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异常快感缺失作为强迫症的一种潜在内表型

Abnormal Anhedonia as a Potential Endophenotype in Obsessive-Compulsive Disorder.

作者信息

Xu Chuanyong, Chen Jierong, Cui Zitian, Wen Rongzhen, Han Hongying, Jin Lili, Wan Guobin, Wei Zhen, Peng Ziwen

机构信息

Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China.

Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People's Republic of China.

出版信息

Neuropsychiatr Dis Treat. 2020 Dec 8;16:3001-3010. doi: 10.2147/NDT.S268148. eCollection 2020.

Abstract

BACKGROUND

Obsessive-compulsive disorder (OCD) is often accompanied by cognitive, particularly executive function, impairments. Recently, anhedonia has emerged as an apparently important symptom of OCD reflecting altered emotion regulation. These two aspects are often comorbid in OCD. However, little is known about whether anhedonia may be a trait marker for OCD.

METHODS

To verify the role of executive function and evaluate the role of anhedonia in OCD and its relationship with OCD symptoms, we recruited 60 OCD patients, 30 unaffected first-degree relatives (FDRs), and 60 healthy controls (HCs). Participants completed psychometric testing to assess depression, anxiety, and anhedonia symptoms, as well as two cognitive tests to assess executive function, namely the Wisconsin Card Sorting Test (WCST) and the Stroop Color-Word Test (SCWT).

RESULTS

Compared to HCs, OCD patients and FDRs had significantly lower anticipatory and consummatory pleasure scores. The severity of anticipatory anhedonia correlated positively with obsessive-compulsive symptoms ( = 0.253, = 0.009), even after controlling for depression and anxiety symptoms. Compared to HCs, OCD patients and FDRs made more errors and achieved fewer categories in the WCST. For all three SWCT components, OCD patients and FDRs took more time to name colors than HCs, but the three groups had similar numbers of errors.

CONCLUSION

This family-based study showed dampened pleasure together with cognitive dysfunction in OCD patients. The similar consummatory pleasure findings between OCD and FDR groups suggest anhedonia may be considered as a candidate OCD endophenotype.

摘要

背景

强迫症(OCD)常伴有认知功能损害,尤其是执行功能。最近,快感缺乏已成为强迫症的一个明显重要症状,反映了情绪调节的改变。这两个方面在强迫症中常合并出现。然而,对于快感缺乏是否可能是强迫症的一种特质标记知之甚少。

方法

为了验证执行功能的作用,并评估快感缺乏在强迫症中的作用及其与强迫症症状的关系,我们招募了60名强迫症患者、30名未受影响的一级亲属(FDRs)和60名健康对照者(HCs)。参与者完成了心理测量测试,以评估抑郁、焦虑和快感缺乏症状,以及两项认知测试以评估执行功能,即威斯康星卡片分类测试(WCST)和斯特鲁普颜色-文字测试(SCWT)。

结果

与HCs相比,强迫症患者和FDRs的预期性和满足性愉悦得分显著更低。即使在控制了抑郁和焦虑症状后,预期性快感缺乏的严重程度与强迫症状呈正相关(r = 0.253,p = 0.009)。与HCs相比,强迫症患者和FDRs在WCST中犯的错误更多,完成的类别更少。对于所有三个SWCT组件,强迫症患者和FDRs命名颜色的时间比HCs更长,但三组的错误数量相似。

结论

这项基于家族的研究表明,强迫症患者存在愉悦感降低和认知功能障碍。强迫症组和FDR组在满足性愉悦方面的相似结果表明,快感缺乏可能被视为强迫症的一种候选内表型。

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