CN113662546A

CN113662546A - Method, kit and device for early screening or assisted diagnosis of mental diseases

Info

Publication number: CN113662546A
Application number: CN202111130215.1A
Authority: CN
Inventors: 惠李; 朱振华; 贾秋放; 王菁
Original assignee: Suzhou Guangji Hospital
Current assignee: Hui Li
Priority date: 2021-09-26
Filing date: 2021-09-26
Publication date: 2021-11-19

Abstract

The invention discloses a method, a kit and a device for early screening or auxiliary diagnosis of mental diseases, and relates to the field of mental disease diagnosis. The method of the invention takes the stereoscopic vision as an index, carries out early screening or auxiliary diagnosis on the mental diseases, and has more scientific and reliable results.

Description

Method, kit and device for early screening or assisted diagnosis of mental diseases

Technical Field

The invention relates to the field of mental disease diagnosis, in particular to a method, a kit and a device for early screening or auxiliary diagnosis of mental diseases.

Background

Schizophrenia is a chronic and serious psychotic disorder. Schizophrenia is characterized by a distorted thought, point of view, emotion, language, self-awareness and behavior. Common symptoms include hallucinations (auditory or seeing something absent) and delusions (insisting on false beliefs).

Depression is characterized by depressed mood, loss of interest, feelings of fatigue, guilt or low self-value, inattention, sleep and/or appetite. In addition, the duration of depression is persistent, recurrent and so on, which severely impairs the ability of the individual to work, school or daily life. In the most serious cases, the depression can cause suicide, and the depression is the disease with the highest psychiatric suicide rate at present.

Bipolar affective disorder refers to a class of mood disorders with both manic or hypomanic episodes and depressive episodes. Has the characteristics of complex disease course, high recurrence rate, high disability rate, low diagnosis rate and low treatment rate. Has been receiving high attention and wide attention from mental health workers in various countries for a long time.

Clinical diagnosis of mental disorders has also stayed at the level of phenomenological diagnosis, primarily based on the criteria in the American society for mental medicine, the fifth edition of the handbook of mental disorders diagnosis and statistics (DSM-5) or the International Classification of diseases and related health problems of the world health organization (ICD-10). These criteria are based on the personal experience the seeker complains and the abnormal behavioral description of the seeker by others, followed by clinical evaluation by a mental health professional. Before diagnosis, the symptoms associated with mental illness must occur continuously in the patient and need to be of a certain severity. There are currently no objective biomarkers for such diseases to diagnose.

In view of this, the invention is particularly proposed.

Disclosure of Invention

The invention aims to provide a method, a kit and a device for early screening or auxiliary diagnosis of mental diseases.

The invention is realized by the following steps:

in a first aspect, the present invention provides a method for early screening or assisted diagnosis of a psychiatric disease comprising the steps of:

(a) detecting stereo vision of the subject;

(b) diagnosing the subject according to the stereoscopic vision detection result; if the visual acuity score for stereo vision is above 70 arcsec (. gtoreq.70 ″), this indicates that the subject suffers from a psychiatric disorder, which may be schizophrenia, also bipolar disorder and also depression.

Stereoscopic vision is a high-level visual function existing only on humans and higher animals, assisting humans to accurately judge target depth from 3D space using monocular and binocular cues.

Stereoscopic vision is a skill to determine a target depth from a 3D space based on various depth cues, including monocular and binocular cues. Binocular parallax is a main clue for determining stereoscopic vision, and means that images seen by left and right eyes are slightly different due to a certain horizontal interval (about 6 cm) between the eyes. The difference image is transmitted to the cerebral cortex through a visual pathway and begins to be analyzed and processed, so that people can be helped to quickly and conveniently extract the depth information of the surrounding environment, the scanning amount required by extracting spatial information is reduced, the process of distinguishing the slight difference of basic visual characteristics is facilitated to be improved, the distances of all objects in a visual field are deduced from complex visual information, and a three-dimensional image is formed.

The ability to stereoscopically observe is typically measured in visual acuity, which is measured in arc seconds ("). There is no absolute criterion for the threshold for stereoscopic obstruction due to differences in measurement methods. The stereovision of children starts to rise from the age of 7 to the age of 9, and the maturity level of 40' can be reached by the age of 9, and the stereovision is not statistically different from that of adults. Stereoscopic vision disorders may be associated with infantile and childhood developmental disorders.

