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未服药神经性贪食症患者反应抑制功能的研究

摘要: 目的·探究未服药神经性贪食症(bulimia nervosa, BN)患者反应抑制功能的改变,及其与进食障碍症状和自评冲动性之间的关联。方法·选择2018年8月—2019年6月来自上海交通大学医学院附属精神卫生中心心理咨询门诊的35名未服药BN患者和招募的23名健康对照者(healthy controls,HC)作为研究对象,分别使用中文版进食障碍检查自评问卷6.0(Eating Disorder Examination Questionnaire 6.0,EDE-Q 6.0)、巴瑞特冲动量表(Barrett Impulsiveness Scale-11,BIS-11)比较2组对象的进食障碍症状及冲动性;使用信号停止任务(stop signal task,SST)评估反应抑制能力。对2组对象的量表评分及SST结果进行比较,并研究停止信号反应时间(stop signal reaction time,SSRT)与BIS-11评分、EDE-Q 6.0评分、起病年龄和病程之间的相关性。结果·在SST中,与HC组相比BN组SSRT更长(P=0.003)。BN组BIS-11总分(P=0.004)、注意冲动分量表评分(P=0.008)和无计划冲动分量表评分(P=0.002)均高于HC组。在BN组SSRT与起病年龄呈正相关(r=0.503,P=0.006),与EDE-Q 6.0体质量顾虑分量表评分呈负相关(r=-0.337,P=0.048),与BIS-11评分及病程无相关性。结论·未服药BN患者冲动性过高,其反应抑制缺陷与起病年龄和体质量顾虑相关。

关键词: 神经性贪食症, 反应抑制, 信号停止任务, 抑制控制, 进食障碍

Abstract:

Objective · To investigate the change of response inhibition function in patients with drug-naive bulimia nervosa (BN) and its relationship with eating disorders and self-reporting impulsiveness. Methods · Thirty-five drug-naive BN patients who accepted psychological counseling in Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine between Aug. 2018 and Jun. 2019, and 23 healthy controls (HC) were recruited. The eating disorder and impulsiveness were compared between the two groups by using the Chinese version of Eating Disorder Examination Questionnaire 6.0 (EDE-Q 6.0) and Barrett Impulsiveness Scale-11 (BIS-11), respectively. The stop signal task (SST) was used to assess response inhibition function. The scale scores and SST results were compared between the two groups, and the correlation of stop signal reaction time (SSRT) with BIS-11 score, EDE-Q 6.0 score, the age of onset and the duration of illness was analyzed. Results · Compared with the HC group, the BN group demonstrated significantly longer SSRT in the SST (P=0.003), and had a higher total score of BIS-11 (P=0.004), attentional impulsiveness score (P=0.008) and non-planning impulsiveness score (P=0.002). SSRT was positively associated with the age of onset (r=0.503,P=0.006), negatively associated with the score of weight concern subscale (r=-0.337, P=0.048), and not correlated with the BIS-11 score and the duration of illness in drug-naive BN patients. Conclusion · Drug-naive BN patients have high impulsiveness, and their defects in response inhibition are associated with the age of onset and weight concern.

Key words: bulimia nervosa (BN), response inhibition, stop signal task (SST), inhibitory control, eating disorder

中图分类号: 

R749.92

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