CN109346178A - Schizoid model is diagnosed based on cognitive function - Google Patents
Schizoid model is diagnosed based on cognitive function Download PDFInfo
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- CN109346178A CN109346178A CN201811260313.5A CN201811260313A CN109346178A CN 109346178 A CN109346178 A CN 109346178A CN 201811260313 A CN201811260313 A CN 201811260313A CN 109346178 A CN109346178 A CN 109346178A
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- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
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Abstract
The invention discloses one kind to diagnose schizoid model based on cognitive function, which is the Combining diagnosis model bringing Multivariate logistic regression analysis into according to the cognition index of the subject of measurement and then establishing.The schizoid susceptibility of Model Diagnosis of the present invention is up to 90% or more, and specificity is up to 80% or more, therefore model of the invention can be used for clinic efficiently to diagnose schizophrenia.
Description
Technical field
The invention belongs to area of medical diagnostics, are related to a kind of schizoid diagnostic model, and in particular to based on cognition
The schizoid model of functional diagnosis.
Background technique
Schizophrenia (schizophrenia) is currently a kind of phrenoblabia that pathogenic factors is not complete.The disease mostly occurs
In adolescence, this four aspect performances such as sensory perception, thinking aspect, emotion and act of will when being mainly reflected in morbidity
Phrenoblabia out, the cerebration for existing simultaneously inner experience and ambient enviroment and patient are not in tune.Patient shows to anticipate
When knowing awake, no intelligence damage complete to the directive force of time, place, personage lacks the state of an illness judgement to oneself, nothing
The demand actively sought medical advice, social function also receive certain damage, and the state of an illness is in delay more.China schizophreniac exists
The ratio of Inpatients in Psychiatric Hospital is up to 50% or so, and schizophreniac accounts for 60% or so in chronic patient.When
Modern social economy is fast-developing, and the pressure and challenge that people are subject to also are continuously increased, and spirit and the psychology for seriously affecting people are strong
Health.The disease incidence presentation of mental disease gradually increases trend, and schizophrenia is right as one of one of the most common type mental disease
The harm of society is also relatively large.And schizoid prognosis mala, majority are not cured all the life, cause to grow with society to family
The heavy burden of phase.
The reason of schizophrenia, is influenced by many factors.Inherent cause is its important risk factor, by next
From multiple family's pedigree follow-up investigations both domestic and external, it is found that illness rate of the schizophrenia in close relative is higher than general family.
In the genetic connection of the patient, the closer relatives' disease incidence of relationship is higher, in close relative most with parent and Sibling's illness rate
It is high.In addition to inborn foreign genetic element, the patient for during real-life Psychological stimulation, pregnancy with the presence or absence of it is certain simultaneously
Hair disease, the influence of season alternation temperature change and influence of physical disease etc. are also known as always being that schizoid morbidity lures
Cause.The study of incident mechanism of the disease specifically includes that the 1. hyperfunction vacation of Dopamine there may be certain neural biochemical basis
It says, the severity of the positive symptom of patient and D2 secretion are how many related.2. glutamic acid biochemistry hypothesis, in terms of clinical trial,
Glutamate receptor antagonists and other nmda receptor antagonists can cause it is observed that obvious mental symptom, referred to as positive disease
Shape (various types of illusion and vain hope etc.) and negative symptoms (apathy and hypobulia etc.).3. dopamine system and paddy
Propylhomoserin system function imbalance hypothesis.Pass through the clinical observation long-term to some patients, it is believed that schizophrenic onset be due to
Under brain leveling caused by the imbalance of the neurotransmitter secretion of Dopamine system and glutamic acid function system.
Schizophrenia is a kind of mankind's complex disease, joint effect of the cause of disease by inherent cause and environmental factor.Essence
Refreshing Split disease has an extremely complex hereditary pattern, the research of the past oneself it is found that having more than 100 genetic fragments and spirit point
The generation for splitting disease is related.Numerous research datas show that schizophrenic onset is also more obvious by environmental factor, the factor by
Biological factor, psychosocial factor and trophic factor composition.
Schizoid diagnostic criteria: what is be affected in the world at present is the international disease that the World Health Organization formulates
General 10th revised edition (ICD-10) of disease classification and U.S.'s diagnosis use " Americanism obstacle diagnosis and statistic handbook " the 4th edition
It (DSM-IV) is diagnostic criteria.It is domestic more at present with ICD-10 diagnostic criteria.Schizophrenia includes multiple syndromes, is led to
It often requires to be implicitly present in the most of the time in one month or more period in syndrome and contains 1 Special Significance syndrome (two
A or multiple symptoms) or the very specific syndrome of at least two groups.Different types of schizophrenia, symptom required for diagnosing
It is different.According to the symptom of the pathogenic process of patient occurred, specific diagnosis is given.It can be seen that in current practice, spirit point
The diagnosis for splitting disease relies primarily on clinical symptomatology, lacks objective effective biological diagnosis index.Thus it is desirable that can look for
To diagnosis and screening early stage schizoid objective indicator and effective diagnostic model.
