【作者】 王会；

【导师】 苏中华；

【作者基本信息】 山东大学 ， 内科学， 2011， 硕士

【摘要】 目的：探讨冰毒所致精神障碍患者的认知功能损害特征、冲动攻击性人格特点,以及抗精神病药物治疗后的转归情况。方法：采用病例对照研究设计。选择在山东省安康医院戒毒所接受戒毒治疗的100例自愿戒毒者(男性90例,女性10例),在入院第一周(±3天)和第四周末(±3天)采用注意网络测验(ANT)、心理旋转测验、爱荷华博弈测验(IGT)、WCST和N-back测验评估受试者的认知功能,采用Barratt冲动人格量表和Buss攻击性人格量表评估受试者冲动攻击性人格特点,并根据性别、年龄(±3)匹配的原则在工厂、酒店等工作的人员中便利选择100例正常对照。所有数据输入采用SPSS 12.0统计软件进行统计分析,P<0.05为差异有统计学意义。结果：1、认知功能结果：注意网络功能：(1)与对照组相比,冰毒所致精神障碍患者第一次ANT的平均反应时明显延长,正确率、定向作用和执行控制功能明显下降(如：平均反应时867.37±272.24ms/668.56±136.20ms;正确率0.88±0.06/0.88±0.06；定向作用-217.86±198.0 ms/-59.67±85.07ms;执行控制功能184.74±66.61ms/74.71±50.77ms),而警觉网络功能则明显提高(如：151.17±198.27ms/50.60±67.47ms),差异有统计学意义(P<0.05)；(2)与第一次ANT成绩相比冰毒所致精神障碍患者的第二次ANT成绩的平均反应时明显缩短,正确率、定向作用和执行控制功能明显提高(如：平均反应时867.37±272.24ms/650.52±136.69ms;正确率0.88±0.06/0.99±0.01定向作用-217.86±198.0ms/-67.56±77.20ms；执行控制功能184.74±66.61ms/61.19±56.93ms)而警觉网络功能则明显下降(如：151.17±198.27ms/34.11±74.20ms),差异有统计学意义(P<0.05)；(3)第二次ANT成绩与对照组,差异无统计学意义(P>0.05)。行为选择：(1)与对照组相比,冰毒所致精神障碍患者前后两次爱荷华博弈测验有利选择与不利选择的差值明显高于对照组,第一次赢钱数少于对照组,输钱数多于对照组,差异有统计学意义(P<0.05)；(2)第二次爱荷华博弈测验与第一次相比差别无统计学意义(P>0.05)。(3)第二次爱荷华博弈测验结果与对照组相比,差异无统计学意义(P>0.05)。执行功能：(1)冰毒所致精神障碍患者第一次WCST成绩均差与对照组,差异有统计学意义(P<0.01)；(2)第二次与第一次WCST成绩相比,成绩均好于第一次,差异有统计学意义(P<0.01)；(3)第二次WCST成绩与对照组相比差异无统计学意义(P>0.05)。心理旋转功能：(1)冰毒所致精神障碍患者第一次心理旋转测验成绩均差与对照组,差异有统计学意义(P<0.01)；(2)第二次与第一次心理旋转成绩相比,第二次心理旋转成绩均好于对照组,差异有统计学意义(P<0.01)；(3)第二次心理旋转测验成绩与对照组相比差异无统计学意义(P>0.05)；(4)与对照组一样,冰毒所致精神障碍患者在心理旋转测验中旋转角度为0°时,反应时最短,旋转角度为180°时,反应时最长。工作记忆：(1)冰毒所致精神障碍患者第一次N-back平均反应时长于对照组,正确率低于对照组,差异有统计学意义(P<0.05)；(2)冰毒所致精神障碍患者的第二次N-back成绩平均反应时短于第一次,正确率高于第一次,差异有统计学意义(P<0.05)；(3)第二次N-back成绩与对照组相比,差异无统计学意义(P>0.05)。2.冲动、攻击性人格结果：(1)冰毒所致精神障碍患者第一次BIS、BAS评分均高于对照组(P<0.01)；(2)第二次与第一次BIS、BAS评分相比,第二次评分成绩较第一组次下降,差异有统计学意义(P<0.01)；(3)第二次BIS、BAS评分成绩高于对照组差异有统计学意义(P<0.01)。结论：(1)冰毒所致精神障碍患者的注意网络功能、行为选择功能、执行功能、空间视觉功能、工作记忆存在缺陷,经抗精神病药物治疗后可于一月内恢复；(2)冰毒所致精神障碍患者有明显的冲动、攻击性行为；更多还原

