首发抑郁症患者的心灵理论认知障碍

Theory of mind deficits in first-episode depression

目的探讨首发抑郁症患者心灵理论两成分加工的特点。方法采用眼区心理状态阅读任务和失言觉察任务分别测查56例首发抑郁症患者和55名正常对照心灵理论社会知觉加工和社会认知加工的能力,患者又分为有和无精神病性症状组(PD组和NPD组)。采用贝克抑郁自评量表和简明精神病量表评估患者的临床症状。结果患者组心理状态阅读成绩(t=7.42,P<0.01)和失言觉察问题得分(t=13.57,P<0.01)显著差于对照组。而PD组(n=23)、NPD组(n=33)和对照组3组间心理状态阅读成绩(F=33.08,P<0.01)和失言觉察得分(2=78.50,P<0.01)差异也有统计学意义,两两比较显示,在两种任务情况下PD组和NPD组均差于对照组(P<0.05)。以贝克抑郁量表评分为协变量的协方差分析进一步显示,PD组在两种任务下的得分均差于NPD组(P<0.01)。患者组心理状态阅读成绩和失言觉察问题得分分别与BPRS总分(r=-0.36,P<0.01;r=-0.48,P<0.01)和敌对因子分(r=-0.73,P<0.01;r=-0.77,P<0.01)呈显著负相关。结论抑郁症患者在心灵理论加工的两个亚成分上均存在损害,且与精神病性症状及其严重程度相关。

Objective To characterize the two components of theory of mind （TOM） in patients with first episode depression. Methods Fifity-six depressed patients （33 nonpsychotic depressed patients, 23 psychotic depressed patients） and 55 normal controls were assessed using Reading the mind in the Eyes, Faux pas Task, Verbal Fluency Test （VFT） , Digit Span Test （DST） and WAIS-IQ. The depressed patients were also assessed using BDI- II and BPRS. Results Significant differenee was found between depressed group and normal controls on tasks involving ToM social-pereeptual component （ Mind Reading ： t = 7.42, P 〈 0. 01 ） , test involving ToM social-cognitive component （ Faux pas Questions ： t = 13. 57, P 〈 0. 01 ）. Significant difference was also found among groups on Mind Reading （ F = 33. 08, P 〈 0. 01 ） and Faux pas Questions ： χ^2 = 78.50, P 〈 0. O1 ）. The psyehotic depressed patients and nonpsychotie depressed individuals performed worse than normal controls both on Mind Reading and Faux pas Questions （ P 〈 0. 05 ）. The psychotic depressed patients significantly performed worse than nonpsychotic depressed individuals on task involving ToM （ Mind Reading： F = 19. 12, P 〈 0. 01 ;Faux pas Questions： F = 35.94, P 〈 0. 01 ）. Significant associations were found between the ToM performanees and BPRS total scores （ Mind Reading： r = - 0. 36, P 〈 0. 01 ; Fanx pas Questions ： r = - 0.48, P 〈 0. 01 ） and hostile-suspieiousness factor （ Mind Reading： r = - 0. 73, P 〈 0. 01 ; Faux pas Questions ： r = - 0. 77, P 〈 0. 01 ） in depressed group. Conclusions The two ToM eomponents are both impaired in depressed patients, indicating that there may be an association between ToM deficits and psychotic symptoms in elinical depression.