Summary of the invention
In order to overcome the drawbacks of the prior art, the purpose of the present invention is to provide one kind based on cognitive function diagnosis spirit point
Split the model of disease.
To achieve the goals above, present invention employs following technical solutions:
The present invention provides one kind for diagnosing schizoid cognition index, and the cognition index includes information processing
Speed pays attention to alertness, working memory, vocabulary learning, reasoning and Resolving probiems, MCCB total score.
The present invention also provides one kind to diagnose schizoid model, public affairs below the model use based on cognitive function
Formula calculates:
Logit (P)=- 0.339+ (- 1.144) * information processing rate+(- 1.832) * pays attention to alertness+(- 0.232) *
Working memory+(- 0.440) * vocabulary learning+(- 0.099) * reasoning and Resolving probiems+(0.015) * MCCB total score.
Parameter in above formula: information processing rate pays attention to alertness, working memory, vocabulary learning, reasoning and problem
It solves, the fraction representation to be obtained in MCCB.
The present invention also provides the construction methods of mentioned-above model, and described method includes following steps:
(1) the mentioned-above cognition index of subject is measured；
(2) mentioned-above model is constructed using Logistic homing method.
The present invention also provides a kind of schizoid methods of diagnosis, and described method includes following steps:
(1) the mentioned-above cognition index of subject is measured；
(2) Logit (P) is calculated according to mentioned-above model；
(3) if Logit (P) < 0.333, judge that the subject does not suffer from schizophrenia or judges that the subject suffers from
There is schizoid risk small, judges that the subject should with schizophrenia or judgement if Logit (P) >=0.333
Subject is big with schizoid risk.
The present invention also provides mentioned-above cognition indexs to construct the application in mentioned-above model.
The present invention also provides application of the mentioned-above cognition index in building schizophrenia diagnosis system.
The present invention also provides application of the mentioned-above model in building schizophrenia diagnosis system.
" diagnosing " both as described herein includes whether suffering from schizoid judgement to subject, also includes to subject
Judgement with schizoid risk size.
" MCCB " refers to cognition of schizophrenia battery of tests common recognition version as described herein.
The advantages of the present invention:
The present invention constructs one kind for the first time and diagnoses schizoid model based on cognitive function, which has higher examine
Disconnected sensibility, specificity, accuracy, can be applied to be clinically used for schizoid diagnosis.
Detailed description of the invention
Fig. 1 shows that model of the invention distinguishes the ROC curve of schizophreniac and Healthy People.
Specific embodiment
The present invention is described in detail with experiment with reference to embodiments.
1 schizophrenia of embodiment recognizes Indexs measure
1, research object
This research is included in go to a doctor and (containing outpatient service, is hospitalized and suffers from the first episode schizophrenia that hospital meets diagnostic criteria
Person), enter 43 patients of group altogether.
Inclusion criteria: 1. meeting ICD-10 schizophrenia diagnosis standard, and 2 cure mainly and above Psycs diagnosis
Unanimously；2. First episode, without systematic treating；Total score > 60 point Positive and Negative Symptoms 3. (PANSS)；4. journey of receiving an education
Spend >=6 years (graduating from primary school)；5. the age 22-28 years old；6. can complete independently quiz content, obtain I or family members or guardian,
Or legal representative book and informed consent form.
Exclusion criteria: 1. merge brain organic psychosis, emotionality squeezes other mentally disturbeds such as refreshing obstacle；2. suffering from tight
Weight physical disease or the disease that may interfere with assessment；3. having drug abuse or pharmacological dependence history person in past 1 year；4. making before selected
Used antipsychotics, antidepressants, curtain thread, which stablize medicine, resists insane carbuncle medicine and Benzodiazepine etc. may interfere with the medicine of assessment
Object；5. there is serious conamen person；6. gestation or breast feeding women；7. the sense of hearing, visually impaired person.
Healthy control group totally 51, it is all from local community volunteer, the age 18-35 years old, education level >=6 year were (small
Learn graduation), previously listless history of disease, can cooperate completion to test.
2, process
All patients and healthy control group complete the acquisition and neuro-cognitive assessment of general information, wherein starting spirit point
Disease group is split before carrying out neuropsychological test, the conformability that its mental symptom completes test to it is assessed, so as to guarantee it
It can complete a whole set of neuropsychological test.
