本文選題：精神分裂癥 + 社會(huì)認(rèn)知��； 參考：《安徽醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：精神分裂癥是一種常見的復(fù)雜的重性精神疾病，其社會(huì)認(rèn)知功能受損嚴(yán)重，主要包括情緒認(rèn)知、失言識(shí)別、眼區(qū)情緒識(shí)別等。社會(huì)認(rèn)知的神經(jīng)基礎(chǔ)涉及前額葉、眶額葉和扣帶回等腦區(qū)，而神經(jīng)心理學(xué)、神經(jīng)電生理及神經(jīng)影像學(xué)等研究都發(fā)現(xiàn)精神分裂癥患者上述腦區(qū)也存在結(jié)構(gòu)性的或者功能性的受損。精神分裂癥發(fā)病期間會(huì)引起c-fos原癌基因快速、短暫地表達(dá)，并表達(dá)在相應(yīng)的腦功能區(qū)。c-fos的異常表達(dá)將產(chǎn)生廣泛的病理作用，造成精神分裂癥患者腦組織功能性或器質(zhì)性的特征性的改變。先前有研究發(fā)現(xiàn)氯氮平、利培酮等藥物可以通過調(diào)節(jié)c-fos基因表達(dá)而改善精神分裂癥患者的社會(huì)認(rèn)知，但是研究結(jié)果并不一致。因此，本研究的目的是：其一，運(yùn)用神經(jīng)心理學(xué)的方法檢測(cè)精神分裂癥患者是否存在社會(huì)認(rèn)知功能障礙；其二，分別對(duì)不同的患者進(jìn)行氯氮平、利培酮藥物治療，探討其社會(huì)認(rèn)知是否有改善，并且觀察兩種藥物的療效是否相同。 方法：本研究對(duì)66例符合美國(guó)精神疾病診斷與統(tǒng)計(jì)手冊(cè)第4版（DSM-IV）精神分裂癥診斷標(biāo)準(zhǔn)的患者，及32名性別構(gòu)成、年齡及受教育年限相匹配的正常對(duì)照組被試進(jìn)行研究。患者組被試被隨機(jī)分配為氯氮平治療組和利培酮治療組，前者為34例，后者為32例。治療前對(duì)所有被試進(jìn)行簡(jiǎn)易精神狀態(tài)檢查（MMSE）、詞匯流暢檢測(cè)（VF）、數(shù)字廣度（DS）等神經(jīng)心理學(xué)背景測(cè)試；治療前和治療后分別對(duì)患者組被試進(jìn)行陽性與陰性癥狀量表測(cè)試（PANSS）；治療前和治療后分別對(duì)所有被試進(jìn)行失言識(shí)別測(cè)試（faux pas）和眼區(qū)情緒識(shí)別任務(wù)測(cè)試。 結(jié)果：三組被試的簡(jiǎn)易精神狀態(tài)檢測(cè)、詞匯流暢性檢測(cè)以及數(shù)字廣度得分比較，差異均無統(tǒng)計(jì)學(xué)意義（P＞0.05）。治療前，faux pas測(cè)試患者組被試在失言1、失言2、失言3以及失言4上與對(duì)照組比較，均表現(xiàn)較差，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）；患者組被試識(shí)別喜、驚、恐、悲、厭、怒六種基本眼區(qū)情緒與對(duì)照組比較，均表現(xiàn)較差，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。其中，氯氮平組患者識(shí)別恐、厭兩種情緒及利培酮組患者識(shí)別驚、恐兩種情緒表現(xiàn)更差，差異更顯著（P＜0.01）。治療后，患者組被試在失言識(shí)別上的表現(xiàn)有改善，但是還是較差：氯氮平組患者在失言1、失言3以及失言4上與對(duì)照組比較，均表現(xiàn)較差，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）；利培酮組患者在失言2、失言3以及失言4上與對(duì)照組比較，均表現(xiàn)較差，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）�；颊呓M被試識(shí)別基本眼區(qū)情緒有改善，但仍然存在差異。其中，氯氮平組患者識(shí)別恐、厭、怒三種情緒及利培酮組患者識(shí)別驚、恐、厭三種情緒較差，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。 結(jié)論：精神分裂癥患者存在社會(huì)認(rèn)知功能受損，其在失言識(shí)別及眼區(qū)情緒識(shí)別上表現(xiàn)較差。經(jīng)過藥物治療后，其社會(huì)認(rèn)知功能只是部分改善，說明社會(huì)認(rèn)知功能受損可能是精神分裂癥患者的特質(zhì)性改變。另外，氯氮平和利培酮對(duì)社會(huì)認(rèn)知功能都有改善作用，，但是其改善作用體現(xiàn)在不同的方面。
[Abstract]:Objective: schizophrenia is a common and complex mental illness. Its social cognitive function is badly damaged, including emotional cognition, loss of speech recognition, and eye area emotion recognition. The neural basis of social cognition involves the frontal lobe, the frontal lobe and cingulate gyrus, and neuropsychology, neurophysiology and neuroimaging. It is found that there is also structural or functional impairment in the above-mentioned brain areas of schizophrenic patients. During the onset of schizophrenia, the c-fos proto oncogene can be expressed rapidly and briefly, and the abnormal expression of.C-fos in the corresponding brain function area will produce a wide range of pathological effects, resulting in the function of brain tissue in schizophrenic patients or Qualitative changes. Previous studies have found that clozapine, risperidone, and other drugs can improve the social cognition of schizophrenic patients by regulating the expression of c-fos gene, but the results are not consistent. Social cognitive impairment; second, different patients were treated with clozapine and risperidone to explore whether the social cognition was improved and the efficacy of the two drugs was observed to be the same.
