童年创伤对缓解期双相障碍患者情绪认知的影响
发布时间：2018-08-02 18:31
【摘要】：背景:双相障碍(bipolar disorder,BD)是遗传-应激综合作用的结果,环境因素尤其是早年创伤事件在双相障碍的发生发展中具有重要的作用,成为发病的危险因素之一。目前双相障碍已成为严重的医学问题和社会问题,有75%的缓解期双相障碍患者无法达到病前的社会功能水平。而社会功能水平的下降和社会认知尤其是情绪认知关系密切。目前关于童年创伤对缓解期双相障碍患者的情绪认知功能的影响尚不十分清楚。目的:探讨童年创伤对缓解期双相障碍患者情绪认知功能的影响;方法:纳入2015年3月至2016年12月期间于河北医科大学第一医院精神科门诊就诊的缓解期双相障碍患者72例,健康对照组70例,收集一般人口学资料、社会心理学资料,评估缓解期双相障碍患者童年期创伤及情绪认知功能,情绪认知的评估采用情绪面孔识别(Fcial affect recognition,FAR)分析6种表情高兴、悲伤、愤怒、厌恶、恐惧和惊讶的识别正确率。采用SPSS21.0统计软件进行统计分析,计量资料统计描述以均数±标准差表示,两组间比较采用两独立样本t检验或非参数检验,计数资料统计描述采用构成比,率的比较采用χ2检验,情绪认知影响因素的分析采用逐步线性回归方法。结果:1缓解期双相障碍患者对悲伤识别正确率为53.5%,愤怒52.0%,高兴89.8%,惊讶64.6%,厌恶35.9%,恐惧23.4%;健康对照组对悲伤识别正确率为60.9%,愤怒58.1%,高兴95.5%,惊讶68.7%,厌恶43.3%,恐惧30.9%;两组在悲伤(t=-2.424,P=0.017),愤怒(t=-2.018,P=0.046),高兴(t=-3.492,P=0.001),恐惧(t=-3.331,P=0.001)和厌恶(t=-2.596,P=0.011)识别正确率具有显著性差异。2双相障碍组和健康对照组在CTQ总分(t=5.702,P=0.000),情感虐待(t=3.146,P=0.002),情感忽视(t=5.637,P=0.000),性虐待(t=2.277,P=0.025),躯体忽视(t=3.179,P=0.002),躯体虐待(t=3.270,P=0.001)有统计学差异。3缓解期双相障碍组,有童年创伤(任何一种创伤类型)的患者愤怒面孔识别正确率较差(t=-2.021,P=0.048),有统计学意义;高兴面孔识别正确率显著降低,有统计学意义(t=-2.027,P=0.041);惊讶识别正确率显著降低(t=-2.019,P=0.049),有统计学意义。4双相障碍组,采用逐步线性回归分析,在α入=0.05、α出=0.10水平下,悲伤识别正确率的影响因素有婚姻(t=-2.804,P=0.007),抗精神病药物种类(t=-3.073,P=0.003)和生活事件(t=2.761,P=0.008);愤怒识别正确率影响因素躁狂发作次数(t=-2.453,P=0.017)和情感忽视(t=-2.205,P=0.032);高兴识别正确率影响因素只有情感忽视(t=-2.030,P=0.047);惊讶识别正确率影响因素有性虐待(t=2.308,P=0.025)和婚姻状态(t=-2.007,P=0,050);恐惧识别正确率影响因素为YMRS(t=-2.203,P=0.032);厌恶识别正确率影响因素有伴发精神病性症状(t=2.687,P=0.010)和体重指数(t=-2.310,P=0.025)。结论:1缓解期双相障碍患者仍对特定表情识别障碍。2双相障碍患者童年期经历的创伤类型广泛及程度严重。3经历童年创伤的双相障碍患者,缓解期残留的认知症状明显,尤其是情感忽视对愤怒和高兴表情识别的影响严重,存在剂量-效应关系。
[Abstract]:Background: bipolar disorder (BD) is the result of the combined effect of genetic stress. Environmental factors, especially early years, have an important role in the development of bipolar disorder and become one of the risk factors of the disease. Bipolar disorder has become a serious medical and social problem, with 75% bipolar disorder in remission period. The decline of social function level and social cognition are closely related to social cognition, especially emotional cognition. The influence of childhood trauma on the emotional cognitive function of patients with bipolar disorder in remission stage is not very clear. Methods: 72 patients with bipolar disorder and 70 healthy controls were included in the psychiatric clinic of the first hospital of Hebei Medical University from March 2015 to December 2016. The general demographic data and social psychology data were collected to assess the childhood trauma and emotional cognitive function of the patients with bipolar disorder during remission. The cognitive assessment used the Fcial affect recognition (FAR) to analyze the recognition accuracy of 6 expressions of happiness, sadness, anger, aversion, fear and surprise. Statistical analysis was carried out by SPSS21.0 statistical software, and the statistical description of the measurement data was shown in the mean number of standard deviation tables, and the two groups were compared with two independent samples t test or non parameter. The statistical description of the count data used the ratio of composition, the ratio of the rate was compared with the chi 2 test, and the analysis of the influence factors of emotional cognition was carried out by stepwise linear regression. Results: the correct rate of distress recognition in the 1 patients with bipolar disorder was 53.5%, 52%, 89.8%, 64.6%, 35.9%, and 23.4%. The correct rate was 60.9%, the anger 58.1%, the happy 95.5%, the surprise 68.7%, the aversion 43.3%, the fear 30.9%, the two groups in t=-2.424, P=0.017, t=-2.018, P=0.046, t=-3.492, P=0.001, t=-3.331, P=0.001, and aversion (t=-2.596, P= 0.011), the accuracy of identification was significant difference between the.2 biphasic disorder group and the healthy control group in the total CTQ total. 