抑郁症患者执行风险决策的对照研究  

A controlled study on the risk decision making in the patients with depression

作　　者：魏旻俊 陈炯[1] 杨絮[2] 高静芳[3] WEI Minjun;CHEN Jiong;YANG Xu;GAO Jingfang(Psychosomatic Department,Zhejiang Provincial Tongde Hospital,Hangzhou 310012,China;Department of Pharmacy,Zhejiang Provincial Tongde Hospital,Hangzhou 310012,China;Department of Mental Health,The First Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310053,China)

机构地区：[1]浙江省立同德医院心身科,浙江杭州310012 [2]浙江省立同德医院药剂科,浙江杭州310012 [3]浙江中医药大学附属第一医院精神卫生科,浙江杭州310053

出　　处：《中国现代医生》2018年第31期91-94,共4页China Modern Doctor

摘　　要：目的观察抑郁症患者与正常人群在面对风险选择时的不同决定,验证抑郁症患者不管在奖赏后抑或者惩罚后决策时均倾向于回避风险,而且惩罚后患者更加倾向于风险回避的假说。方法选取来自2014年5月～2016年6月浙江省中医院精神卫生科门诊和浙江省立同德医院心身科住院抑郁症患者50例和与其资料相匹配的正常人群志愿者50例作为对照组,采用风险决策任务试验,并比较两组执行风险决策时选择风险的能力。结果研究组选择风险的频率,惩罚后要比奖赏后低,差异有统计学意义(P<0.01);对照组选择风险的频率,惩罚后要比奖赏后低,差异有统计学意义(P<0.01)。研究组比对照组平均获得总分高,差异有统计学意义(P<0.01);惩罚后,研究组比对照组选择风险的频率低,差异有统计学意义(P<0.01),奖赏后,研究组比对照组选择风险的频率低,差异有统计学意义(P<0.01)。结论抑郁症患者倾向规避风险,面对惩罚等负反馈刺激反应比较敏感,面对奖赏等正反馈刺激反应迟钝。Objective To observe the different decisions of patients with depression and normal people in the face of risk selection, and to verify the hypothesis that patients with depression tend to avoid risks whether they are after reward or after punishment, and after the punishment, the patient is more inclined to avoid risks. Methods 50 hospitalized patients with depression from the Outpatient Department of Mental Health in Zhejiang Provincial Hospital of Traditional Chinese Medicine and the Psychosomatic Department in Zhejiang Provincial Tongde Hospital from May 2014 to June 2016 were selected and 50 healthy volunteers whose information matched with the patients were selected as the control group. The risk decision task test was adopted, and the ability of risk selection when implementing risk decisions was compared between the two groups. Results The frequency of risk selection after punishment in the study group was lower than that after rewards, and there was a significant difference（P〈0.01）; the frequency of risk selection was lower after punishment in the control group than after rewards, and there was also a significant difference（P〈0.01）. The average score in the study group was higher than that in the control group, and the difference was statistically significant（P〈0.01）; after punishment, the frequency of risk selection in the study group was lower than that in the control group, and the difference was statistically significant（P〈0.01）. After rewards, the frequency of risk selection in the study group was lower than that in the control group, and the difference was statistically significant（P〈0.01）. Conclusion Patients with depression tend to avoid risk. Negative feedback stimuli such as punishment are sensitive, and positive feedback stimuli such as rewards are insensitive.

关 键 词：抑郁症 风险决策 奖赏 惩罚 

分 类 号：R749.4[医药卫生—神经病学与精神病学]