本文選題：雙相障礙　切入點(diǎn)：雙眼競爭　出處：《安徽醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的雙眼競爭是指當(dāng)二眼同時(shí)呈現(xiàn)不同圖像時(shí),無法形成單一、穩(wěn)定的知覺,進(jìn)而造成知覺動(dòng)態(tài)交替變化的視覺生理現(xiàn)象。在雙眼競爭范式中,存在客觀恒定的物理刺激與主觀交替的知覺體驗(yàn)相分離的現(xiàn)象,是研究意識問題的一個(gè)突破口,提供了一個(gè)精神障礙和認(rèn)知/視覺神經(jīng)科學(xué)之間的聯(lián)系。雙相情感障礙是一種常見的精神障礙,以躁狂和抑郁交替發(fā)作為特點(diǎn)的疾病,是一類重性、高殘性心境障礙。國外研究表明,雙相障礙的終生患病率為1.5%左右,患病人口約占總?cè)藬?shù)的4.4%。據(jù)世界衛(wèi)生組織統(tǒng)計(jì),雙相障礙是所有疾病中傷殘調(diào)整生命年的第六個(gè)原因,已經(jīng)嚴(yán)重影響雙相障礙患者的認(rèn)知方式、人際關(guān)系和適應(yīng)能力,引起家庭、社會的廣泛關(guān)注。本文以雙相障礙患者為研究對象,以意識交替速率為測量指標(biāo)來觀察雙相情感障礙患者在雙眼競爭范式中表現(xiàn),并進(jìn)一步探討抑郁和躁狂情緒狀態(tài)下交替速率的改變有無統(tǒng)計(jì)學(xué)差異,抑郁癥狀的嚴(yán)重程度和躁狂癥狀的嚴(yán)重程度對意識交替速率是否具有相關(guān)性,進(jìn)而推測雙眼競爭下雙相障礙患者表現(xiàn)的可能神經(jīng)生物學(xué)機(jī)制,進(jìn)一步證實(shí)減慢的雙眼競爭交替速率是否有可能作為雙相障礙的特征性標(biāo)志,作為雙相障礙患者鑒別診斷的手段之一 方法納入未服用精神類相關(guān)藥物的30例雙相障礙患者組與30名正常對照組,采用雙眼競爭范式對兩組被試進(jìn)行雙眼競爭意識交替速率的測試。 結(jié)果①在雙眼競爭范式實(shí)驗(yàn)中,雙相障礙患者組與正常對照組雙眼競爭意識交替速率存在顯著差別,雙相障礙患者組意識平均交替速率為(4.59±1.70)s,對照組為(2.70±0.81)s,患者組速率較對照組明顯減慢,兩組差異有統(tǒng)計(jì)學(xué)意義(t=5.493,P0.01)。②患者組按照情緒狀態(tài)分為兩亞組：躁狂組和抑郁組；躁狂組、抑郁組和對照組的雙眼競爭意識交替速率經(jīng)方差分析存在顯著的統(tǒng)計(jì)學(xué)差異(F=29.43,P0.01)。進(jìn)一步進(jìn)行躁狂組和抑郁的間兩兩比較,雙相障礙患者中躁狂組意識平均交替速率(3.50±0.99)s比抑郁組的意識平均交替速率(5.55±1.63)s快,二者之間存在統(tǒng)計(jì)學(xué)差異(P0.01)。躁狂組意識平均交替速率慢于對照組(2.70±0.81)s,抑郁組的意識交替速率也慢于對照組,且二組與正常對照組之間比較均存在統(tǒng)計(jì)學(xué)差異(P0.01)。③躁狂組意識平均交替速率與楊氏躁狂量表評分高低無相關(guān)性(P=0.522,r=-0.187),抑郁組意識平均交替平均速率和HAMD抑郁量表評分高低無相關(guān)性(P=0.957,r=-0.015)。 結(jié)論減慢的雙眼競爭交替速率有可能作為雙相障礙的特征性標(biāo)志,從而成為雙相障礙患者鑒別診斷的方法之一。不同的情緒狀態(tài)可能會影響競爭的意識交替速率。情緒癥狀的嚴(yán)重程度與雙眼競爭意識交替速率沒有相關(guān)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 鹵1.70 s in the bipolar disorder group and 2.70 鹵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 鹵0.99 s faster than that in depression group (5.55 鹵1.63). The average rate of consciousness alternation in manic group was slower than that in control group (2.70 鹵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.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R749.4

【共引文獻(xiàn)】

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本文編號：1641271