5.702, P=0.000), t=3.146 (P=0.002), emotional neglect (t=5.637, P=0.000), t=2.277 (P=0.025), physical neglect (t=3.179, P=0.002), physical abuse (t=3.270, P=0.001), there were statistical differences in the biphasic disorder group, with a childhood trauma (any type of trauma) with a poor correct rate of face recognition. P=0.048) was statistically significant; the correct rate of recognition of happy faces was significantly reduced, with statistical significance (t=-2.027, P=0.041); the correct rate of surprise recognition was significantly reduced (t=-2.019, P=0.049), and there was a statistically significant.4 biphasic disorder group, by stepwise linear regression analysis, the influence factors of the correct rate of sadness identification at alpha into =0.05 and alpha =0.10 level T=-2.804 (P=0.007), antipsychotic drugs (t=-3.073, P=0.003) and life events (t=2.761, P=0.008); anger recognition accuracy affects the frequency of manic episodes (t=-2.453, P=0.017) and emotional neglect (t=-2.205, P=0.032); the factors affecting the positive rate of happiness recognition are only emotional neglect (t=-2.030, P=0.047); and the correct rate of surprise recognition The influencing factors were t=2.308 (P=0.025) and marital status (t=-2.007, P=0050); the influencing factors of the correct rate of fear recognition were YMRS (t=-2.203, P=0.032); the factors affecting the correct rate of aversion identification were associated with psychosis (t=2.687, P=0.010) and body mass index (t= -2.310, P=0.025). Conclusion: 1 patients with bipolar disorder still have specific facial expressions. The types of childhood experience in patients with.2 bipolar disorder have extensive and severe types of childhood traumas, and.3 experienced childhood trauma with bipolar disorder. The cognitive symptoms remained in the remission period, especially the effect of emotional neglect on anger and expression recognition, and there was a dose effect relationship.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.4
本文编号：2160328
[Abstract]:Background: bipolar disorder (BD) is the result of the combined effect of genetic stress. Environmental factors, especially early years, have an important role in the development of bipolar disorder and become one of the risk factors of the disease. Bipolar disorder has become a serious medical and social problem, with 75% bipolar disorder in remission period. The decline of social function level and social cognition are closely related to social cognition, especially emotional cognition. The influence of childhood trauma on the emotional cognitive function of patients with bipolar disorder in remission stage is not very clear. Methods: 72 patients with bipolar disorder and 70 healthy controls were included in the psychiatric clinic of the first hospital of Hebei Medical University from March 2015 to December 2016. The general demographic data and social psychology data were collected to assess the childhood trauma and emotional cognitive function of the patients with bipolar disorder during