發(fā)布時(shí)間：2018-05-02 08:17

  本文選題：抑郁癥 + 自殺意念��； 參考：《重慶醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的抑郁癥是一類具有嚴(yán)重危害性的精神障礙,10%-15%的患者可有自殺行為。自殺意念是自殺死亡的重要危險(xiǎn)因素,有效預(yù)測自殺意念并及時(shí)進(jìn)行干預(yù)可減少抑郁癥的自殺風(fēng)險(xiǎn)。目前國內(nèi)外主要是從社會(huì)心理學(xué)角度對抑郁癥的自殺意念進(jìn)行研究,但其相應(yīng)生物學(xué)指標(biāo)尚不明確。故本研究將運(yùn)用靜息態(tài)功能磁共振比率低頻振幅和事件相關(guān)電位P3來研究伴自殺意念抑郁癥的腦影像學(xué)和腦電生物學(xué)特征。方法按照性別、年齡、受教育程度相匹配的原則在重慶醫(yī)科大學(xué)附屬第一醫(yī)院心理衛(wèi)生中心收集未治療伴自殺意念抑郁癥患者30例、不伴自殺意念抑郁癥患者30例和正常對照組30名,完成一般資料收集及臨床心理量表的評定。采集三組被試的靜息態(tài)腦功能磁共振成像(resting-state functional magnetic resonance imaging,rs-fMRI)數(shù)據(jù),用比率低頻振幅方法對伴與不伴自殺意念抑郁癥組、對照組的靜息態(tài)腦功能磁共振圖像進(jìn)行比較,得到差異腦區(qū),將伴自殺意念抑郁癥組差異腦區(qū)的比率低頻振幅值與漢密爾頓抑郁量表17項(xiàng)總分、Beck自殺意念量表的總分、自殺意念和自殺危險(xiǎn)因子分分別做相關(guān)分析;伴自殺意念抑郁癥組完成詞-面孔干擾的情緒stroop試驗(yàn),并記錄其腦電和行為學(xué)數(shù)據(jù),比較該組患者在不同類型詞-面孔情緒stroop試驗(yàn)的反應(yīng)時(shí)及p3波形的潛伏期和波幅。并將事件相關(guān)電位p3的潛伏期和波幅與漢密爾頓抑郁量表17項(xiàng)、beck自殺意念量表的總分、自殺意念和自殺危險(xiǎn)因子分分別做相關(guān)分析。結(jié)果1、與正常對照組相比,伴自殺意念抑郁癥組左側(cè)枕上回/枕中回、右側(cè)枕中回/枕下回falff值升高,而右側(cè)顳下回、左側(cè)顳下回及左側(cè)額中回/額上回falff值降低;與正常對照組相比,不伴自殺意念抑郁癥組左側(cè)枕上回/枕中回falff值升高,而右側(cè)顳下回、左側(cè)顳下回及左側(cè)額中回/額上回falff值降低;與不伴自殺意念抑郁癥組相比,伴自殺意念抑郁癥組左側(cè)枕上回/枕中回、右側(cè)枕中回/枕下回falff值升高。伴自殺意念抑郁癥組雙枕中回的falff值分別與hamd-17項(xiàng)總分正相關(guān),而與beck自殺意念量表相關(guān)無統(tǒng)計(jì)學(xué)意義。2、在不同類型詞-面孔情緒stroop條件的下,伴自殺意念抑郁癥組平均反應(yīng)時(shí)、erps相關(guān)成分p3的波幅差異有統(tǒng)計(jì)學(xué)意義。p3的波幅與hamd-17項(xiàng)總分、beck自殺意念量表總分、自殺意念因子分和自殺危險(xiǎn)因子分負(fù)相關(guān)。結(jié)論伴自殺意念抑郁癥組的雙側(cè)枕中回的腦功能活動(dòng)存在異常,抑郁嚴(yán)重程度可能影響其局部異常腦功能活動(dòng)。伴自殺意念抑郁癥在不同情緒面孔刺激下可出現(xiàn)不同程度的注意偏向和認(rèn)知損害。
[Abstract]:Objective Depression is a serious mental disorder with 10-15% of patients with suicidal behavior. Suicide ideation is an important risk factor for suicide death. Effective prediction of suicide ideation and timely intervention can reduce the suicide risk of depression. At present, the suicide ideation of depression is mainly studied from the angle of social psychology at home and abroad, but its corresponding biological index is not clear. In this study, the resting functional magnetic resonance ratio, low-frequency amplitude and event-related potential P3 were used to study the brain imaging and electrobiological characteristics of depression with suicidal ideation. Methods 30 patients with suicidal ideation depression were collected from the Mental Health Center of the first affiliated Hospital of Chongqing Medical University according to the principle of matching sex, age and education. 30 patients with depression without suicidal ideation and 30 normal controls completed general data collection and evaluation of clinical psychological scale. Resting-state functional magnetic resonance imagingrs-fMRI data were collected from three groups of subjects. The resting brain functional magnetic resonance images of depression group with and without suicidal ideation and control group were compared with low-frequency amplitude ratio method, and the difference brain regions were obtained. The low frequency amplitudes of different brain regions in patients with depression with suicidal ideation were correlated with the total scores of 17 items of Hamilton Depression scale and Beck suicide ideation scale, suicide ideation and suicide risk factors. The mood stroop test of word face interference was completed in the depression group with suicide ideation, and the EEG and behavioral data were recorded. The latency and amplitude of p3 wave were compared in the response time and p3 wave of different types of word face emotion stroop test. The latency and amplitude of event-related potential p3 were correlated with the total scores of 17 items of Hamilton Depression scale, suicidal ideation scale, suicidal ideation score and suicide risk factor score. Results 1. Compared with the control group, the falff values of left superior occipital gyrus / middle occipital gyrus, right middle occipital gyrus / inferior occipital gyrus increased, while falff values of right infratemporal gyrus, left infratemporal gyrus and left middle frontal / suprafrontal gyrus decreased in patients with suicide ideation depression. Compared with the control group, the falff value of left superior occipital gyrus / middle occipital gyrus in depression group without suicidal ideation was increased, while the falff value in right inferior temporal gyrus, left inferior temporal gyrus and left middle frontal / superior frontal gyrus was lower than that in depression group without suicidal ideation. The falff values of left superior / middle occipital gyrus and right middle occipital / suboccipital gyrus were increased in patients with suicide ideation depression. The falff value of the middle occipital gyrus in the depression group with suicidal ideation was positively correlated with the total score of hamd-17, but had no significant correlation with the beck suicide ideation scale. Under the stroop condition of different types of word-face emotion, there was no significant difference between them. There was a significant difference in the amplitude of p3 in patients with suicidal ideation depression. The amplitude of p3 was negatively correlated with the total score of hamd-17, the factor score of suicidal ideation and the score of suicide risk factor. Conclusion the brain function of bilateral middle occipital gyrus is abnormal in patients with suicidal ideation depression, and the severity of depression may affect the local abnormal brain function. Depression with suicidal ideation may lead to different degrees of attention bias and cognitive impairment under the stimulation of different emotional faces.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R749.4

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本文編號：1833114