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研究生:林靜宜
研究生(外文):Ching-I Lin
論文名稱:第一型與第二型雙極症病患之人格特質與基因的相關探討
論文名稱(外文):Personality Dimensions and Genes in Bipolar I and Bipolar II Disorder Patients
指導教授:陸汝斌陸汝斌引用關係
指導教授(外文):Ru-Band Lu
學位類別:碩士
校院名稱:國立成功大學
系所名稱:行為醫學研究所
學門:社會及行為科學學門
學類:心理學類
論文種類:學術論文
畢業學年度:96
語文別:中文
論文頁數:66
中文關鍵詞:血清素轉運子基因多巴胺第三型接受器基因交互作用雙極症性格特質
外文關鍵詞:5-HTTDRD3bipolar disorderpersonality dimensionsinteraction
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研究背景:
研究指出第一型與第二型雙極症有不同的病因及病程,但也有學者質疑兩者是同一種疾病,只是嚴重程度不同。過去研究證實遺傳因子是雙極症重要病因,其中多巴胺第三型接受器基因(dopamine D3 receptor gene; DRD3)、血清素轉運子基因(serotonin transporter gene; 5-HTT)都是主要候選基因,另有學者從性格特質瞭解雙極症。

研究目的:
本研究目的是想瞭解性格特質(逃避傷害與尋求新奇)、兩候選基因之基因多型性 (DRD3 Ser9Gly和5-HTT gene-linked polymorphic region; 5-HTTLPR)與之間的交互作用是否能預測並區分第一型及第二型雙極症患者。

研究方法:
共收集47例第一型雙極症病患、61例第二型雙極症病患、與56名一般控制組。人格變項則使用自填式三向度人格量表的中文修訂版,並進行抽血及DNA萃取經過實驗室方法獲得DRD3 Ser9Gly 與 5-HTTLPR 的基因多型性資料。


研究結果:
以二元邏輯式回歸分析方法分析,在控制了性別與年齡後發現,逃避傷害(p=.006)與尋求新奇 * DRD3 Ser9Gly基因型(p =.045) 可預測並區分一般控制組與第一型雙極症患者。然而只有逃避傷害(p =.001)可預測並區分出一般控制組與第二型雙極症患者。且尋求新奇 * DRD3 Ser9Gly基因型(p =.016) 可預測並區分出第一型與第二型雙極症患者。

研究結論:
本研究發現 DRD3 Ser9Gly基因型調節了尋求新奇與第一型與第二型雙極症之間的關係,顯示性格與基因之交互作用在區分第一型與第二型雙極症有重要角色。
Background:
Previous literatures have documented that bipolar I (BP-I) and bipolar II (BP-II) disorders might have different etiology, phenomenology and characteristics in the course of the illness. The actual existence of BP-II disorder has been questioned in whether it was simply a milder form of BP-I or if it was a distinct disorder altogether. In reference to familial studies which provided genetic evidence for contribution to bipolar disorders and is also a heritable source in personality traits, we examined the Ser9Gly polymorphism of dopamine D3 receptor (DRD3) gene, the 5-HTT gene-linked polymorphic region (5-HTTLPR) genotypes, Novelty Seeking (NS) and Harm Avoidance (HA) personality traits to see if they contributed differently to BP-I and BP-II patients among Han Chinese in Taiwan.

Methods:
Forty-seven BP-I, 61 BP-II patients and 56 normal subjects were recruited. All participants were genotyped by the PCR method and assessed with Tridimensional Personality Questionnaire (TPQ).


Results:
We found significant main effects for HA (p=.006), NS and DRD3 Ser9Gly genotypes interacted significantly (p=.045) in predicting subjects as BP-I patients or normal subjects. However, only HA (p=.001) could significantly predict subjects as BP-II patients or normal subjects, suggesting the distinction between BP-I and BP-II. Binary regression analyses revealed that NS and DRD3 Ser9Gly genotypes interacted significantly (p=.016) in predicting patients as BP-I or BP-II patients.

Conclusions:
This study provided initial evidence that DRD3 Ser9Gly genotypes moderated the association between NS and bipolar disorders. These findings indicated that unique differences existed between BP-I and BPII in gene and personality variance interactions.
中文摘要 I
英文摘要 III
致謝 V
目錄 VI
表目錄 VIII
附錄 IX

第一章 研究背景1
第一節 雙極症研究的重要性1
第二節 雙極症與人格特質4
第三節 雙極症的分子遺傳研究8
第四節 過去研究缺失11
第五節 研究目的 13
第二章 研究方法 14
第一節 研究對象 14
第二節 研究工具 16
第三節 研究流程 22
第四節 統計分析 24

第三章 研究結果 25
第一節 人口學變項與臨床特性的資料分析 25
第二節 DRD3 Ser9Gly、5-HTTLPR基因之哈-溫平衡方程式(Hardy-Weinberg Equilibrium, HWE)檢驗 26
第三節 第一型雙極症、第二型雙極症、一般控制組在Cloninger三向度人格量表上的分數表現之比較 27
第四節 將5-HTTLPR與DRD3 Ser9Gly基因型分組後,第一型雙極症、第二型雙極症、一般控制組基因型分佈頻率之差異28
第五節 性格特質、兩候選基因之基因多型性、與之間的交互作用是否能預測並區分出第一型、第二型雙極症患者、一般控制組 29
第四章 討論 30
第一節 本研究之主要發現與解釋 30
第二節 本研究之限制 36
第三節 未來之方向 37

參考文獻 38

表一 三組受試者在人口學資料、臨床特性、性格向度與基因分佈頻率之比較 51
表二 以二元邏輯式回歸分析性格特質、兩候選基因之基因多型性、與之間的交互作用是否能預測並區分出第一型、第二型雙極症患者、一般控制組 52
附錄一 中文版三向度性格量表 53
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