The study of the present invention found that the stereovision of healthy subjects and three patients with mental diseases (schizophrenia, bipolar disorder, and depression) were significantly different, but there was no significant difference between the three mental diseases. Therefore, when stereoscopic vision is used as a diagnostic index of mental disease, only healthy subjects and mental disease patients can be distinguished, and the mental disease patients may suffer from schizophrenia, bipolar disorder and depression, and particularly, which mental disease needs to be further diagnosed by other means. It is not possible to give a result of which specific mental disease by stereoscopic vision, and misdiagnosis may be caused if the subject is judged to be specifically schizophrenia, bipolar disorder, or depression based on the stereoscopic visual acuity score. When the visual acuity score threshold is controlled to be 70 arc seconds, the result accuracy can reach 89.7 percent, namely, the visual acuity score is 89.7 percent of the possibility of mental diseases (which may be schizophrenia, bipolar affective disorder and depression) when being more than 70 arc seconds, at the moment, attention or high attention should be paid, and further diagnosis is recommended through other diagnosis means; but visual acuity below 70 arc seconds (< 70") is not certain to be a healthy individual or to have a psychiatric illness, suggesting a consultant with a medical practitioner.

Optionally, in some embodiments, in step (a), stereo vision is detected using a Titmus look-up map.

The Titmus method is a common image used for detecting stereoscopic vision in the field, and the method for detecting the stereoscopic vision is easy to realize for a person skilled in the art, but the invention discloses that the stereoscopic vision is used as an index for early screening or auxiliary diagnosis of mental diseases for the first time.

In a second aspect, the present invention provides a kit for early screening or assisted diagnosis of a psychiatric disease comprising:

(a) a stereoscopic vision detection unit; the detection unit is configured with an inspection image for detecting stereoscopic vision of the subject;

(b) polarizing glasses; the subject viewing the inspection image after wearing the polarized glasses to detect stereoscopic vision thereof; if the stereoscopic visual acuity score is above 70 arcsec, the subject is indicated to have a psychiatric disorder, which may be schizophrenia, also bipolar disorder, and also possibly depression.

Based on the method provided by the first aspect of the invention, the invention provides the kit for early screening or auxiliary diagnosis of mental diseases, and the kit can realize the method.

Optionally, in some embodiments, the inspection image is a Titmus inspection image or the like.

The Titmus inspection image commonly used in the art is shown in fig. 1 and 2, and based on the similar image design principle, a person skilled in the art can design a similar image which can detect stereo vision besides fig. 1 and 2, and whatever image is, as long as it can detect stereo vision, belongs to the protection scope of the present invention.

Optionally, in some embodiments, the stereoscopic vision detection unit is a card, an album, an electronic device, or the like.

It is easy for those skilled in the art to configure the Titmus inspection image on a card, or on an album, or on an electronic device such as a mobile phone, a computer, a tablet computer, a kindle, etc. having an image display function, and therefore, it is within the scope of the present invention to configure the Titmus inspection image on any carrier.

In a third aspect, the present invention provides a method of assembling a kit for early screening or assisted diagnosis of mental disorders, the method comprising: namely, the stereoscopic vision detection unit, the polarized glasses and the instruction are assembled into a packaging container.

The detection unit is configured with a check image or the like for detecting stereoscopic vision of the subject;

the instruction book records a method for early screening or auxiliary diagnosis of mental diseases by using the kit, and the method mainly comprises the following steps: observing the inspection image after the subject wears the polarized glasses to detect stereo vision of the subject; if the stereoscopic visual acuity score is above 70 arcsec, the subject is indicated to have a psychiatric disorder, which may be schizophrenia, also bipolar disorder, and also possibly depression.

Optionally, in some embodiments, the stereoscopic vision detection unit is a card album, an electronic device, or the like.

Alternatively, in some embodiments, the packaging container may be a packaging bag, a packaging box, or other container having a packaging function.

In a fourth aspect, the present invention provides a device for early screening or diagnosis assistance of mental diseases, comprising: an image display module for displaying an inspection image for detecting stereoscopic vision of a subject;

the information feedback module is used for proposing a question and a corresponding alternative option according to the inspection image and acquiring answer information of the test subject to the question under the condition of wearing the polarizer;

the judging module is used for scoring the visual acuity of the subject according to the answer information and judging according to the result of the visual acuity score; determining that the subject has a psychiatric disorder if the visual acuity score is above 70 arcsec, wherein the psychiatric disorder is likely schizophrenia, likely bipolar disorder, and likely depression;

a result display module for displaying a mental disease diagnosis result of the subject.

Optionally, in some embodiments, the information feedback module obtains the subject's response information to the question through at least one of a keyboard, voice, touch, limb movement, and a handle.

Drawings

In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings needed to be used in the embodiments will be briefly described below, it should be understood that the following drawings only illustrate some embodiments of the present invention and therefore should not be considered as limiting the scope, and for those skilled in the art, other related drawings can be obtained according to the drawings without inventive efforts.