remission. The cognitive assessment used the Fcial affect recognition (FAR) to analyze the recognition accuracy of 6 expressions of happiness, sadness, anger, aversion, fear and surprise. Statistical analysis was carried out by SPSS21.0 statistical software, and the statistical description of the measurement data was shown in the mean number of standard deviation tables, and the two groups were compared with two independent samples t test or non parameter. The statistical description of the count data used the ratio of composition, the ratio of the rate was compared with the chi 2 test, and the analysis of the influence factors of emotional cognition was carried out by stepwise linear regression. Results: the correct rate of distress recognition in the 1 patients with bipolar disorder was 53.5%, 52%, 89.8%, 64.6%, 35.9%, and 23.4%. The correct rate was 60.9%, the anger 58.1%, the happy 95.5%, the surprise 68.7%, the aversion 43.3%, the fear 30.9%, the two groups in t=-2.424, P=0.017, t=-2.018, P=0.046, t=-3.492, P=0.001, t=-3.331, P=0.001, and aversion (t=-2.596, P= 0.011), the accuracy of identification was significant difference between the.2 biphasic disorder group and the healthy control group in the total CTQ total. 5.702, P=0.000), t=3.146 (P=0.002), emotional neglect (t=5.637, P=0.000), t=2.277 (P=0.025), physical neglect (t=3.179, P=0.002), physical abuse (t=3.270, P=0.001), there were statistical differences in the biphasic disorder group, with a childhood trauma (any type of trauma) with a poor correct rate of face recognition. P=0.048) was statistically significant; the correct rate of recognition of happy faces was significantly reduced, with statistical significance (t=-2.027, P=0.041); the correct rate of surprise recognition was significantly reduced (t=-2.019, P=0.049), and there was a statistically significant.4 biphasic disorder group, by stepwise linear regression analysis, the influence factors of the correct rate of sadness identification at alpha into =0.05 and alpha =0.10 level T=-2.804 (P=0.007), antipsychotic drugs (t=-3.073, P=0.003) and life events (t=2.761, P=0.008); anger recognition accuracy affects the frequency of manic episodes (t=-2.453, P=0.017) and emotional neglect (t=-2.205, P=0.032); the factors affecting the positive rate of happiness recognition are only emotional neglect (t=-2.030, P=0.047); and the correct rate of surprise recognition The influencing factors were t=2.308 (P=0.025) and marital status (t=-2.007, P=0050); the influencing factors of the correct rate of fear recognition were YMRS (t=-2.203, P=0.032); the factors affecting the correct rate of aversion identification were associated with psychosis (t=2.687, P=0.010) and body mass index (t= -2.310, P=0.025). Conclusion: 1 patients with bipolar disorder still have specific facial expressions. The types of childhood experience in patients with.2 bipolar disorder have extensive and severe types of childhood traumas, and.3 experienced childhood trauma with bipolar disorder. The cognitive symptoms remained in the remission period, especially the effect of emotional neglect on anger and expression recognition, and there was a dose effect relationship.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.4
【参考文献】
相关期刊论文 前2条
1 陀柠瑜;刘铁榜;杨海晨;荣晗;张建;沈其杰;;双相障碍患者社会认知功能的比较研究[J];中华精神科杂志;2013年06期
2 郑尤民;张程峧;;心理干预对双相障碍患者认知功能影响的对照研究[J];中国民康医学;2010年17期
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