强迫性障碍患者执行功能研究.docVIP

强迫性障碍患者执行功能研究 　　【摘 要】 目的：探讨影响强迫性障碍患者执行功能的因素。方法：纳入强迫性障碍患者60例，采用威斯康星卡片、连线测验、河内塔测验、Ｓtroop测验，言语流畅性测验等神经心理学测验评定执行功能。同时使用社会功能缺陷量表评定社会功能水平，耶鲁布朗量表评定疾病严重程度，汉米尔顿量焦虑抑郁量表评定合并的焦虑抑郁程度。结果：强迫怀疑的出现与模式转换的威斯康星卡片分类测验的概念认知下降相关（r＝-0.388,P 　　【关键词】 强迫性障碍；执行功能；病例研究 　　中图分类号：R749.79、B845.1 文献标识码：A 文章编号：1000-6729(2007)07-00492-04 　　 　　Executive Function in Obsessive-Compulsive Disorder 　　YAN Jun，WANG Yu-Feng,CUI Yu-Hua 　　Institute of Mental Health, Peking University, Beijing 100083 　　【Abstract】 Objectives: To study the correlated factors of executive function in patients with obsessive-compulsive disorder. Methods: 60 Patients met with ICD-10 criteria for obsessive-compulsive disorder (OCD) were enrolled. All of them finished a series of neuropsychological tests including Wisconsin card sorting test (WCST), Trail-making test (TMT), Tower of Hanoi (TH), Stroop test and Word fluency test (WFT). They were also assessed by Yale-Brown Obsessive Compulsive scale and Hamilton anxiety and depression inventory. Results: 1.Different symptoms of OCD were correlated with different executive function. Significant correlations were found in: doubting with set shifting (r＝-0.388), checking with plan (r＝0.295), ritual with inhibition (r＝0.278), asking with fluency (r＝-0.261). 2.Combined anxiety and depression correlated with set-shifting and plan (r＝0.297，0.359).Conclusions:1. Different symptoms correlated with different types of executive function impairments. 2. Executive function of OCD patients correlates with combined anxiety and depression. 　　【Key words】 obsessive-compulsive disorder; executive function; cases study 　　 　　强迫性障碍，又称强迫症，是以强迫观念和强迫行为为表现的一种疾病。患者在解决问题和执行某个行动上表现出反复的怀疑和不确信，在明知原因和结果的前提下不能忽略无关的因素而仍固执于一种行为模式。Welsh和Pennington认为执行功能与感觉、语言、记忆等认知功能有别，但是在一些程度上和注意、问题解决等领域有重叠。执行功能是一种为完成所赋予的目标而去计划、排序、监控自己行为的能力，同时也能在改变任务要求下去灵活调整认知的适应性。强迫性障碍患者存在多方面的认知功能障碍，可能执行功能的障碍是主要的，并影响其他认知功能［1,2］。但是，目前执行功能的神经心理学测试并未在强迫性障碍产生特殊的、可以重复的模式，可能与强迫的临床状态、干预、症状不同等有关［3-5］。本研究尝试分析强迫性障碍的执行功能的各种影响因素，探讨强迫性障碍的执行功能特点。 　　 　　1