FIG. 1 is a Titmus graded circular stereovision test kit including polarized glasses and a panel configured with a Titmus inspection map.

FIG. 2 is a graph of a graded circle of a Titmus inspection map.

FIG. 3 is the difference in stereovision between healthy control group and psychiatric group, h-healthy control group, sbd-psychiatric group (including schizophrenia, bipolar disorder and depression); the ordinate is Log₁₀A value of visual acuity.

Figure 4 is a ROC curve identifying healthy controls versus psychiatric disease.

Fig. 5 is the stereovision difference between healthy controls and three psychiatric disorders (schizophrenia, bipolar disorder and depression), respectively.

FIG. 6 is a ROC curve identifying healthy controls versus different psychiatric disorders, and between different psychiatric disorders; (a) -identifying a ROC curve for healthy controls versus schizophrenia; (b) -identifying a ROC curve for healthy control versus bipolar affective disorder; (c) -identifying a ROC curve for healthy controls versus depression; (d) -identifying a ROC curve for bipolar affective disorder and depression; (e) -identifying a ROC curve for bipolar disorder and schizophrenia; (f) -identifying the ROC curve for depression and schizophrenia.

FIG. 7 is Log of healthy controls versus psychiatric disorders₁₀Visual acuity distribution plots.

Detailed Description

In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below. The examples, in which specific conditions are not specified, were conducted under conventional conditions or conditions recommended by the manufacturer. The reagents or instruments used are not indicated by the manufacturer, and are all conventional products available commercially.

The features and properties of the present invention are described in further detail below with reference to examples.

Example 1

Study subjects:

depression group: co-cohort 90 depression patients (male/female 31/59) were recruited from the guangji hospital, suzhou city. The inclusion criteria were: (1) age 18-65 years; (2) depression was diagnosed according to the diagnostic and statistical manual for mental disorders, version 4 (DSM-IV) [ american psychiatric association, 1994 ]; (3) receiving education for at least 4 years; (4) with written informed consent, and stereoscopic vision, HAMD assessment can be completed. Exclusion criteria: (1) other psychiatric disorders meeting DSM-IV diagnostic criteria are combined: such as schizophrenia, bipolar disorder, psychoactive substance use, etc.; (2) present and past serious somatic diseases; (3) a woman in pregnancy or lactation; (4) those who have a previous surgical history or have recently suffered a severe infection.

Schizophrenia group: a cohort of 157 schizophrenic patients (male/female 73/84) were recruited from the guangji hospital, suzhou city. Inclusion criteria were: (1) age 18-45 years; (2) diagnosed as schizophrenia according to DSM-IV; (3) the education period exceeds 4 years; (4) the course of disease does not exceed 2 years; (5) stereoscopic vision, PANSS assessment can be done with written informed consent. Exclusion criteria: (1) other psychiatric disorders meeting DSM-IV diagnostic criteria are combined: such as depression, bipolar disorder, psychoactive substance use, etc.; (2) present and past serious somatic diseases; (3) a woman in pregnancy or lactation; (4) those who have a previous surgical history or have recently suffered a severe infection.

Bipolar affective group: 148 patients with co-enrolled bipolar affective disorder (male/female 47/101) were recruited from the Guangxi Hospital, Suzhou city. Inclusion criteria were: (1) age 18-45 years; (2) is diagnosed as bipolar disorder according to DSM-IV; (3) the education period exceeds 4 years; (4) stereoscopic vision, PANSS assessment can be done with written informed consent. Exclusion criteria: (1) other psychiatric disorders meeting DSM-IV diagnostic criteria are combined: such as schizophrenia, depression, psychoactive substance use, etc.; (2) present and past serious somatic diseases; (3) a woman in pregnancy or lactation; (4) those who have a previous surgical history or have recently suffered a severe infection.

Healthy control group: group-shared healthy control group 116 (male/female 54/62) were recruited from suzhou city. Mental status of healthy subjects, an individual mental history and a family mental history were assessed by a psychiatrist through an unstructured clinical visit. The inclusion criteria were: (1) no history of mental diseases, family history of first-class relatives; (2) those without major somatic diseases; (3) non-pregnant or lactating women; (4) there has been no history of the use and dependence of psychoactive substances.

Eligible subjects must meet the following stereoscopic vision detection requirements (1) no vision or eye disease: including amblyopia, achromatopsia, strabismus, glaucoma, diabetic retinopathy, and the like; (2) the vision of the left eye and the right eye respectively reaches at least 0.6 after correction; (3) the difference in vision between the two eyes does not exceed row 1 of the E-standard logarithmic chart.

