强迫症患者在风险明确及不明确情境下的决策分离  

Dissociation of decision making under ambiguity and decision making under risk in patieonts with obsessive-compulsive disorder

作　　者：张龙[1,2] 汪凯[1,2] 季益富[3] 朱春燕[1] 杨平[1] 马慧娟[2] 

机构地区：[1]安徽医科大学医学心理学系,合肥230032 [2]安徽医科大学第一附属医院神经心理学实验室,合肥230022 [3]安徽省精神卫生中心,合肥230022

出　　处：《中国心理卫生杂志》2012年第3期209-214,共6页Chinese Mental Health Journal

基　　金：国际科技合作计划项目(10080703040);安徽省自然科学基金项目(090413147);安徽医科大学校基金(2010xkj032)

摘　　要：目的:探讨强迫症(OCD)患者在风险明确及不明确情境下的决策功能。方法:对45例符合美国精神障碍诊断与统计手册第4版(DSM-IV)OCD诊断标准的患者和48名性别构成、年龄、受教育年限相匹配的对照组被试进行爱荷华博弈任务(IGT)、色子任务(GDT)、连线任务(TMT)、Stroop色词任务(SCWT)和威斯康星卡片分类任务(WCST)测试,同时对OCD患者进行Yale-Brown强迫症状量表(Y-BOCS)、汉密尔顿焦虑量表(HAMA)和贝克抑郁量表(BDI)评定。结果:OCD组IGT净得分低于对照组(P<0.05),而两组GDT净得分差异无统计学意义(P>0.05)。两组TMT、SCWT和WCST得分差异无统计学意义(均P>0.05)。OCD组在IGT及GDT上的净得分与发病年龄、病程、Y-BOCS、HAM A、BDI得分不相关,OCD组中接受药物治疗与没有接受药物治疗的病人的IGT和GDT净得分差异无统计学意义(均P>0.05)。结论:OCD患者在风险不明确情境下决策受损,而在风险明确情境下决策未受损,即OCD患者在风险明确及不明确情境下决策出现明显的分离。Objective： To investigate the decision making under ambiguity and decision making under risk in patients with obsessive-compulsive disorder （OCD）. Methods： Forty-five patients who met the Diagnostic and Sta- tistical Manual of Mental Disorders, Fourth Edition （DSM-IV） diagnosis for OCD and 48 healthy control group subjects matched for age, gender, education were assessed with the Iowa Gambling Task （IGT）, Game of Dice Task （GDT） and a neuropsychological test battery for executive functions, including Trail Making Test （TMT）, Stroop Colour Word Test （SCWT） and Wisconsin Card Sorting Test （WCST）. Additionally, the OCD patients were meas- ured with the Yale-Brown Obsessive-Compulsive Scale （Y-BOCS）, Hamilton Anxiety Scale （HAMA） and Beck Depression Inventory （BDI）. Results： The OCD patients scored lower in IGT than the controls （P = 0. 023）, there was no differences between the two groups in GDT sores （P 〉 0.05）. No differences were found between the twogroups in scores of TMT, SCWT and WCST （Ps 〉0. 05）. The scores of IGT and GDT in the OCD patients were not correlated with age of onset （r = -0. 05, -0. 20）, duration of illness （r =0. 02, -0. 14）, scores of Y-BOCS（r =0. 01,0. 12）, HAMA （r = -0. 03, -0. 06） and BDI（r =0. 09, 0. 08） （Ps 〉0. 05）. And there was no differences between medicated patients and unmedicated patients in the scores of IGT and GDT （Ps 〉 0. 05）. Conclusion： It suggests that the patients with obsessive-compulsive disorder have impairment in decision making under ambiguity, while no impairment in decision making under risk, i. e., there may be a clear dissociation of decision making under ambiguity and decision making under risk.

关 键 词：强迫症 决策 爱荷华博弈任务 色子任务 

分 类 号：R749.79[医药卫生—神经病学与精神病学]