青年女性进食障碍患者的认知灵活性  

Cognitive flexibility in young female patients with eating disorders

作　　者：梅冬蕾 吴艳坤 陈超[1] 李雪霓[1] 林靖宇 代悠然 张大荣[1] 孔庆梅[1] 司天梅[1] MEI Donglei;WU Yankun;CHEN Chao;LI Xueni;LIN Jingyu;DAI Youran;ZHANG Darong;KONG Qingmei;SI Tianmei(Peking University Sixth Hospital,Peking University Institute of Mental Health,National Clinical Research Center for Mental Disorders(Peking University Sixth Hospital),NHC Key Laboratory of Mental Health(Peking University),Beijing 100083,China)

机构地区：[1]北京大学第六医院,北京大学精神卫生研究所,国家精神心理疾病临床医学研究中心(北京大学第六医院),国家卫生健康委员会精神卫生学重点实验室(北京大学),北京100083

出　　处：《中国心理卫生杂志》2023年第4期273-278,共6页Chinese Mental Health Journal

摘　　要：目的:探索青年女性进食障碍(ED)患者的认知灵活性特征,及其与ED临床特征的关系。方法:纳入92例青年女性ED患者包括28例神经性厌食(AN)、64例神经性贪食(BN)和38例健康对照(HC)。使用威斯康星卡片分类测试(WCST)中的持续性错误率(PPE)和持续性应答率(PPR)评估认知灵活性,进食障碍调查量表-1(EDI-1)及进食障碍问卷(EDQ)评估ED临床特征。结果:ED组的PPE[(5.0±4.7)%vs.(2.8±2.8)%;P<0.01]及PPR[(11.7±7.8)%vs.(6.4±5.9)%;P<0.001]均高于HC组,但AN与BN两组间PPE[(5.5±5.4)%vs.5.0±4.5)%,P>0.05]和PPR[(11.2±7.8)%vs.(11.1±7.3)%,P>0.05]差异无统计学意义。PPE(r=0.21,P<0.05)、PPR(r=0.27,P<0.01)均与EDI-1总分呈正相关;PPR与ED组使用食欲抑制剂(r=0.28,P=0.010)及跳过几餐(r=0.30,P=0.004)的频率呈正相关。结论:青年女性ED患者存在认知灵活性缺陷,与ED临床特征相关,提示有作为疾病内表型的可能。Objective:To explore the characteristic of cognitive flexibility in young female patients with eating disorders(EDs),including anorexia nervosa(AN)and bulimia nervosa)BN),and its relationship with the clinical features of ED.Methods:Ninety-two young female patients with EDs,including 28 patients with AN and 64 patients with BN,and 38 normal controls were enrolled.Cognitive flexibility was assessed with percentage of persistent errors(PPE)and percentage of persistent responses(PPR)of the Wisconsin Cad Sorting Test(WCST),and clinical features of ED by using the Eating Disorder Inventory-1(EDI-1).Results:The PPE[(5.0±4.7)%vs.(2.8±2.8)%,P<0.01]and PPR[(11.7±7.8)%vs.(6.4±5.9)%,P<0.001]were higher in ED group than in normal control group,but the differences on PPE[(5.5±5.4)%vs.(5.0±4.5)%,P>0.05]and PPR[(11.2±7.8)%vs.(11.1±7.3)%,P>0.05]between AN and BN groups were not statistically significant The PPE(r=0.21,P<0.05)and PPR(r=0.27,P<0.01)were positively correlated with the EDI-1 total scores.PPR was positively correlated with the frequency of appetite suppressant use(r=0.28,P<0.05)and skipping several meals(r=0.30,P<0.01)in the ED group.Conclusion:The presence of cognitive flexibility deficits in young female patients with eating disorders,and their correlation with clinical features of eating disorders further support the possi-bility of being an endophenotype of eating disorders.

关 键 词：进食障碍 认知灵活性 内表型 威斯康星卡片分类测试(WCST) 进食障碍调查量表-1(EDI-1) 

分 类 号：R749.79[医药卫生—神经病学与精神病学]