强迫症患者高发与散发一级亲属心理健康状况及认知功能的对照研究

A control study of the mental health and cognitive function in the first-degree relatives of patients with high and sporadic incidence of obsessive-compulsive disorder

目的探讨强迫症患者一级亲属的心理健康状况及认知功能。方法选择2015年6月~2017年6月在荆州市精神卫生中心住院的强迫症患者的一级亲属72名为研究对象,按照家族中有无其他患病者将72名亲属分为高发家系组(48名)和散发家系组(24名)。采用汉密尔顿焦虑量表(HAMA)、耶鲁-布朗强迫量表(Y-BOCS)评价两组的焦虑症状和强迫症状,采用斯特鲁普色词测验(Stroop)、威斯康星卡片分类测验(WCST)、持续操作测验(CPT)量表、简易视觉空间记忆测验-修订版(BVMT-R)测试两组的认知功能。结果 (1)高发家系组HAMA量表、Y-BOCS量表总分均高于散发家系组,差异有统计学意义(P<0.05);(2)高发家系组Stroop测试的B、C部分得分显著低于散发家系组,差异有统计学意义(P<0.05);高发家系组WCST正确数、完成分类数得分显著低于散发家系组(P<0.05),持续错误数、随机错误数得分显著高于散发家系组,差异有统计学意义(P<0.05)。(3)高发家系组CPT得分显著低于散发家系组,差异有统计学意义(P<0.05);(4)高发家系组BVMT-R中联想学习、图像自由回忆、人像特点回忆项目显著低于散发家系组,差异有统计学意义(P<0.05)。结论高发家系组一级亲属较多出现焦虑、强迫症状,更易出现注意力、记忆力等方面的认知功能损害。

Objective To investigate the mental health status and the cognitive function in the first-degree relatives of patients with obsessive-compulsive disorder.Methods From June 2015 to June 2017,72 first-degree relatives of patients with obsessive-compulsive disorder in Jingzhou Mental Health Center were selected as research objects and divided into the high incidence family group(48 cases)and the sporadic incidence family group(24 cases)according to the presence of others in the family.Hamilton anxiety scale(HAMA)and Yale-Brown obsessive compulsive scale(Y-BOCS)were used to assess the anxiety and compulsive symptoms.Stroop color word test(Stroop),Wisconsin card sorting test(WCST),continuous performance test(CPT)and brief visuospatial memory test-revised(BVMT-R)were applied to evaluate the cognitive function.Results①The total scores of HAMA and Y-BOCS in the high incidence family group were all higher than those of sporadic family group,with statistically significant differences(2.6965,P<0.05).②In the Stroop,the scores of B and C in the high incidence family group were lower than those of sporadic family group,with statistically significant differences(P<0.05).The WCST scale showed that the number of correctness and completed categories in the high incidence family group were lower than those of sporadic family group,with statistically significant differences(P<0.05),while significantly higher as regards the number of persistent error and random error(P<0.05).③The score of CPT in the high incidence family group was significant lower than that of sporadic family group,with statistically significant difference(P<0.05).④BVMT-R showed that in terms of associative learning,group image free recall and memorizing the characteristics of human pictures in the high incidence family group were significant lower than those of sporadic family group,with statistically significant differences(P<0.05).Conclusion The first-degree family members of patients with high incidence of obsessive-compulsive disorder are more likely to show signs of anxiety and obsessive-compulsive symptom and more likely to suffer from cognitive impairment,such as attention and memory.