| Background and objective Alcohol dependence syndrome is a common chronic recurrent disease.The main clinical symptoms are the body’s strong physical and psychological dependence on alcohol,resulting in a group of cognitive,behavioral and physical symptoms,with a high recurrence rate and high recovery.Drinking rate seriously affects the physical and mental health of patients,causing patients and their families to worry and doubt about the patient’s re-drinking,and lose confidence in the treatment of alcohol dependence.The high recurrence rate is a major challenge in the clinical treatment of alcohol dependence,so preventing recurrence is very important.Alcohol dependence patients often have emotional disorders,and emotional symptoms are composed of a variety of different symptoms,including anhedonia,and alcohol dependence syndrome patients with emotional symptoms have a significantly higher re-drinking rate than other patients.But emotional symptoms are not the same as anhedonia.Anhedonia refers to a lack of response to pleasure stimuli or a decrease in the ability to feel pleasure.Past studies have mostly focused on a decrease in the ability to experience happiness.However,in recent years,more and more evidence has shown that Impaired reward functions such as expectation,motivation,and decision-making may be the core of the symptom,and these unique symptoms may affect the outcome of treatment.This study explored the anhedonia symptoms of patients with alcohol dependence syndrome and the correlation between anhedonia symptoms and reward decision-making,and found out the impairment of reward decision-making in patients with alcohol dependence syndrome during the withdrawal period.And through the follow-up of patients for half a year after treatment,to explore the predictive effect of anhedonia and other related risk factors on the high re-drinking rate and high recurrence rate of alcohol dependence syndrome.Method A total of 68 patients were enrolled in the Substance Dependence Department of the Fourth People’s Hospital of Hefei in this study,and patients with alcohol dependence syndrome were diagnosed as the alcohol dependence syndrome group;At the same time,62 healthy subjects were recruited as the normal control group;During the patient’s withdrawal period,let the patient complete the general demographic data and the Snaith-Hamilton Pleasure Scale(SHAPS),Temporal Pleasure Experience Scale(TEPS),Michigan Alcohol Dependence Questionnaire(MAST)and smoker nicotine Rely on the test scale(FTND),and then use the application software(E-Prime2.0)to complete the DDT-Delay Discount Task.The system records the patient’s reaction time and selection status under different immediate rewards and different delay times.The patient’s delayed discount rate is calculated by formula;normal subjects also complete the corresponding test.Telephone follow-ups were conducted 6 months after the end of treatment to understand the patient’s re-drinking status.Results1)General information survey form There was no significant difference in age,working years,education years,etc.between the alcohol dependence syndrome group and the normal control group(P>0.05),and the results were comparable;2)The comparison of the scores of the alcohol dependence syndrome group and the normal control group,the comparison of Ln K and reaction time RT in the DDT paradigm,both use independent sample t test.The alcohol dependence syndrome group is comparable to the normal control group.Compared with the SHAPS scale score,the expected anhedonia and the Ln K delayed discount rate,the results are statistically significant(P<0.05),but there is no statistical significance in the consumption anhedonia and reaction time RT(P>0.05);3)Comparison of anhedonia symptoms and delayed discount rate in alcohol dependence syndrome group,using Spearman correlation analysis,there was a significant positive correlation between the SHAPS scale score and the delayed discount rate(P<0.05);the expected anhedonia was significantly negatively correlated with the delayed discount rate(P<0.05),and the comparison between the lack of consumer pleasure and the delayed discount rate showed no statistical significance(P>0.05);4)Regarding whether patients with alcohol dependence syndrome are re-drinking,first use one-way analysis of variance to find factors related to alcohol re-drinking,and then incorporate these factors into the binary logistic regression model for further analysis.The results show that anhedonia and nicotine dependence are the predictors Factors,the results are statistically significant(P<0.05).Conclusion Patients with alcohol dependence syndrome have obvious anhedonia,which is specifically manifested as a lack of anticipatory anhedonia,and only the lack of anticipatory anhedonia is related to the decision-making of reward processing,leading to obvious "short-sighted" behaviors in patients.High nicotine dependence and anhedonia symptoms caused by withdrawal stress will greatly increase the risk of relapse after treatment. |
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