缓解期双相障碍患者面孔表情识别功能及其相关因素

Facial expression recognition function and related factors in patients with bipolar disorder in remission

目的探究缓解期双相障碍患者面孔表情识别功能损害及其相关因素。方法连续纳入2015年3月至2016年12月河北医科大学精神卫生中心门诊招募的53例缓解期双相障碍患者(双相障碍组),以及河北医科大学精神卫生中心的工作人员及陪同或探望患者而与患者无血缘关系的人员(健康对照组)64名,全部被试采用面孔表情识别任务进行评估,比较6种面孔表情(高兴、悲伤、愤怒、恐惧、厌恶和惊讶)识别的准确率和反应时间,并采用Pearson相关分析方法分析面孔表情识别功能与临床特征(总病程、受教育年限、总发作次数)、杨氏躁狂量表(YMRS)和汉密尔顿抑郁量表(24项,HAMD)评分、匹兹堡睡眠质量指数(PSQI)的相关性。结果双相障碍组所有面孔识别准确率均低于健康对照组[高兴:(0.881±0.145)比(0.959±0.848);悲伤:(0.516±0.197)比(0.609±0.166);愤怒:(0.497±0.190)比(0.589±0.179);恐惧:(0.249±0.140)比(0.309±0.133);厌恶:(0.340±0.164)比(0.433±0.160);惊讶:(0.588±0.214)比(0.687±0.160);均P<0.05];所有面孔反应时间均长于健康对照组[高兴:(1819±463)比(1526±412)ms;悲伤:(2635±591)比(2326±461)ms;愤怒:(2628±585)比(2371±442)ms;恐惧:(2723±558)比(2388±483)ms;厌恶:(2666±618)比(2424±470)ms;惊讶:(2557±597)比(2196±543)ms],且差异均有统计学意义(均P<0.05)。相关分析结果显示,愤怒面孔识别的准确率与总发作次数呈负相关(r=-0.294,P=0.033);惊讶面孔识别准确率与总病程呈正相关(r=0.281,P=0.042),与受教育年限呈正相关(r=0.284,P=0.039);惊讶面孔反应时间与总病程呈正相关(r=0.308,P=0.025),与受教育年限呈负相关(r=-0.273,P=0.048)。悲伤、高兴、恐惧面孔识别的准确率与临床特征及HAMD、YMRS、PSQI评分无相关性(均P>0.05);悲伤、愤怒、高兴、恐惧面孔识别的反应时间与临床特征及HAMD、YMRS、PSQI评分无相关性(均P>0.05)。结论缓解期双相障碍患者面孔表情识别功能下降,部分面孔表情识别的准确率与反应时间与总病程、受教育年限、总发作次数存在相关性。

Objective To explore the impairment of facial expression recognition(FER)function and related factors in patients with bipolar disorder(BD)in remission.Methods A total of 53 BD patients in remission were continuously recruited from Mental Health Center of Hebei Medical University from March 2015 to December 2016(BD group).Another 64 individuals including the staff of Mental Health Center of Hebei Medical University and people who accompanied or visited the patients without blood relationship(control group).All subjects were evaluated by facial expression recognition task,and the recognition accuracy and response time of six facial expressions(happy,sad,angry,fearful,disgusted and surprised)were compared.Pearson correlation analysis was used to analyze the correlation between facial expression recognition and clinical features(total course of disease,years of education,total episodes),Young Mania Rating Scale(YMRS),Hamilton Depression Scale(HAMD)score,Pittsburgh Sleep Quality Index(PSQI).Results The accuracy of face recognition of the BD group was all lower than that of the control group[happy:(0.881±0.145)vs(0.959±0.848),sad:(0.516±0.197)vs(0.609±0.166),angry:(0.497±0.190)vs(0.589±0.179),fearful:(0.249±0.140)vs(0.309±0.133),disgusted:(0.340±0.164)vs(0.433±0.160),surprised:(0.588±0.214)vs(0.687±0.160)](P<0.05).The response time of the BD group was significantly longer than that of the healthy controls[happy:(1819±463)vs(1526±412)ms,sad:(2635±591)vs(2326±461)ms,angry:(2628±585)vs(2371±442)ms,fearful:(2723±558)vs(2388±483)ms,disgusted:(2666±618)vs(2424±470)ms,surprised:(2557±597)vs(2196±543)ms],and the differences were statistically significant(P<0.05).Correlation analysis showed that the accuracy of angry face recognition was negatively correlated with the total number of attacks(r=-0.294,P=0.033).The accuracy of surprise face recognition was significantly positively correlated with the total course of disease(r=0.281,P=0.042)and with the years of education(r=0.284,P=0.039).The response time of surprise faces was significantly positively correlated with the total course of disease(r=0.308,P=0.025),and was significantly negatively with the years of education(r=-0.273,P=0.048).There was no significant correlation between the accuracy of sad,happy and fearful face recognition and clinical features,HAMD,YMRS and PSQI scores(P>0.05).There was no significant correlation between the response time of sad,angry,happy and fearful face recognition and the clinical features,HAMD,YMRS and PSQI scores(P>0.05).Conclusions In remission stage,BD has decreased FER function,the accuracy and response time of partial facial expression recognition are correlated with the total course of disease,years of education and the total number of attacks.