共病强迫型人格障碍的强迫症患者认知灵活性受损的行为学与脑电特征分析  

The bahavioral and electroencephalographic characteristics of impaired cognitive flexibility in OCD patients with comorbid obsessive-compulsive personality disorder

作　　者：李凤[1] 熊港琴 王豪哲 程明[2] 吴大兴[3] 钟明天[1] Li Feng;Xiong Gangqin;Wang Haozhe;Cheng Ming;Wu Daxing;Zhong Mingtian(Key Laboratory of Brain,Cognition and Education Sciences,South China Normal University,Ministry of Education Center for Studies of Psychological Application,School of Psychology,and Guangdong Key Laboratory of Mental Health and Cognitive Science,South China Normal University,Guangzhou 510631,China;Department of Clinical Psychology,Hunan Brain Hospital,Changsha 410007,China;Medical Psychological Center,Second Xiangya Hospital,Central South University,Changsha 410011,China)

机构地区：[1]华南师范大学脑认知与教育科学教育部重点实验室、华南师范大学心理应用研究中心、心理学院、心理健康与认知科学广东重点实验室,广州510631 [2]湖南省脑科医院临床心理科,长沙410007 [3]中南大学湘雅二医院医学心理中心,长沙410011

出　　处：《中华精神科杂志》2025年第4期259-266,共8页Chinese Journal of Psychiatry

基　　金：国家自然科学基金(31871112);华南师范大学冲补强心理学高峰学科资助。

摘　　要：目的探究共病强迫型人格障碍的强迫症患者在认知灵活性方面的行为学与脑电特征。方法前瞻性收集2019年9月至2021年12月在长沙市2所三甲医院心理科就诊的强迫症患者,包括31例共病强迫型人格障碍的强迫症患者[共病组:男18例,女13例,年龄15~46(22.8±8.4)岁]和39例强迫症患者[强迫症组:男25例,女14例,年龄15~34(21.6±4.2)岁]。同期招募年龄匹配的健康对照者(健康对照组)32名,其中男18名,女14名,年龄18~25(20.8±1.7)岁。同步采集被试完成Switch范式的行为学和事件相关电位数据,分析比较3组被试者在行为学及脑电数据(电极点:FZ、FCZ、CZ、PZ;脑电成分:P2、N2、P3的波幅与潜伏期)上的差异。结果共病组和强迫症组的反应时均显著长于健康对照组[(1182±287)和(1119±194)比(886±95)ms;F=18.48,均P<0.001],且正确率均低于健康对照组[(77±14)%和(77±13)%比(84±7)%;F=4.00,均P<0.05]。共病组和强迫症组在转换任务中CZ的N2的潜伏期显著短于健康对照组[(290±22)和(291±29)比(308±27)ms;F=3.81,均P<0.05]。此外,在FZ和FCZ 2个电极,共病组进行转换任务的N2潜伏期[FZ:(285±23)ms;FCZ:(288±23)ms]显著短于重复任务[FZ:(306±20)ms;FCZ:(308±21)ms;F=15.35,9.92;均P<0.01]。结论共病强迫型人格障碍的强迫症患者表现出更严重的认知灵活性受损,并表现出异常的电生理模式。ObjectiveThis study was to explore the behavioral and electroencephalographic characteristics of impaired cognitive flexibility in patients with obsessive-compulsive disorder(OCD)with comorbid obsessive-compulsive personality disorder(OCPD).MethodsA cross-sectional study was designed to collect data prospectively from OCD patients who visited the psychology departments at two top-tier hospitals in Changsha between September 2019 and December 2021.The study included 31 patients with OCD+OCPD(18 males,13 females;aged 15-46(22.8±8.4)years)and 39 patients with OCD only(25 males,14 females;aged 15-34(21.6±4.2)years).Additionally,32 age-matched healthy controls(HC:18 males,14 females;aged 18-25(20.8±1.7)years).All participants completed the Task-Switching paradigm while behaioral and event-related potentials(ERPs)were recorded simultaneously.Repeated measures analysis of variance was used to compare the group differences in behavioral and ERP data(electrode sites:FZ,FCZ,CZ,PZ;ERP components:amplitude and latency of P2,N2,and P3).ResultsThe reaction times in both the comorbid and OCD groups were significantly longer than those in the healthy control group((1182±287)ms and(1119±194)ms vs.(886±95)ms;F=18.48,both P<0.001).Accuracy rates in the comorbid and OCD groups were also significantly lower than in the healthy control group((77±14)%and(77±13)%vs.(84±7)%;F=4.00,both P<0.05).In the task-switching condition,the N2 latency at the CZ electrode was significantly shorter in the comorbid and OCD groups compared to the healthy control group((290±22)ms and(291±29)ms vs.(308±27)ms;F=3.81,both P<0.05).Furthermore,at the FZ and FCZ electrodes,the N2 latency in the comorbid group was significantly shorter in the switching task compared to the repetition task.ConclusionOCD patients with comorbid OCPD show more severe cognitive flexibility impairments and display abnormal electrophysiological patterns.

关 键 词：强迫性障碍 强迫型人格障碍 认知灵活性 Switch范式 事件相关电位 

分 类 号：R749.7[医药卫生—神经病学与精神病学]