have cognitive function damage in many aspects. The depressive symptoms (sleep changes, cognitive disorders, retardation and so on), age and marital status may be the influ⁃encing factors on cognitive impairment in first-episode depression patients with sleep disorder.%目的：探讨伴发睡眠障碍首发抑郁症患者的认知功能损害特点及其影响因素。方法纳入318例首发抑郁症患者，根据睡眠情况分为伴发睡眠障碍组（202例）和不伴发睡眠障碍组（116例），并纳入243名正常对照。采用重复性成套神经心理状态测验（repeatable battery for the assessment of neuropsychological status， RBANS）评估所有被试的认知功能（即刻记忆、视觉广度、言语功能、注意、延迟记忆），并采用17项汉密尔顿抑郁量表（Hamilton depression rating scale，HAMD-17）评估患者的抑郁症状。结果伴发睡眠障碍组即刻记忆、视觉广度、言语功能、延时记忆得分及量表总分均比不伴发睡眠障碍组及对照组差（均P<0.05）；而不伴发睡眠障碍组的即刻记忆、言语功能、延时记忆得分及量表总分比对照组差（均P<0.05）。多因素线性回归分析示，伴发睡眠障碍组中，RBANS量表总分与HAMD认知障碍因子相关联（β=6.29，P=0.04），即刻记忆得分与年龄相关联（β=-0.24，P=0.04），视觉广度得分与HAMD睡眠变化因子相关联（β=2.33，P=0.01），言语功能得分与婚姻（β=-5.74，P=0.01）及HAMD阻滞因子（β=-1.20，P=0.03）相关联；不伴发睡眠障碍组中，RBANS的言语功能得分与年龄相关联（β=-0.32，P=0.04），注意得分与HAMD阻滞因子相关联（β=2.52，P=0.01）。结论伴发睡眠障碍组患者存在多方面的认知功能损害，抑郁相关症状（睡眠变化、认知障碍、阻滞等）、年龄及婚姻状况可能是伴发睡眠障碍抑郁患者认知功能损害的影响因素。
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