Methods: in this study, 66 patients with schizophrenia diagnosed with the fourth version of the American psychiatric diagnostic and Statistical Manual (DSM-IV), and 32 normal control groups with matched age and year of education were studied. The patients were randomly assigned to the clozapine treatment group and the risperidone treatment group, the former was 34. For example, the latter was 32. Before and after treatment, all subjects were treated with simple mental state examination (MMSE), lexical fluency test (VF), digital breadth (DS) and other neuropsychological background tests. Before and after treatment, positive and negative symptom scale test (PANSS) were performed on the patients group, and all the subjects were lost before and after treatment, respectively. Speech recognition test (Faux Pas) and eye area emotion recognition task test.
Results: there was no significant difference between the three groups of simple mental state detection, vocabulary fluency detection and digital breadth score comparison (P > 0.05). Before treatment, the patients in the faux pas test group were 1, 2, 3 and 4, and the difference was statistically significant (P < 0.05). The six kinds of basic eye area mood in the group were compared with the control group, and the difference was statistically significant (P < 0.05). Among them, the patients in the clozapine group identified the fear, the two kinds of emotions and the risperidone group, and the two mood tables were worse, and the difference was more significant (P < 0.01). After treatment, the patients group was lost. The performance of the speech recognition was improved, but it was still poor: the patients in the clozapine group were 1, 3 and 4, and the difference was statistically significant (P < 0.05). The patients in the risperidone group were 2, the lost 3 and the loss of the words 4 compared with the control group, the difference was statistically significant (P < 0.05). In the patients group, the subjects identified the improvement in the basic eye area mood, but there were still differences. Among them, the patients in the clozapine group identified the three emotions and the risperidone group to recognize the horror, the fear, and the three kinds of bad mood, and the difference was statistically significant (P < 0.05).
Conclusion: Patients with schizophrenia have impaired social cognitive function and poor performance in the recognition of loss of speech and recognition of eye areas. After medications, the social cognitive function is only partially improved, indicating that the impairment of social cognitive function may be the idiosyncratic change of schizophrenic patients. Knowledge function has improvement effect, but its improvement effect is reflected in different aspects.

【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R749.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 何瑞榮;賈z嚴(yán)

本文編號(hào)：1894262