抑郁障碍患者的决策行为及其与抑郁焦虑症状的关系  

Decision-making behavior in patients with depressive disorder and its relationship with depressive and anxiety symptoms

作　　者：王昱翔 张罗雅 张毛毛 邓娟 彭彦杰 成晓彤 刘可智 雷威 陈晶 Wang Yuxiang;Zhang Luoya;Zhang Maomao;Deng Juan;Peng Yanjie;Cheng Xiaotong;Liu Kezhi;Lei Wei;Chen Jing(Affiliated Hospital of Southwest Medical University,Luzhou 646000,China;Southwest Medical University,Luzhou 646000,China;Sichuan Mental Health Center·The Third Hospital of Mianyang,Mianyang 621000,China;Zigong Mental Health Center,Zigong 643000,China)

机构地区：[1]西南医科大学附属医院,四川泸州646000 [2]西南医科大学,四川泸州646000 [3]四川省精神卫生中心·绵阳市第三人民医院,四川绵阳621000 [4]自贡市精神卫生中心,四川自贡643000

出　　处：《四川精神卫生》2025年第1期22-27,共6页Sichuan Mental Health

基　　金：2019年度泸州科技局-西南医科大学联合项目(项目名称:抑郁症目标导向-习惯学习系统异常及其神经机制,项目编号:2019LZXNYDJ39)。

摘　　要：背景 抑郁障碍患者常表现出决策功能受损。目前,抑郁障碍患者决策能力与抑郁焦虑症状的关系尚不清楚。目的 探讨抑郁障碍患者的决策行为特征,并分析其与临床症状的关系。方法 纳入2020年10月—2023年5月于西南医科大学附属医院心身医学科就诊的、符合《精神障碍诊断与统计手册(第4版)》(DSM-Ⅳ)抑郁障碍诊断标准的48例患者。同期在泸州市招募与抑郁组年龄和性别相匹配的52名健康人为对照组。采用贝克抑郁量表(BDI)和贝克焦虑量表(BAI)进行评定。通过概率翻转学习(PRL)任务考查受试者的决策行为特征,分析指标包括达标试次、固执错误、赢后保持率、输后转移率。采用Spearman相关分析考查抑郁组BDI评分及BAI评分与PRL任务各指标间的相关性。结果 抑郁组PRL任务输后转移率高于对照组,差异有统计学意义(t=3.684,P<0.01);两组PRL任务达标试次、固执错误和赢后保持率比较,差异均无统计学意义(t=0.329、0.132、0.609,P均>0.05)。相关分析结果显示,抑郁障碍患者BDI和BAI评分与赢后保持率均呈正相关(r=0.450、0.398,P均<0.01)。结论 抑郁障碍患者在面对负性结果时更倾向于改变选择策略;患者的抑郁和焦虑症状越严重,其在得到正反馈后越倾向于维持已有决策。Background Patients with depressive disorder often exhibit impaired decision-making functions.However,the relationship between decision-making abilities and depressive and anxiety symptoms in these patients remains unclear.Objective To explore the characteristics of decision-making behavior in patients with depressive disorder,and to analyze its relationship with clinical symptoms.Methods A total of 48 patients diagnosed with depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders,fourth edition(DSM-IV)were recruited from the Department of Psychosomatic Medicine of the Affiliated Hospital of Southwest Medical University from October 2020 to May 2023.Concurrently,52 healthy individuals matched for age and gender were recruited from Luzhou as the control group.Beck Depression Inventory(BDI)and Beck Anxiety Inventory(BAI)were used for assessment,and decision-making behavior was evaluated using Probabilistic Reversal Learning(PRL)task.Indicators assessed included the number of trials to criterion,perseverative errors,win-stay rate and lose-shift rate.Spearman correlation analysis was used to assess the correlation between BDI and BAI scores and PRL task indicators.Results The depression group showed a significantly higher lose-shift rate compared with the control group(t=3.684,P<0.01).There were no statistically significant differences between two groups in trials to criterion,perseverative errors and win-stay rate(t=0.329,0.132,0.609,P>0.05).In depression group,BDI and BAI scores were positively correlated with the win-stay rate(r=0.450,0.398,P<0.01).Conclusion Patients with depressive disorder are more likely to change their decision-making strategies following negative outcomes.Furthermore,the severity of depressive and anxiety symptoms is associated with a greater propensity to maintain existing decisions after receiving positive feedback.[Funded by 2019 Joint Project of Luzhou Science and Technology Bureau-Southwest Medical University(number,2019LZXNYDJ39)]

关 键 词：抑郁障碍 决策行为 概率翻转学习 抑郁焦虑症状 

分 类 号：R749.4[医药卫生—神经病学与精神病学]