Research On Risk Decision-making And Social Cognitive Function Characteristics Of Patients With Major Depression

ObjectiveTo investigate the characteristics of risk decision making function and social cognition in major depressive disorders?MDD?and its possible psychological mechanism.MethodsStudy 1:Forty-two depressed patients?depression group?aged 18-65 years who met the inclusion criteria were selected,and 65 healthy subjects matched in age,sex and education level were recruited as the control group.Depression group will conduct Hamilton Depression rating Scale?HAMD?after clinical evaluation.All the participants complete the intertemporal choice questionnaire,risk preference questionnaire,Watson selection tasks,conjunction fallacy task and Balloon analog risk task?BART?.Study 2:A total of 51 depressed patients aged 18-65 years who met the inclusion criteria were selected to a selective serotonin reuptake inhibitors treatment group?SSRIsTG,n=27?and tricyclic antidepressants treatment group?TCAsTG,n=24?.30healthy subjects matched in age,sex and education level were recruited as the control group.The Interpersonal Perception Task?IPT-15?and Emotion Intensity Recognition Task?EIRT?were measured at baseline and then after 4 and 12 weeks of treatment with TCAs or SSRIs.Results Study1:1.There was a significant difference in risk preference between the two groups aging from 35 to 49?t=2.302,P=0.032?,the control group?Z=-2.487,P=0.013?and the depression group?Z=-3.944,P=0.000?prefer gain situation.Gender had little effect on risk preference?P all>0.05?.2.The unexploded balloon blown the average number of?t=5.102,P=0.000?,number of blowing up the balloon?t=3.295,P=0.001?,when facing the positive feedback unexploded balloon blown average number?t=2.995,P=0.003?,when facing negative feedback unexploded balloon blown average number?t=2.995,P=0.003?of depression patients aging from 18 to 34 and 50 to 65 were significantly less than those in the control group.Depression patients aging from 35 to 49 have higher success rate than the control group?t=2.444,P=0.019?.Previous decision in the depression group did not affect the next decision?t=0.977,P=0.332?.The unexploded balloon blown the average number of?t=4.097,P=0.000?,the number of blowing up the balloon?t=3.420,P=0.001?,when facing the positive feedback unexploded balloon blown average number?t=2.740,P=0.007?of male depression patients aging from 18 to 34 were significantly higher than those of women.unexploded balloon blown when facing the positive feedback of unexploded balloon blown average number?t=2.506,P=0.021?of male depression aging 35 to 49 were significantly higher than those of women.There were statistically significant differences in decision-making in the male depression group aging from 18 to 34?t=2.617,P=0.015?and 35 to 49?t=4.162,P=0.002?in different feedback situations,while there were no statistically significant differences in female?P all>0.05?.3.There was a significant difference in intertemporal choice of subjects aging from18 to 34?Z=-2.441,P=0.015?and 35 to 49?Z=-2.054,P=0.040?.4.There was no significant linear relationship between BART scores and depression?P all>0.05?.5.The accuracy of Watson's task selection in the MDD group did not change significantly(c^?17?=0.476,P=0.490).6.Two groups show no significant difference in conjunction fallacy task 1(c^?17?=0.085,P=0.085)and task 2(c^?17?=0.995,P=0.995).Study 2:1.The total HAMD score of the subjects at different time points in the treatment showed significant difference?F=1208.133,P=0.000?,and there was no interaction between the groups at time point?F=2.926,P=0.063?.After 4 weeks of treatment,the subjects'total HAMD score decreased by 14.9 points from the baseline?P=0.000?,after 12 weeks of treatment,the total HAMD score decreased by 19.4 points from the baseline?P=0.000?,and after 12 weeks of treatment,the total HAMD score decreased by 4.4 points from the baseline?P=0.000?.However,there was no significant difference between the two experimental groups?F?1,49?=3033.904,P=0.000?.2.At the baseline,there were no significant differences in the total score of IPT-15and the scores of each factor in the SSRIs treatment group and TCAs treatment group?all P<0.05?,which were lower than those in the control group(F _{total score}=56.360,F _kinship=9.103,F _status=8.022,F _competition=25.328,F _intimacy=35.882,all P<0.05).At 4weeks after treatment,there was no significant change in IPT-15 scores in SSRIs treatment group and TCAs treatment group?P>0.05?.After 12 weeks of treatment,the IPT-15 scores of SSRIs treatment group were mostly improved(P _{total score},P _status,P _competition,P _intimacy<0.05),while the TCAs treatment group showed no significant changes?all P>0.05?.3.At baseline,scores of happiness,anger,surprise and disgust are significantly different between SSRIs treatment group,the TCAs treatment group and control group(F?2,78?_happiness=9.404,F?2,78?_anger=4.817,F?2,78?_surprise=7.638,F?2,78?_disgust=4.036,P<0.05),the difference of sadness and fear scores was not significant?P>0.05?.Each score of TCAs treatment group and SSRIs treatment group has no significance?P>0.05?.Four weeks after treatment,there was no significant change in EIRT scores in SSRIs treatment group and TCAs treatment group?P>0.05?.After 12-week treatment,EIRT scores in SSRIs treatment group improved significantly(P _anger=0.020,P _disgust=0.023),while TCAs treatment group did not?all P>0.05?.Conclusions1.Risk preference of patients with Major depressive disorder?MDD?has not changed significantly,and there is no significant difference in individual risk preference between different genders.Individuals are more inclined to seek for risks in the benefit situation than in the loss situation.2.Patients with depression tend to make conservative risk decisions,and their reward learning ability is weakened.Early adulthood was more risky and middle to late adulthood was relevantly stable.The degree of impairment in risk decision making was not associated with the severity of depression.3.The reasoning ability of patients with MDD showed no significant abnormalities.4.Both SSRIs and TCAs can improve the symptoms of depression.SSRIs can improve social cognitive function of depressed patients to some extent.5.Patients with MDD have both impaired risky decision making and social cognitive function.The impairment of two functions may be related to their potential neuropsychological interactions.