目的：研究双相障碍抑郁发作（简称双相抑郁）患者决策风格与临床特征的相关性。
方法：采用病例对照研究,用墨尔本决策问卷（Melbourne Decision Making Questionnaire,MDMQ）评估决策风格,比较双相抑郁患者（n=30）与健康被试（n=30）MDMQ总分及因子分的差异,分析MDMQ各项评分与双相抑郁患者临床特征的相关性及MDMQ评分对双相抑郁患者与健康对照者的鉴别效能。
结果：双相抑郁组MDMQ总分以及过度警觉、拖延和推卸责任的因子分均高于健康对照组（p值分别<0.001、<0.05、<0.05、<0.05）;双相抑郁患者的MDMQ总分和因子分与汉密尔顿抑郁量表-24项（24-item Hamilton Depression Scale,HAMD-24）总分、汉密尔顿焦虑量表总分不相关;MDMQ总分和过度警觉因子分、推卸责任因子分与HAMD-24的认知障碍因子分正相关（依次为：r=0.437,p<0.05;r=0.470,p<0.05;r=0.421,p<0.05）;MDMQ拖延因子分还与HAMD-24的日夜变化因子分正相关（r=0.376,p<0.05）,与HAMD-24的睡眠障碍因子分负相关（r=-0.460,p<0.05）;受试者工作特征曲线分析显示最佳界值为5时,MDMQ拖延因子分对双相抑郁发作的曲线下面积为0.701。
结论：双相抑郁患者存在独特的决策风格,这可能是疾病的临床特质之一,并在疾病的诊断中发挥一定的作用。
Objective: To study the correlations between decision-making style and clinical characteristics in patients with bipolar depression (BD).
Methods: A case-control study was conducted with a sample of 30 patients with BD and 30 healthy subjects. The differences of decision-making styles between the participants of two groups were compared. Moreover, the correlations between decision-making styles and clinical characteristics of patients with BD were analyzed.
Results: The total score of Melbourne Decision Making Questionnaire (MDMQ) (p< 0.001) and the factor scores of hypervigilance, buck-passing and procrastination of patients with BD were higher than those of healthy controls (p<0.05). However, there were no significant correlations between the total score or the factor scores of MDMQ with HAMD-24 score and HAMA score in the participants. Total score of MDMQ (r=0.437, p< 0.05), hypervigilance (r= 0.470, p < 0.05) and buck-passing (r= 0.421, p < 0.05) in BD patients were significantly and positively correlated with cognitive dysfunction score of HAMD-24. In addition, procrastination (r=-0.376, p<0.05) was also positively correlated with atypical circadian rhythm score of HAMD-24, while negatively correlated with sleep disorder score (r=-0.460, p<0.05). Furthermore, ROC curve analysis suggested that, with a cutoff value of 4.50, the AUC of MDMQ factor score (procrastination) on BD was 0.701.
Conclusions: BD patients showed a unique decision-making style, and it might be one of the clinical characteristics of BD and might play a role in the diagnosis of the disease.
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