CAJ | 학술논문

目的探讨男性酒依赖(alcohol dependence,AD)患者认知能力的风险决策.方法将32例AD患者(患者组)与其人口学资料相匹配的正常对照(对照组)作为研究对象,采用爱荷华博弈任务(Iowa Gambling Task,IGT)进行决策能力的测试,分别应用焦虑自评量表(SAS)、抑郁自评量表(SDS)和简明智力量表(MMSE)对2组患者进行评定.结果患者组在IGT中净不利选牌数明显高于对照组[(1.38±18.01)次:(-6.34±12.10)次],2组比较差异有统计学意义[t(65)=2.074,P=0.042].采用2(组)×5(阶段)方差分析比较不同阶段的净不利选牌数结果显示,2组间的主效应显著[F(1,65) =5.357,P=0.024],不同阶段的主效应亦显著[F(4,260)=16.252,P＜0.001];但随着博弈任务卡片选择次数的增多,2组有利选择次数均逐渐增加.AD患者净不利选牌数与初次饮酒年龄及成瘾年龄呈负相关(r=-0.541,P=0.001；r=-0.350,P=0.050).结论男性酒依赖患者可能存在决策能力障碍.
목적 탐토남성주의뢰(alcohol dependence,AD)환자인지능력적풍험결책.방법 장32례AD환자(환자조)여기인구학자료상필배적정상대조(대조조)작위연구대상,채용애하화박혁임무(Iowa Gambling Task,IGT)진행결책능력적측시,분별응용초필자평량표(SAS)、억욱자평량표(SDS)화간명지역량표(MMSE)대2조환자진행평정.결과 환자조재IGT중정불리선패수명현고우대조조[(1.38±18.01)차:(-6.34±12.10)차],2조비교차이유통계학의의[t(65)=2.074,P=0.042].채용2(조)×5(계단)방차분석비교불동계단적정불리선패수결과현시,2조간적주효응현저[F(1,65) =5.357,P=0.024],불동계단적주효응역현저[F(4,260)=16.252,P＜0.001];단수착박혁임무잡편선택차수적증다,2조유리선택차수균축점증가.AD환자정불리선패수여초차음주년령급성은년령정부상관(r=-0.541,P=0.001；r=-0.350,P=0.050).결론 남성주의뢰환자가능존재결책능력장애.
Objective To investigate the characteristics of decision-making in male patients with alcohol dependence (AD).Methods A total of 32 male patients were compared with matched 32 normal controls on the Iowa Gambling Task.Meanwhile,all of the subjects were evaluated with the Self-Rating Anxiety Scale (SAS),Self-Rating Depression Scale (SDS) and Mini-Mental State Examination (MMSE).Results The AD group selected more net disadvantageous cards (number of cards selected from the disadvantageous decks minus number of cards selected from advantageous decks) than normal controls [(1.38 ± 18.01)times vs.(-6.34 ± 12.10) times; t(65) =2.074,P =0.042].The 2(group) ×5(block)ANOVA (analysis of variance) on the cards of net disadvantageous from the gambling task revealed a significant main group effect [F(1,65) =5.357,P =0.024],and a significant main effect of block [F(4,260) =16.252,P ＜ 0.001].The results showed that normal controls and patients with alcohol dependence gradually shifted their selections toward the good decks as the game progresses.The total number of net disadvantageous cards in AD subjects was negatively correlated to the age of initial alcohol use and the age of addiction (r =-0.541,P =0.001 ;r =-0.350,P =0.050;respectively).Conclusion The present study suggests that the decision-making impairment might be in male alcohol dependence patients.