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精神分裂症与抑郁障碍患者振动触觉损害分析

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背景 精神分裂症患者与抑郁障碍患者均存在感知觉异常的表现,既往关于感知觉的研究多采用问卷调查法,对精神分裂症与抑郁障碍患者在客观行为学上的研究尚不足.目的 探讨精神分裂症患者与抑郁障碍患者振动触觉的差异,充实与此部分患者有关的行为学上的研究结果.方法 于2021年3月—2023年9月,在北京回龙观医院门诊部和住院部选择符合《精神障碍诊断与统计手册(第5版)》(DSM-5)诊断标准的33例精神分裂症患者和31例抑郁障碍患者,同期在北京航空航天大学与北京回龙观医院招募34名健康对照组.采用阳性和阴性症状量表(PANSS)评定精神分裂症患者的临床症状,采用汉密尔顿抑郁量表17项版(HAMD-17)评定抑郁障碍患者的抑郁症状.通过改编的振动触觉形式的单样本延迟匹配任务,对三组被试的左手振动触觉情况进行检测,并比较三组被试在单样本延迟匹配任务中振动触觉的正确率.结果 精神分裂症患者在食指、中指与无名指上的正确率均低于健康对照组(P均<0.01),五个手指平均正确率低于健康对照组,差异有统计学意义(P=0.001).抑郁障碍患者在拇指上的正确率低于健康对照组(P=0.026).抑郁障碍患者组与精神分裂症患者组五个手指的振动触觉正确率以及平均正确率差异均无统计学意义(P均>0.05).精神分裂症患者组振动触觉平均正确率与病程、首发年龄、氯丙嗪当量和PANSS总评分的相关性均无统计学意义(r=0.058、0.045、0.114、-0.194,P均>0.05);抑郁障碍患者组振动触觉平均正确率与首发年龄呈负相关(r=-0.415,P=0.020),与病程和HAMD-17评分的相关性均无统计学意义(r=-0.044、0.142,P均>0.05).结论 精神分裂症与抑郁障碍患者均存在振动触觉损害,其中精神分裂症患者在食指、中指与无名指上的振动触觉受到严重损伤,抑郁障碍患者在大拇指上的振动触觉受到严重损伤,此外,抑郁障碍患者振动触觉损伤可能与首发年龄存在关联.
Analysis of impaired vibrotactile sense in patients with schizophrenia and depressive disorders
Background Patients with schizophrenia and depressive disorders exhibit abnormalities in perceptual processing.Previous perceptual studies are mainly based on asking participants to fill in a questionnaire,and little research has been undertaken on objective behavior in patients with schizophrenia and depressive disorders.Objective To explore the behavioral changes in vibrotactile sense among patients with schizophrenia and depressive disorders,so as to enrich relevant findings in objective behavioral research.Methods From March 2021 to September 2023,33 patients with schizophrenia and 31 patients with depressive disorders in the outpatient and inpatient departments of Beijing Huilongguan Hospital and met the Diagnostic and Statistical Manual of Mental Disorders,fifth edition(DSM-5)diagnostic criteria were enrolled.And another 34 healthy controls were concurrently recruited at Beihang University and Beijing Huilongguan Hospital.Patients with schizophrenia were assessed using Positive and Negative Symptom Scale(PANSS),and patients with depressive disorders were assessed using Hamilton Depression Scale-17 item(HAMD-17).The vibrotactile sensitivity of the left hand in all participants was tested in a delay match-to-sample procedure,and the correct rate of vibrotactile delayed discrimination task was compared among the three groups.Results Compared with healthy controls,a reduction was found in the correct rates at index finger,middle finger and ring finger in patients with schizophrenia(P<0.01),the average correct rate at five fingers in patients with schizophrenia(P=0.001),and the correct rate at thumb in patients with depressive disorders(P=0.026).No statistical difference was reported in correct rate of vibrotactile delayed discrimination task between patients with depression disorders and schizophrenia(P>0.05).The average correct rate of vibrotactile sense in schizophrenia group was not significantly correlated with the duration of disease,age of onset,chlorpromazine equivalent doses and PANSS score(r=0.058、0.045、0.114、-0.194,P>0.05).The average correct rate in depressive group was negatively correlated with age of onset(r=-0.415,P=0.020),but not significantly correlated with the duration of disease and HAMD-17 score(r=-0.044,0.142,P>0.05).Conclusion Patients with schizophrenia and depressive disorders have impaired vibrotactile sense.The vibrotactile sense is impaired in index,middle and ring fingers among patients with schizophrenia,and in thumbs of patients with depressive disorders.Moreover,the impairment in patients with depressive disorders may be related to the age of onset.

SchizophreniaDepressive disordersVibrotactile sense

庄芸月、朱嘉琪、邓虎、王春地、陈景旭

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承德医学院,河北 承德 067000

北京回龙观医院/北京大学回龙观临床医学院,北京 100096

北京航空航天大学人文社会科学学院,北京 100191

精神分裂症 抑郁障碍 振动触觉

2023年河北省研究生创新能力培养资助项目

CXZZSS2023140

2024

四川精神卫生
绵阳市精神卫生中心

四川精神卫生

CSTPCD
影响因子:0.565
ISSN:1007-3256
年,卷(期):2024.37(1)
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