精神分裂症患者快感缺失与动机缺乏

Relationship between Anhedonia and Lack of Motivation of Patients with Schizophrenia.

目的了解精神分裂症患者快感缺乏情况,并且探讨快感缺失症状与动机缺乏的相关关系。方法以贝克抑郁自评问卷(BDI)、时间性快感体验量表(TEPS)(分为期待性快感体验和消费性快感体验2个子量表)为工具对28名精神分裂症患者及32名健康被试进行调查,并完成由电脑呈现的付出努力的奖励任务(EEfRT)。结果①两组在BDI总分,期待性快感缺失,消费性快感缺失上均有显著差异(t=-4.966,2.962,5.581;P<0.01);②两组在高概率(88%)及中等概率(50%)下对于困难任务的选择率独立样本t检验差异显著(t=7.141,2.384;P<0.05),而在低概率(12%)水平两组对于困难任务选择率上无统计学意义;③BDI总分及期待性快感缺失与高概率和中等概率水平下的困难任务选择率显著相关(P<0.05)。结论精神分裂症患者存在明显的消费性和期待性快感缺失;且仅期待性快感缺失和奖励加工的动机下降有关。

Objective To explore anhedonia in patients with schizophrenia and further test the correlation between lack of motivation and anhedonia.Methods Total 28 patients with schizophrenia and 32 health controls were investigated with Beck Depression Inventory,Temporal and Experience of Pleasure Scale（TEPS）（including anticipatory and consummatory anhedonia）,then participated in the Effort Expenditure for Rewards Task on the computer.Results ① There were significant differences in BDI index,anticipatory and consummatory anhedonia between two groups（t=-4.966,2.962,5.581;P0.01）;② There were significant differences of proportion of hard-task choice in the high probability（88%）and medium probability（50%）（t=7.141,2.384;P0.05）,but no significant differences in low probability（12%）level.③Proportions of hard-task choices for medium and higher probability trials were significantly correlated with the score on the BDI and anticipatory anhedonia（P0.05）.Conclusion Patients with schizophrenia have significant anticipatory and consummatory anhedonia,but only anticipatory anhedonia is related to reward processing motivation decline.