TABLE 1 basic information of healthy controls and psychiatric groups

	Healthy controls	Mental disease	P value
				Quantity (example)	116	402
Age (year of old)	31.1±11.4	33.7±12.6	0.049
				Percentage of women (%)	53.4	61.9	0.100
Education time limit (year)	12.7±3.5	10.7±3.5	<0.001

TABLE 2 basic information of healthy controls with three psychiatric disease groups, respectively

And (3) stereoscopic vision detection:

first, visual and color vision tests are required. And (4) vision detection, wherein all the people sequentially answer the opening directions of the gradually reduced letters on the visual chart at the position of 5m, so as to judge the vision of the patient. If the left and right eye sight of the subject is still less than 0.6 after correction, the study is automatically exited. And (3) color vision detection: the subject is required to check the color vision through the color vision inspection chart under the environment with sufficient light to judge whether the subject is color blindness or color weakness. If the subject is color blind or color weak, the study is automatically exited.

And performing stereoscopic vision detection after the test is passed. The detection of Stereo vision was performed using a Titmus inspection chart (S/N:1627379199) from Stereo optics, Chicago, USA, see FIG. 1. The stereo vision detection requires the subject to wear polarized glasses, and if the subject wears other glasses, the polarized glasses need to be placed in front of the other glasses. The test started the measurement of stereo vision by looking up the Titmus exam at 40 cm from the glasses.

Firstly, a subject is allowed to observe the fly in the picture, if the subject can observe the flying fly through polarized glasses or feels that the wings of the fly touch in the air, the effect is stereoscopic, if the subject cannot observe the effect, or the subject always touches the surface of the picture during touching, the subject cannot experience the stereoscopic effect, and the study needs to be quit.

In the second step, subjects were asked to observe the left three rows of small animals, each row of animals having and only one being stereogenic. The animals in each row have different visual acuity, and are respectively 400 ', 200 ' and 100 ' from top to bottom. This step is primarily intended to help the subject quickly understand and adapt to the stereoscopic experience, and also serves as a reference for the next detection of a specific threshold of visual acuity.

In the third step, which is the main detection process of stereovision, the subject observes nine-level circle graphs (see fig. 2). Four circles are arranged around each serial number, and only one circle has stereoscopic impression. Each number corresponds to a different visual acuity (in arcseconds, denoted by "x"), with numbers 1-9 corresponding to 800", 400", 200", 140", 100", 80", 60", 50", 40", respectively. The subject is required to recognize a circle (circle having a stereoscopic impression or a protruding circle) having a plane different from that of other circles among the four circles, and as the number increases, the difficulty of recognition also increases. If the subject gives up recognition or fails to recognize the correct circle twice in succession, the measurement of Titmus is terminated and the previous results are considered as the examiner's visual acuity. When detecting, the subject needs to avoid touching the Titmus checking chart, which may interfere with the judgment of the subject and affect the result of the checking.

Statistical analysis:

data analysis was done using the SPSS 25.0 statistical software package. Continuous variables are expressed in x ± s, and categorical variables are expressed in frequency and percentage. In addition, the stereoscopic visual acuity does not conform to the normal distribution, and Log is carried out₁₀After transformation, the normal distribution is conformed. The chi-square test, nonparametric rank sum test and variance analysis are adopted to compare general demographic and clinical data among groups, the covariance correction demographic factor is adopted to analyze the difference among groups of stereoscopic vision, and the LSD test is adopted for post comparison. Stereo vision and PANSS scores, Hamilton Depression Scale, Hamilton anxiety Scale scores using Spearman correlation analysisThe correlation of (c). The clinical significance of stereovision was assessed using Receiver Operating Characteristics (ROC) curves and Area Under the ROC Curve (AUC). With P<A difference of 0.05 is statistically significant.

As a result:

from the results of fig. 3 and 4, it can be seen that there is a significant difference in stereovision between the healthy control group and the psychiatric group; from the following, the following results were obtained, namely, sensitivity 44.5%, specificity 89.7%, and Cutoff 70: visual acuity scores above 70 arcsec are 89.7% likely to have a psychiatric illness, and below 70 arcsec a healthy control or a psychiatric illness cannot be determined, in which case consultation with a medical practitioner is advised.

From the results of fig. 5 and 6, although the stereoscopic vision of the healthy control and the three mental diseases were significantly different, there was no significant difference between the three diseases. Thus, only healthy controls can be distinguished from the psychiatric disorders by stereovision, but not which (i.e., whether a subject is schizophrenia, bipolar disorder, or depression cannot be determined unambiguously, and whether the subject is schizophrenia, bipolar disorder, or depression can only be determined in general terms). And only when the stereoscopic vision is more than 70 arcsec (more than or equal to 70 ℃), the mental disease identification has 89.7 percent of accuracy.

