Gu Yu-Ting, Zhou Chen, Yang Juan, Zhang Qin, Zhu Guo-Hui, Sun Lin, Ge Mao-Hong, Wang Yan-Yu
Department of Psychology, Weifang Medical University, Weifang, China.
Department of Psychiatry, Mental Health Centre of Weifang City, Weifang, China.
Psych J. 2020 Apr;9(2):199-209. doi: 10.1002/pchj.351. Epub 2020 Feb 19.
Deficit in decision-making has been found in patients with schizophrenia (SCZ), major depressive disorder (MDD), and bipolar disorder (BD), respectively, while the common and distinct characteristics of this deficit among these patients are still unclear. The present study aimed to make a transdiagnostic comparison of the affective decision-making ability in patients with SCZ, MDD, and BD. In this study, 33 patients with SCZ, 23 patients with MDD, 29 patients with BD, and 34 healthy controls (HCs) were recruited and the Iowa Gambling Task (IGT) was used to assess the affective decision-making ability. The results showed that all three diagnostic groups tended to select the disadvantageous decks but not advantageous decks compared to HCs. For patients with SCZ, an excessive preference for the disadvantageous decks with larger-magnitude less frequent punishments (deck B) may be the main reason of the deficit in affective decision-making, while that in patients with MDD was a significantly decreased ability to choose advantageous decks on the whole but with larger-magnitude less frequent punishments (deck D). As regards patients with BD, the concurrence of more choices of deck B and fewer choices of deck D was the characteristic of the deficit in affective decision-making. Our findings suggest a common affective decision-making impairment in the context of multiple choices in patients with SCZ, MDD, and BD, while the underlying mechanisms of the impairment among these patients may be slightly different.
研究发现，精神分裂症（SCZ）、重度抑郁症（MDD）和双相情感障碍（BD）患者分别存在决策缺陷，然而这些患者中这种缺陷的共同特征和独特特征仍不明确。本研究旨在对SCZ、MDD和BD患者的情感决策能力进行跨诊断比较。在本研究中，招募了33名SCZ患者、23名MDD患者、29名BD患者和34名健康对照者（HCs），并使用爱荷华赌博任务（IGT）来评估情感决策能力。结果显示，与HCs相比，所有三个诊断组都倾向于选择不利牌组而非有利牌组。对于SCZ患者，对惩罚频率较低但幅度较大的不利牌组（牌组B）的过度偏好可能是情感决策缺陷的主要原因，而MDD患者整体上选择有利牌组的能力显著下降，但惩罚频率较低且幅度较大（牌组D）。至于BD患者，情感决策缺陷的特征是牌组B的选择较多而牌组D的选择较少。我们的研究结果表明，SCZ、MDD和BD患者在多种选择情境下存在共同的情感决策损害，然而这些患者中损害的潜在机制可能略有不同。
