Lack of insight may predict impaired decision making in manic patients
Lack of insight may predict impaired decision making in manic patients
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DOI：
10.1111/j.1399-5618.2008.00618.x
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发表时间：
2008-11-01
影响因子：
5.4
通讯作者：
Goodwin, Guy M.
中科院分区：
文献类型：
--
作者：
Adida, Marc;Clark, Luke;Goodwin, Guy M.
目标：从事危险行为的倾向是双相情感障碍躁狂发作的核心特征。本研究的目的是建立这种特性是否可以量化的决策[爱荷华州赌博任务（IGT）]的实验室措施，并确定临床相关的IGT表现在mania.Methods：急性躁狂症住院患者（n = 45）和健康志愿者（n = 45）进行了评估的IGT。采用Young躁狂量表和汉密尔顿抑郁量表评定患者的情感障碍，并对项目得分进行因素分析。多变量回归被用来评估临床预测受损的决策在躁狂patients.Results：IGT，躁狂患者选择更多的卡从风险的甲板比健康对照组，并表现出很少的能力，从发生的损失。在多变量分析中，躁狂症患者的决策能力受损显着预测的症状因素与缺乏insight.Conclusions：躁狂症患者明确显示决策缺陷，这是强烈相关的缺乏洞察力。支持有效决策的神经回路，包括腹内侧前额叶皮层和躯体感觉皮层，可能与急性躁狂症的病理生理有关。
Objectives: The tendency to engage in risky behaviours is a core feature of the manic episodes of bipolar disorder. The aim of this study was to establish whether this characteristic can be quantified with a laboratory measure of decision making [the Iowa Gambling Task (IGT)] and to determine clinical correlates of the IGT performance in mania.Methods: Inpatients with acute mania (n = 45) and healthy volunteers (n = 45) were assessed on the IGT. Affective symptomatology was assessed with the Young Mania Rating Scale and Hamilton Depression Rating Scale, and item scores were subjected to factor analysis. Multivariate regression was used to assess clinical predictors of impaired decision making in the manic patients.Results: On the IGT, manic patients selected more cards from the risky decks than healthy controls, and showed little capacity to learn from incurred losses. In a multivariate analysis, impaired decision making ability in the manic patients was significantly predicted by a symptom factor associated with lack of insight.Conclusions: Manic patients clearly show defects in decision making, which are strongly related to their lack of insight. Neural circuitry supporting effective decision making, including the ventromedial prefrontal cortex and somatosensory cortex, may be implicated in the pathophysiology of acute mania.