儿童期受虐及认知功能对双相情感障碍患者冲动性攻击行为发生的影响  

Effects of Childhood Abuse and Cognitive Function on Impulsive Aggression in Patients With Bipolar Disorder

作　　者：潘其郎 陈小芬 吴科斌 PAN Qilang;CHEN Xiaofen;WU Kebin(Department of Psychiatry,the Third Hospital of Longyan,Longyan Fujian 364000,China)

机构地区：[1]龙岩市第三医院精神科,福建龙岩364000

出　　处：《中国卫生标准管理》2023年第20期115-118,共4页China Health Standard Management

摘　　要：目的观察双相情感障碍患者冲动性攻击行为的发生与儿童期受虐及认知功能的影响。方法将龙岩市第三医院2019年1月-2021年12月收治的60例双相情感障碍患者以外显行为攻击量表(modified overt aggression scale,MOAS)分组,其中冲动组23例及无冲动组37例。评价双相情感障碍患者冲动性攻击行为的发生与儿童期受虐及认知功能的关系。结果冲动组患者中存在儿童期受虐15例(65.22%),高于无冲动组7例(18.92%)(χ^(2)=13.092,P<0.05)。冲动组患者中蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)评分低于无冲动组(P<0.05)。冲动组患者各项实施认知评估以重复性成套神经心理状态测验(repeatable battery for the assessment of neuropsychological status,RBANS)测试结果低于无冲动组(P<0.05)。将对RBANS测试结果(0=未有影响,1=有影响)作为因变量,对认知评估、对服药认识、对疾病复发及求助方式认识及总分作为自变量,经Logistic回归分析显示,双相情感障碍患者儿童期受虐及MoCA评分低下均为诱发冲动攻击行为发生的危险因素(P<0.05)。结论在双相情感障碍患者中,儿童期受虐及认知功能低下会造成冲动性攻击行为;因此,早期对患者开展儿童时期是否受虐的调查,并评价其认知功能评分,有助于判定是否存在冲动攻击行为,并且可以开展早期的干预,以获得更好的效果。Objective To observe the occurrence of impulsive behavior and the influence of childhood abuse and cognitive function in patients with bipolar disorder.Methods Sixty patients with bipolar disorder admitted to the Third Hospital of Longyan from January 2019 to December 2021 were divided into modified overt aggression scale(MOAS)groups,of which 23 cases were in the impulsive group and 37 cases were in the non-impulsive group.To evaluate the relationship between impulsive aggression and childhood abuse and cognitive function in patients with bipolar disorder.Results There were 15 cases(65.22%)of childhood abuse in the impulsive group,which was higher than 7 cases(18.92%)in the non-impulsive group(χ^(2)=13.092,P<0.05).The scores of Montreal cognitive assessment(MoCA)in the impulsive group were lower than those in the non-impulsive group(P<0.05).The results of repeatable battery for the assessment of neuropsychological status(RBANS)in impulse group were lower than those in nonimpulse group(P<0.05).Using RBANS test results(0=no effect,1=effect)as dependent variables,and cognitive assessment,knowledge of drug taking,knowledge of disease recurrence and seeking for help,and total score as independent variables,Logistic regression analysis showed that Childhood abuse and low MoCA score were risk factors for impulsive aggression in patients with bipolar disorder(P<0.05).Conclusion In patients with bipolar affective disorder,childhood abuse and cognitive function can cause good impulsive behavior.Therefore,early investigation on whether patients are abused in childhood and evaluation of their cognitive function score can help determine whether there is impulsive aggression in intelligence,and early intervention can be carried out to obtain better results.

关 键 词：双相情感障碍 冲动性攻击行为 儿童期受虐 蒙特利尔认知评估 认知功能 相互关系 

分 类 号：R737[医药卫生—肿瘤]