双相情感障碍疼痛共情能力研究

摘要

目的 研究双相情感障碍(bipolar disorder,BD)患者的疼痛共情能力特征.方法 纳入32例BD患者(其中抑郁相16例、躁狂相8例、缓解期8例),以及与患者年龄、性别、教育年限相匹配的32名正常对照.采用疼痛共情范式评估两组疼痛共情能力,即判断疼痛和中性图片中人物是否疼痛,并进行疼痛等级评定,以判断任务正确率、反应时和疼痛评级得分作为疼痛共情指标.采用中文版人际反应指针量表(Chinese version of interpersonal reactivity index,IRI-C)评估两组共情能力.结果 患者组判断疼痛图片的正确率低于对照组[(0.74±0.16) vs. (0.83±0.10)],差异有统计学意义(P<0.05);判断中性图片的正确率组间差异无统计学意义(P>0.05).患者组判断疼痛[(903.84 ± 167.49)ms vs.(765.06 ± 108.21)ms]和中性[(880.44 ± 190.36)ms vs.(750.31 ± 103.15)ms]图片的反应时大于对照组,差异有统计学意义(P<0.05).患者组在IRI-C的观点采择[(9.20±5.43) vs. (12.43±4.13)]、想象力[(11.85±4.57) vs. (15.50±5.56)]及共情性关心[(14.59±5.35) vs. (17.63±3.37)]因子得分均小于对照组,差异有统计学意义(P<0.05).患者判断疼痛图片的正确率和IRI-C想象力因子得分呈正相关(r=0.37,P=0.04),反应时与病程呈正相关(r=0.64,P<0.01).结论 BD患者的疼痛共情能力降低.%Objective To investigate the capability of empathy for pain in bipolar disorder (BD). Methods Thirty-two patients with BD (16, 8 and 8 in depressed, manic and remitted phases, respectively) and 32 healthy controls matched for age, gender and education were recruited. Empathy for pain paradigm were used. Subjects were required to judge whether the person in the picture felt painful and rate pain degree regarding to painful and neutral pictures. Accuracy, reaction time and ratings of pain degree were used as indicators of empathy for pain. Chinese version of Interpersonal Reactivity Index (IRI-C) were used to measure empathy. Results Compared to controls, accuracy of painful pictures was significantly lower in patients [(0.74±0.16) vs.(0.83±0.10), P<0.05]. Reaction time for both painful [(903.84±167.49) ms vs. (765.06±108.21) ms] and neutral [(880.44 ± 190.36) ms vs. (750.31 ± 103.15)ms] pictures were significantly longer in patients (P<0.05). Pa?tients showed lower scores in factors of perspective taking [(9.20±5.43) vs. (12.43±4.13)], fantasy [(11.85±4.57) vs. (15.50± 5.56)] and empathy concern [(14.59±5.35) vs. (17.63±3.37)] in IRI-C (P<0.05). Accuracy of painful pictures was positively correlated with scores in fantasy (r=0.37, P=0.04) and reaction time was positively correlated with duration of disease in pa?tients (r=0.64, P<0.01). Conclusion Bipolar disorder has deficit in the capability of empathy for pain.