【Abstract】 Objective:To investigate the characteristics of the cognitive impairment, impulsive and aggressive personality in the inpatients with mental disorders due to use of amphetamine,and explore the outcomes after the antipsychotic treatment lasted one month.Methods:Adopt case control study.The patients of the Amphetamine-induced psychiatric disorders group were selected randomly from Shandong Ankang Hospital during the period of the drug addicts undergoing treatment.A total of 100 patients were enrolled in the study.90 cases were male,10 cases were female.The cognition function of all patients were assessed with Attentional Network Test (ANT),Mental Rotation,Iowa Gambling Task,Wisconsin Card Sorting Test,N-back test in the first week (±3 days) and the fourth week (±3 days);The impulsive aggressive personality of all patients were assessed with Barratt Impulsivity Scale and Barratt Aggressive Scale.All data was analyzed by the statistic software of SPSS 12.0, and p<0.05 was considered to be the statistical significance.Result:The Result of Cognition Function:(1)Attentional Network Function: Compared with the control group,the first ANT’s response time was significantly increased,the correct rate,orienting and executive control network of Amphetamine-induced psychiatric disorders were significantly reduced ((eg:response time 867.37±272.24ms/668.56±136.20ms,correct rate 0.88±0.06/0.88±0.06, orienting-217.86±198.00ms/59.67±85.07 ms and executive control network 184.74±66.61ms/74.71±50.77 ms,P<0.05),but the alerting network was higher (eg:151.17±198.27ms/50.60±67.47ms).In the second ANT results,there was no significant difference between two groups.Compared with the first ANT results,the second ANT has higher scores in response time,the correct rate,orienting and executive control network (eg:response time 867.37±272.24ms/650.52±136.69ms,correct rate 0.88±0.06/0.99±0.01,orienting-217.86±198.00 ms/-67.56±77.20 ms,P<0.05) and executive control network,but the alerting network was lower (eg:alerting network 51.17±198.27ms/34.11±74.20ms, P >0.05).(2) Decision Making Function:Compared with the control group,Patients with Amphetamine-induced psychiatric disorders were trent to choose cards from the disadvantageous in the first Iowa Gambling Task test, there was significant difference between two groups (P<0.05).The Amphetamine-induced psychiatric disorders group were trent to choose cards from the disadvantageous in the second Iowa Gambling Task test, there was significant difference between two groups (P<0.05).The second Iowa Gambling Task test were better than the first Iowa Gambling Task test performance,there was significant difference between two groups (P<0.05). (3) Executive Function:Compared with the control group,Patients with Amphetamine-induced psychiatric disorders has poorer results in WCST(P<0.01), In the second WCST results,there was no significant difference between two groups (P>0.05).The second WCST were better than the first WCST performance (P<0.01).(4) Mental Rotation Function:Compared with the control group,Patients with Amphetamine-induced psychiatric disorders has poorer results in Mental Rotation,there was significant difference between two groups (P<0.01), In the second Mental Rotation results,there was no significant difference between two groups (P>0.05).The second Mental Rotation were better than the first Mental Rotation performance,there was significant difference between two groups (P<0.01).The same to control group Amphetamine-induced psychiatric disorders had longest reaction time in rotation angle of 180 degrees but had shortest reaction time in rotation angle of 0 degrees. (5) N-back Test:Compared with the control group,the first N-back Test’s response time was higher,but the correct rate was lower (P<0.01);but the second N-back Test’s has no significant difference between two groups.Compared with the first N-back Test’s results,the second N-back Test’s has shorter time,higher correct rate (P<0.01).The Result of Impulsive Aggressive Personality:Compared with the control group,patients with Amphetamine-induced psychiatric disorders has high scores in the first Barratt Impulsivity Scale and Buss Aggressive Scale (P<0.05).In the second results of Barratt Impulsivity Scale and Buss Aggressive Scale,there was significant difference between two groups (P<0.01).The first has higher scords than the second, there was significant difference between two groups (P<0.01)Conclusion:These results suggest that Amphetamine-induced psychiatric disorders has impairment in cognitive function, these could be recovered within one month by antipsychotic treatment. Amphetamine-induced psychiatric disorders has higher Impulsive Aggressive behavior.更多还原