3, neuro-cognitive is assessed
Cognitive appraisal tool used by this research is Chinese edition cognition of schizophrenia battery of tests common recognition version
(MCCB).US National mental hygiene research institute (NIMH) started in 2003 improve cognition of schizophrenia measurement with
The plan for the treatment of establishes the standardized cognition of schizophrenia battery of tests one by Consensus of experts and clinical trial
Common recognition version, reflects schizoid cognitive function from a variety of different dimensions comprehensively.MCCB includes 7 cognitive domains: at information
It manages speed, pay attention to alertness, working memory, vocabulary learning, visual learning, reasoning and Resolving probiems, social recognition.Wherein, believe
Ceasing processing speed includes digit-symbol test, classification tri- fluency test-animal naming, trail making test A subtests, pays attention to police
Feel property aspect uses ongoing operation test-pairing, in terms of working memory using Webster test of memory third edition spatial extent and
Alphanumeric sequence, vocabulary learning use Thelma Hopkins verbal learning test revised edition, and visual learning uses simple visual learning
Revised edition is test, reasoning and Resolving probiems are test using the labyrinth NAB, and social recognition is test using Emotional intelligence quotient management.
All cognitions, which check and examine score and are all made of the mode of computerization, to be carried out, to avoid human factor influence.Cognition is checked and examined
It is completed by two professional psychological assessments teacher, psychological assessment teacher is before being checked and examined by system, one-week consistency
Training.
4, model is constructed
It is normalized firstly, MCCB is recognized each variable, is converted into Z distribution, mean value 0, variance 1.It calculates
MCCB recognizes each variable effect value Cohen ' s d, and the variable of d >=0.8 is included in building model.Including information processing rate, pay attention to
Alertness, working memory, vocabulary learning, reasoning and Resolving probiems, MCCB total score.
It brings Multivariate logistic regression analysis into, establishes Combining diagnosis model, calculation formula are as follows:
Logit (P)=- 0.339+ (- 1.144) * information processing rate+(- 1.832) * pays attention to alertness+(- 0.232) *
Working memory+(- 0.440) * vocabulary learning+(- 0.099) * reasoning and Resolving probiems+(0.015) * MCCB total score.
It is analyzed through ROC curve, P value description value is 0.333, this model is good to schizoid diagnosis effect, specific to tie
Fruit is as shown in table 1 and Fig. 1.
1 diagnosis effect of table statistics
The explanation of above-described embodiment is only intended to understand method and its core concept of the invention.It should be pointed out that for this
For the those of ordinary skill in field, without departing from the principle of the present invention, several improvement can also be carried out to the present invention
And modification, these improvement and modification will also be fallen into the protection scope of the claims in the present invention.
Claims (7)
1. one kind is for diagnosing schizoid cognition index, which is characterized in that the cognition index includes information processing speed
Degree pays attention to alertness, working memory, vocabulary learning, reasoning and Resolving probiems, MCCB total score.
2. one kind diagnoses schizoid model based on cognitive function, which is characterized in that the model use following formula meter
It calculates:
Logit (P)=- 0.339+ (- 1.144) * information processing rate+(- 1.832) * pays attention to alertness+(- 0.232) * work
Memory+(- 0.440) * vocabulary learning+(- 0.099) * reasoning and Resolving probiems+(0.015) * MCCB total score.
3. the construction method of model as claimed in claim 2, which is characterized in that described method includes following steps:
(1) subject's cognition index described in claim 1 is measured；
(2) model as claimed in claim 2 is constructed using Logistic homing method.
4. cognition index described in claim 1 is constructing the application in model as claimed in claim 2.
5. application of the cognition index described in claim 1 in building schizophrenia diagnosis system.
6. application of the model as claimed in claim 2 in building schizophrenia diagnosis system.
7. a kind of schizoid method of diagnosis, described method includes following steps:
(1) subject's cognition index described in claim 1 is measured；
(2) model according to claim 2 calculates Logit (P)；
(3) if Logit (P) < 0.333, judge that the subject does not suffer from schizophrenia or judges the subject with essence
The risk of refreshing Split disease is small, and the subject is judged if Logit (P) >=0.333 with schizophrenia or judges that this is tested
Person is big with schizoid risk.
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Cited By (1)
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| CN112992364A (en) * | 2021-02-07 | 2021-06-18 | 广州医科大学附属脑科医院 | Cognition-based universal first schizophrenia diagnosis model for teenagers and adults, construction method and diagnosis system |
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| US20040167380A1 (en) * | 2003-02-24 | 2004-08-26 | Ely Simon | Standardized medical cognitive assessment tool |
| CN104239697A (en) * | 2014-08-29 | 2014-12-24 | 北京大学第六医院 | Matrics (Measurement and Treatment Research to Improve Cognition In Schizophrenia) consensus cognitive test battery PAD system construction method |
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| CN112992364A (en) * | 2021-02-07 | 2021-06-18 | 广州医科大学附属脑科医院 | Cognition-based universal first schizophrenia diagnosis model for teenagers and adults, construction method and diagnosis system |
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