双相障碍患者双眼竞争现象的研究

发布时间：2018-03-20 23:29

本文选题：双相障碍　切入点：双眼竞争　出处：《安徽医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的双眼竞争是指当二眼同时呈现不同图像时,无法形成单一、稳定的知觉,进而造成知觉动态交替变化的视觉生理现象。在双眼竞争范式中,存在客观恒定的物理刺激与主观交替的知觉体验相分离的现象,是研究意识问题的一个突破口,提供了一个精神障碍和认知/视觉神经科学之间的联系。双相情感障碍是一种常见的精神障碍,以躁狂和抑郁交替发作为特点的疾病,是一类重性、高残性心境障碍。国外研究表明,双相障碍的终生患病率为1.5%左右,患病人口约占总人数的4.4%。据世界卫生组织统计,双相障碍是所有疾病中伤残调整生命年的第六个原因,已经严重影响双相障碍患者的认知方式、人际关系和适应能力,引起家庭、社会的广泛关注。本文以双相障碍患者为研究对象,以意识交替速率为测量指标来观察双相情感障碍患者在双眼竞争范式中表现,并进一步探讨抑郁和躁狂情绪状态下交替速率的改变有无统计学差异,抑郁症状的严重程度和躁狂症状的严重程度对意识交替速率是否具有相关性,进而推测双眼竞争下双相障碍患者表现的可能神经生物学机制,进一步证实减慢的双眼竞争交替速率是否有可能作为双相障碍的特征性标志,作为双相障碍患者鉴别诊断的手段之一方法纳入未服用精神类相关药物的30例双相障碍患者组与30名正常对照组,采用双眼竞争范式对两组被试进行双眼竞争意识交替速率的测试。结果①在双眼竞争范式实验中,双相障碍患者组与正常对照组双眼竞争意识交替速率存在显著差别,双相障碍患者组意识平均交替速率为(4.59±1.70)s,对照组为(2.70±0.81)s,患者组速率较对照组明显减慢,两组差异有统计学意义(t=5.493,P0.01)。②患者组按照情绪状态分为两亚组：躁狂组和抑郁组；躁狂组、抑郁组和对照组的双眼竞争意识交替速率经方差分析存在显著的统计学差异(F=29.43,P0.01)。进一步进行躁狂组和抑郁的间两两比较,双相障碍患者中躁狂组意识平均交替速率(3.50±0.99)s比抑郁组的意识平均交替速率(5.55±1.63)s快,二者之间存在统计学差异(P0.01)。躁狂组意识平均交替速率慢于对照组(2.70±0.81)s,抑郁组的意识交替速率也慢于对照组,且二组与正常对照组之间比较均存在统计学差异(P0.01)。③躁狂组意识平均交替速率与杨氏躁狂量表评分高低无相关性(P=0.522,r=-0.187),抑郁组意识平均交替平均速率和HAMD抑郁量表评分高低无相关性(P=0.957,r=-0.015)。结论减慢的双眼竞争交替速率有可能作为双相障碍的特征性标志,从而成为双相障碍患者鉴别诊断的方法之一。不同的情绪状态可能会影响竞争的意识交替速率。情绪症状的严重程度与双眼竞争意识交替速率没有相关性。
[Abstract]:Objective Binocular competition is a visual physiological phenomenon in which two eyes present different images at the same time and can not form a single and stable perception, which results in the dynamic alternation of perception. The existence of the separation of objective and constant physical stimulation from subjective alternating perceptual experience is a breakthrough in the study of consciousness. Provides a link between mental disorders and cognitive / visual neuroscience. Bipolar disorder is a common mental disorder characterized by alternating mania and depression. The lifetime prevalence of bipolar disorder is about 1.5%, and the population is about 4.4 percent of the total. According to the World Health Organization, bipolar disorder is the sixth cause of disability adjustment life year of all diseases. It has seriously affected the cognitive style, interpersonal relationship and adaptability of patients with bipolar disorder, and has aroused widespread concern in the family and society. Using the rate of consciousness alternation as a measure, we observed the performance of bipolar affective disorder in the binocular competition paradigm, and further explored whether there was statistical difference in the change of the rate of alternation between depression and mania. Whether the severity of depressive symptoms and the severity of mania is related to the rate of consciousness alternation, and then speculating on the possible neurobiological mechanism of bipolar disorder under binocular competition. Further confirm whether the slow rate of binocular competition alternation may be used as a characteristic marker of bipolar disorder and as a means of differential diagnosis in patients with bipolar disorder. Methods Twenty patients with bipolar disorder and 30 normal controls were enrolled in this study. The rate of bilateral competition was measured by binocular competition paradigm. Results 1 in the binocular competition paradigm experiment, there was a significant difference in the rate of bilateral competition consciousness alternation between the bipolar disorder group and the normal control group. The average rate of consciousness alternation was 4.59 卤1.70 s in the bipolar disorder group and 2.70 卤0.81 s in the control group. The rate in the patient group was significantly slower than that in the control group. The difference between the two groups was statistically significant, and the two groups were divided into two subgroups according to their emotional state: mania group and depression group, manic group, manic group, manic group, and manic group. There was significant statistical difference in the rate of binocular competitive consciousness alternation between the depression group and the control group by ANOVA. Further comparison was made between the manic group and the depression group. In bipolar disorder patients, the average rate of consciousness alternation in manic group was 3.50 卤0.99 s faster than that in depression group (5.55 卤1.63). The average rate of consciousness alternation in manic group was slower than that in control group (2.70 卤0.81) s, and the rate of consciousness alternation in depression group was also slower than that in control group. There was statistical difference between the two groups and the normal control group. There was no correlation between the average alternating rate of consciousness and the score of Yang's mania scale in manic group. There was no correlation between the average rate of consciousness alternation in depression group and the score of HAMD depression scale. Conclusion the slow rate of bilateral competition may be a characteristic marker of bipolar disorder. Different emotional states may affect the rate of competitive consciousness alternation. There is no correlation between the severity of emotional symptoms and the rate of binocular competitive consciousness alternation.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R749.4

【共引文献】