FIG. 7 (Log on abscissa)₁₀Visual acuity values, in ordinate counts and dotted Log₁₀(cutoff) is Log₁₀(70) Results) also further indicate that mental illness predominates above 70 arcsec, while less than 70 minutes fails to determine whether healthy controls or mental illness.

In addition, the results in table 3 show that there is no correlation between stereoscopic vision and the symptoms of all three mental diseases, suggesting that stereoscopic vision is an indicator independent of symptoms, and a high risk group of mental diseases can be identified without symptoms (before onset).

TABLE 3 correlation results of stereovision with three psychiatric symptoms.

Example 2

The invention provides a method for early screening or auxiliary diagnosis of mental diseases, which comprises the following steps:

(1) stereoscopic vision of the subject was detected using a Titmus exam (method performed with reference to example 1);

(2) (ii) indicating that the subject is at substantial risk for a psychiatric disorder, possibly schizophrenia, possibly bipolar disorder, and possibly depression, if the visual acuity score is greater than or equal to 70 arcsec, as determined by the stereoscopic score; at this point, attention or high concern should be drawn, suggesting that the subject be diagnosed further by other diagnostic means.

If the visual acuity score is less than 70 arc seconds, in this case, a healthy individual or a mental illness patient cannot be determined, and consultation with a medical practitioner is advised.

Example 3

The embodiment provides a kit for early screening or auxiliary diagnosis of mental diseases, which comprises polarized glasses and an electronic device or a card or an atlas configured with a Titmus inspection chart.

In conclusion, the invention provides an objective screening means for early screening of mental diseases (schizophrenia, bidirectional affective disorder and depression), can accurately identify the susceptible population of the mental diseases before the occurrence of complete mental symptoms, accurately intervenes in early stage, reduces the morbidity and the severity of the mental diseases to the maximum extent, improves the prognosis of patients and provides scientific and objective basis for auxiliary diagnosis of the mental diseases (schizophrenia, bidirectional affective disorder and depression).

The above description is only a preferred embodiment of the present invention and is not intended to limit the present invention, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims

1. A method for early screening or aided diagnosis of mental diseases, which is characterized by comprising the following steps:

(a) detecting stereo vision of the subject;

(b) diagnosing the subject according to the stereoscopic vision detection result; if the stereoscopic visual acuity score is above 70 arcsec, the subject is indicated to have a psychiatric disorder, which may be schizophrenia, also bipolar disorder, and also possibly depression.

2. The method of claim 1, wherein in step (a) stereovision is detected using a Titmus look-up map.

3. A kit for early screening or assisted diagnosis of a psychiatric disease, comprising:

(b) polarizing glasses; observing the inspection image after the subject wears the polarized glasses to detect the subject stereoscopic vision; if the stereoscopic visual acuity score is above 70 arcsec, the subject is indicated to have a psychiatric disorder, which may be schizophrenia, also bipolar disorder, and also possibly depression.

4. The kit of claim 3, wherein the inspection image is a Titmus inspection image.

5. The kit according to claim 4, wherein the stereoscopic vision detecting unit is a card, an album, or an electronic device.

6. A method of assembling a kit for early screening or aided diagnosis of a mental disorder, the method comprising: assembling the stereoscopic vision detection unit, the polarized glasses and the instructions into a packaging container;

the detection unit is configured with an inspection image for detecting stereoscopic vision of the subject;

the instruction book records a method for early screening or auxiliary diagnosis of mental diseases by using the kit, and the method comprises the following steps: observing the inspection image after the subject wears the polarized glasses to detect stereo vision of the subject; if the stereoscopic visual acuity score is above 70 arcsec, the subject is indicated to have a psychiatric disorder, which may be schizophrenia, also bipolar disorder, and also possibly depression.

7. The assembly method of claim 6, wherein the inspection image is a Titmus inspection image.

8. The assembling method according to claim 7, wherein the stereoscopic vision detecting unit is a card, an album, or an electronic device.

9. An apparatus for early screening or aided diagnosis of mental diseases, comprising: an image display module for displaying an inspection image for detecting stereoscopic vision of a subject;

the judging module is used for scoring the visual acuity of the subject according to the answer information and judging according to the result of the visual acuity score; determining that the subject has a psychiatric disorder if the acuity score is above 70 arcsec, the psychiatric disorder being schizophrenia, bipolar disorder, and depression;

10. The apparatus of claim 9, wherein the inspection image is a Titmus inspection image.