强迫性障碍患者的执行功能研究

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<0.01),强迫检查的出现与计划的河内塔测验开始时间长短成正比(r=0.295,P<0.05),强迫仪式动作的出现与抑制的Stroop测验的时间延长和错误数目增加成正比(r=0.278、0.300,P<0.05),强迫询问与流利性的说出数目多少成负相关(r=-0.261,P<0.05)。合并的焦虑抑郁情绪与模式转换的威斯康星卡片分类测验和连线测验的操作时间成正比,与计划的河内塔测验总时间成正比(r=0.297,0.359,P<0.05)。结论:不同强迫症状与执行功能的不同层面相关,合并的焦虑抑郁情绪程度与模式转换、计划能力的下降有关。

Executive Function in Obsessive-Compulsive Disorder

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.