抑郁症患者外显及内隐情绪面孔的反应抑制特点

Response inhibition to explicit and implicit emotional faces in major depressive disorder

目的:探究抑郁症患者外显及内隐情绪面孔反应抑制的特点及其与快感缺失的关系。方法:采用情绪面孔停止信号任务测评38例符合DSM-5诊断标准的抑郁症患者及40例正常对照在外显和内隐条件下的反应抑制能力。采用Chapman社会和躯体快感缺失量表(CSAS&CPAS)评估快感缺失水平,采用汉密顿抑郁量表(HAMD-24)评估患者抑郁程度。采用混合模型方差分析组内和组间的差异。结果:在外显任务中,抑郁症组的停止信号反应时(SSRT)大于正常对照组[(296.2±10.3)msvs.(242.1±10.1)ms,P<0.001],而成功抑制率(PI)[(0.51±0.01)vs.(0.55±0.01)]、停止信号延迟时间(SSD)[(246.5±13.4)msvs.(311.4±13.0)ms]均小于正常对照组(均P<0.01)。在内隐任务中,抑郁症组的SSRT大于正常对照组[(292.4±10.8)msvs.(230.2±10.5)ms,P<0.001],而PI[(0.52±0.01)vs.(0.55±0.01)]、SSD[(266.9±13.7)msvs.(324.4±13.3)ms]均小于对照组(均P<0.05);相关分析显示,抑郁症组外显中性(r=0.38)和悲伤(r=0.36)、内隐中性(r=0.43)和悲伤(r=0.39)面孔的SSRT与快感缺失得分呈正相关。结论:抑郁症患者外显和内隐情绪反应抑制存在缺损,并可能与其快感缺失的严重程度有关。

Objective:To explore the characteristics of response inhibition to emotional facial expressions and its relationship to anhedonia under both explicit and implicit conditions in patients with major depressive disorder(MDD).Methods:The ability of response inhibition of 38 patients with MDD meeting the diagnostic criteria of DSM-5 and 40 normal controls were assessed by a stop signal task combined with facial stimuli under explicit and implicit emotional conditions.The Chapman Social Anhedonia Scale and Chapman Physical Anhedonia Scale(CSAS&CPAS)was used to evaluate the severity of anhedonia,and the 24-item Hamilton Depression Rating Scale(HAMD-24)was used to evaluate the severity of depression.Mixed-model ANOVA was used for statistical analysis of intra-group and inter-group differences.Results:Under the explicit condition,the stop-signal reaction time(SSRT)[(296.2±10.3)ms vs.(242.1±10.1)ms,P<0.001]was longer,the Probability of Inhibition(PI)[(0.51±0.01)vs.(0.55±0.01)]was lower and the Stop Signal Delay time(SSD)[(246.5±13.4)ms vs.(311.4±13.0)ms]were shorter in the MDD group than in the control group(Ps<0.01).Under the implicit condition,the SSRT[(292.4±10.8)ms vs.(230.2±10.5)ms,P<0.001]was higher,the PI[(0.52±0.01)vs.(0.55±0.01)]was lower,and the SSD time[(266.9±13.7)ms vs.(324.4±13.3)ms]was shorter in the MDD group than in the control group(Ps<0.05).The SSRT of explicit neutral(r=0.38)and sad face(r=0.36),and implicit neutral(r=0.43)and sad face(r=0.39)were significantly positively correlated with the CSAS&CPAS anhedonia scores in the MDD group.Conclusion:The results suggest that both explicit and implicit emotional response inhibition in patients with major depressive disorder,which may be related to the severity of anhedonia.