早发型强迫障碍患者风险决策特点  

The characteristics of risk decision making in patients with early onset obsessive-compulsive disorder

作　　者：叶刚[1] 李佳[1] 汤臻[1] 付佳林 伏天 刘期春 李哲[1] 袁颖[1] 张兰兰[1] 杜向东[1] 钱正康 

机构地区：[1]苏州市广济医院,江苏苏州215000

出　　处：《精神医学杂志》2017年第3期173-176,共4页Journal of Psychiatry

基　　金：苏州市"科教兴卫"青年科技项目(编号:kjxw2014031);苏州市科技计划项目应用基础研究(编号:SYS201578);苏州市临床重点病种诊疗技术专项(编号:LCZX201316);苏州市广济医院青年科技项目(编号:gjyy201504)

摘　　要：目的探讨早发型强迫障碍患者风险决策特点及强迫思维、强迫动作对风险决策的不同影响。方法对38名早发型强迫障碍患者(研究组)及38名正常被试(对照组)应用Yale-Brown强迫量表(Y-BOCS)、剑桥赌博任务(CGT)、信息采集任务(IST)进行测定。结果研究组Y-BOCS各因子分及总分均高于对照组(P<0.05)。研究组CGT决策时间长于对照组(P<0.05),风险值、风险校正值低于对照组(P<0.05),总体下注比例少于对照组(P<0.05)。研究组IST总、收益固定和收益递减平均翻开方块数多于对照组(P<0.05),总、收益固定和收益递减平均翻开方块反应时大于对照组(P<0.05)。研究组CGT总体下注比例与Y-BOCS强迫思维因子分、总分呈负相关(P<0.05)。研究组IST总平均翻开方块反应时、收益递减情景下平均翻开方块反应时与Y-BOCS各因子分及总分呈正相关(P<0.05)。结论早发型强迫障碍患者存在风险决策缺陷,其风险决策与临床症状间存在一定关联。Objective To explore the characteristics of risk decision making in patients with early onset obsessive-compulsive disorder and different influences of obsessive thoughts and compulsive behaviors on risk decision making. Method A total of 38 patients with early-onset obsessive-compulsive disorder in study group and 38 healthy subjects in control group were selected and assessed with Yale-Brown Obsessive-Compulsive Scale（ Y-BOCS）,Cambridge Gambling Task（ CGT） and Information Sampling Task（ IST）. Results The total score and all factor scores of Y-BOCS in study group were all significantly higher than those in control group（ P〈0. 05）. In study group,the decision-making time of CGT was significantly longer than that in control group（ P〈0. 05）,and the value-at-risk,risk corrected value and overall bet proportion of CGT were significantly lower than those in control group（ P〈0. 05）. The overall mean number of boxes opened per trial,and mean number of boxes opened per trial in fixed win condition and decreasing win condition of IST in study group were all significantly more than those in control group（ P〈0. 05）,and the overall mean box opening latency,and mean box opening latency in fixed win condition and decreasing win condition of IST were all significantly longer than those in control group（ P〈0. 05）. In study group,the overall bet proportion of CGT was negatively correlated with the total score and factor score of obsession of Y-BOCS（ P〈0. 05）. In study group,the overall mean box opening latency and mean box opening latency in decreasing win condition of IST were positively correlated with the total score and all factor scores of Y-BOCS（ P〈0. 05）. Conclusion There is impairment for risk decision making in patients with early onset obsessive-compulsive disorder and their risk decision making is correlated with clinical symptoms to some extent.

关 键 词：强迫障碍 早发型 风险决策 

分 类 号：R749.7[医药卫生—神经病学与精神病学]