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研究生:許民憲
研究生(外文):Min-hsien Hsu
論文名稱:第一型與第二型雙極症患者的語言記憶與執行功能表現差異
論文名稱(外文):The different performances on verbal memory and executive functions in patients with Bipolar I and Bipolar II Disorder
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
論文出版年:2008
畢業學年度:96
語文別:中文
論文頁數:49
中文關鍵詞:雙極症執行功能語言記憶第二型雙極症第一型雙極症
外文關鍵詞:bipolar disordersbipolar I disorderbipolar II disorderverbal memoryexecutive functions
相關次數:
  • 被引用被引用:1
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  • 下載下載:53
  • 收藏至我的研究室書目清單書目收藏:1
研究背景:
  雙極症造成個人痛苦、家屬和社會福利制度的沈重負擔,如何協助患者減少病後適應困難是目前實務上的重要議題。近年來已有研究指出雙極症在心理社會與職業方面的失能與神經心理功能受損有關,這樣的結果指出,若能透過神經心理功能的復健介入,對改善雙極症患者的病後適應可能有所幫助。
  第一型與第二型雙極症患者具備許多不同臨床表現和病理特徵,應視為不同疾病,治療上亦應有所區分,然而大多數的雙極症神經心理研究主要是以第一型雙極症患者為受試對象,第一型與第二型雙極症患者間的神經心理功能表現差異尚未被充份了解,實務工作者沒有足夠文獻可作為此兩亞型在治療或復健計劃上的參考,因此本研究認為有必要對第一型與第二型雙極症患者的神經心理功能進行比較。
研究方法:
  本研究採「病例對照研究設計」。受試者來源為國立成功大學附設醫院精神科門診及住院中的第一型與第二型雙極症患者,年齡在18至65 歲之間,在取得受試者同意後,受試者先經精神科專科醫師晤談、由訓練良好的臨床人員以中文化終生精神疾病之診斷晤談版(Schedule for Affective and Schizophrenia- Lifetime Chinese Version, SADS-L)確定診斷。追蹤確定受試者情緒狀態達穩定時,開始評估受試者的神經心理功能表現。
結果:
  受試者總人數為63人,第一型雙極症患者30人,第二型雙極症患者33人。第一型雙極症患者在Wisconsin Card Sorting Test「完成分類量」與邏輯記憶II的「再認分數」表現顯著較第二型雙極症患者差。
討論:
第一型雙極症患者的語言記憶編碼效率較第二型雙極症患者差且較快遺忘,在抽象推理、形成策略或計劃等方面能力較第二型雙極症患者差,臨床工作者在進行治療或擬定復健計劃時,應將這些差異納入考量。
Background:
Previous studies found that psychosocial and occupational dysfunctions during the remission period among patients with Bipolar Disorder (BP) were associated with neuropsychological impairments, especially pertaining to executive function and verbal memory disabilities. Clinically, Bipolar I Disorder (BP-I) and Bipolar II Disorder (BP-II) were the most severe and frequently observed subtypes. Due to their distinct pathological characteristics, rehabilitation and intervention programs should be designed accordingly on the basis of the subtypes’ neuropsychological weaknesses to achieve a better treatment outcome. Currently however, reference literatures were limited. Thus, the present study aimed to further examine the different neuropsychological functions in patients with BP-I and BP-II.
Method:
All subjects were recruited from National Cheng Kung University Hospital. The Schedule for Affective and Schizophrenia-Lifetime Chinese version (SADS-L) were assessed to confirm diagnoses. When the patients’ mood symptoms were stabilized neuropsychological tests were administered.
Results:
Sixty-three patients diagnosed with BP participated in this study. The results showed that BP-I patients performed significantly worse on the number of categories completed in the Wisconsin Card Sorting test and the recognition total score of Logical Memory II compared to patients with BP-II.
Conclusion:
Overall, our results indicated that BP-I patients had relatively poorer performances on verbal memory encoding and a greater tendency to forget faster than BP-II patients; in regards to abstractive reasoning, either strategy formulation or planning abilities were comparatively worse in BP-I patients. Thus, clinical practitioners should keep in mind the distinctive characteristics of the two BP subtypes when constructing treatment or rehabilitation programs.
目錄
第一章 緒論...........................1
第一節 雙極症研究的重要性....................1
第二節 雙極症患者的神經心理功能.................6
第三節 雙極症患者的神經心理功能與心理社會與職業功能損害的關連..8
第四節 第一型與第二型雙極症患者神經心理功能表現比較的研究近況..9
第五節 神經心理功能—語言記憶與執行功能.............11
第六節 研究目的與研究假設....................16
第二章 研究方法.........................17
第一節 研究設計.........................17
第二節 受試者..........................18
第三節 資料收集流程.......................19
第四節 研究工具.........................21
第五節 統計分析.........................27
第三章 研究結果.........................28
第一節 受試者特性........................28
第二節 基本人口學變項與情緒症狀嚴重度的比較...........29
第三節 神經心理測驗結果的比較..................30
第四章 討論...........................31
第一節 本研究主要發現......................31
第二節 兩組亞型的神經心理功能表現差異與意義...........32
第三節 研究結果對雙極症患者病後復健計劃的意義..........34
第四節 未來研究方向.......................35
第五節 研究限制.........................36
參考文獻.............................37

表目錄
表一、DSM-IV中躁症發作與輕躁發作的定義比較............ 45
表二、兩雙極症亞型在人口學變項與臨床變項上的比較.........46
表三、兩雙極症亞型在語言記憶、執行功能與心理運動速度的比較....47

附錄
附錄一 漢氏憂鬱量表.......................48
附錄二 楊氏躁症量表.......................49
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