摘要
目的:强迫性障碍的发病年龄跨度较大,尝试比较不同发病年龄强迫性障碍患者的执行功能状况。方法:纳入来自北京大学精神卫生研究所2004-11/2005-11门诊和住院明确诊断为强迫性障碍的患者60例,男40例,女20例;以首次发病年龄是否超过18岁为界限,分为18岁前起病组31例,18岁后起病组29例。采用威斯康星卡片分类测验、连线测验、河内塔测验、Rey复杂图形、色字干扰测验,言语流畅性测验等神经心理学测验评定执行功能,比较18岁前后发病患者的执行功能。进行如下指标的观察:①威斯康星卡片分类测验:评价模式转换能力,指标有总测验数、完成归类数、错误应答数、持续性错误数、完成第1个分类所需应答数。②连线测验:评价模式转换能力,指标有操作时间和错误数目。③河内塔测验:评价计划能力,指标有为移动次数,所需时间,从试验开始到开始移动的时间,放弃的次数,出错次数。④Rey复杂图形:评价工作记忆,指标有记忆结构分数。⑤色字干扰测验:评价抑制能力,评价指标有每部分时间。⑥言语流畅性测验:评价流畅性,指标有说出数目、重复数目。结果:参与实验的60例患者全部进入结果分析。①模式转换方面测试结果:18岁前起病组连线测验B部分时间较18岁后起病组短(Z=-2.739,P=0.006),完成第1个分类所需应答数少(Z=-2.197,P=0.028),完成归类数多(Z=-2.030,P=0.042)。②计划方面测试结果:18岁前起病组总时间较18岁后起病组短(Z=-2.107,P=0.035)。③抑制方面测试结果:18岁前起病组第3部分干扰字意的读取时间较18岁后起病组短(Z=-2.268,P=0.009)。④工作记忆和流利性方面测试结果:两组差异没有显著性意义(Z=-0.213,P=0.831)。结论:不同发病年龄的强迫性障碍患者的执行功能不同,晚发和早发组可能是2种不同类型机制的强迫性障碍,具有不同的神经心理病理基础。
AIM： To compare executive function between different onset groups in patients with obsessive-compulsive disorder （OCD）, age of onset is with great span.
METHODS： Totally 60 patients （40 males and 20 females） diagnosed as having OCD were enrolled from Institute of Mental Health, Peking University from November 2004 to November 2005. They were divided by 18 years old into 2 groups： first onset before 18 years group （group A） with 31 cases and first onset after 18 years group （group B） with 29 cases. All finished a series of neuropsychological tests including Wisconsin card sorting test （WCST）, Trail-making test （TMT）, Tower of Hanoi （TH）, Rey-Osterrieth complex Figure test, Stroop test and Word fluency test （WFT）. Executive functions were compared between the two groups divided by 18 years old. As follows： ①Wisconsin card sorting test was used to evaluate set-shifting. The indexes were total cards, categories, total errors, perseverative errors, cards to finish the first category. ②Trail-making test was also used to evaluate set-shifting. The indexes were performing time and errors of part A and B. ③Tower of Hanoi was used to evaluate planning. The indexes were time of movement, total time, time to start, errors and total steps. ④Rey-Osterrieth complex Figure test was used to evaluate working memory. The indexes were framework score. ⑤Stroop test was used to evaluate inhibition. The indexes were times of every part. ⑥Word fluency test was used to evaluate fluency. The indexes were total words and errors.
RESULTS： A total of 60 patients were involved in the result analysis. ①Set-shifting： Patients in the group A were better than those of group B in TMT part B time （Z =-2.739, P =0.006）, cards to finish the first category （Z=-2.197, P =0.028）, and categories （Z =-2.030, P =0.042）. ②Planning： The total time was shorter in TH in the group A than the Group B （Z =-2.107, P =0.035）. ③Inhibition： Patients in the group A were better in part C time of Stroop test （Z =-2.268, P =0.009）. ④No significant differences were found in working memory and fluency （Z=-0.213, P =0.831 ）. CONCLUSION： Executive functions are found differently in different onset patients with obsessive-compulsive disorder. Patients in the early onset and late onset groups may be with 2 different kinds of OCD, and with different neurological, psychological and pathological basis.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第39期7845-7847,共3页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
北京大学精神卫生研究所青年科研启动基金~~
