JP5426502B2 - Psychiatric disorder diagnosis apparatus and program - Google Patents

Description

  The present invention relates to a psychiatric disorder diagnosis apparatus and program for diagnosing the presence or absence of a psychiatric disorder.

  In modern society, various stresses based on the social environment are increasing. Therefore, in recent years, an increase in patients with mental illnesses such as depression and autonomic dysfunction has become a major social problem.

  And if you fall into such a mental illness, the dysfunction that causes the autonomic nerves to not function normally will occur, causing serious distress to the mind and body, and enormous social life such as neglect, unemployment, withdrawal There is a risk of hindrance. In addition, it is estimated that the majority of the suicides, more than 30,000 per year, suffered from depression, a mental illness. The number of patients with mental illness is expected to increase in the future. Establishing a system for accurately diagnosing and quickly treating mental illness leads to improvement of people's lives and is an urgent need for society as a whole.

  Therefore, a method for diagnosing the presence or absence of mental illness is required. In general diagnosis methods for mental illnesses, the patient's medical history is listened to, how and when symptoms appearing in psychological behavior appear, and what obstacles are occurring in social and family life. It was done by the method of judging from the attitude at the time of consultation and the content of conversation. However, such a method has a problem that it is necessary to have a sufficient knowledge and a diagnosis by a skilled expert and cannot be easily diagnosed.

  In addition, as a simple method, there is a screening method using a self-filled questionnaire, but since it is filled in subjectively by the patient, it is possible to distinguish depression from factors such as the patient's personality and mood swings due to poor physical condition. I couldn't do it and the objectivity was poor.

  Thus, for example, Patent Document 1 discloses a method of objectively diagnosing a mental illness by performing gene analysis using a solid-phase nucleic acid sample on whole blood-derived RNA. Patent Document 2 discloses a method of determining whether a subject is suffering from a mental illness using a gene expression level as an index.

JP 2008-79537 A JP 2009-112266 A

  However, the above-described conventional diagnostic method is a time-consuming method such as collecting and analyzing a subject's gene in order to diagnose the subject's presence or absence of mental illness. It was not a diagnosis.

  An object of the present invention relates to a mental illness diagnosis apparatus and program capable of objectively and simply diagnosing the presence or absence of a mental illness.

[Mental disease diagnosis device]
In order to achieve the above object, an electrocardiogram measuring means for measuring the electrocardiogram of the subject,
Instructing means for instructing a load test for the diagnosed person,
CVRR calculation means for calculating an electrocardiogram RR interval variation coefficient based on the electrocardiogram data measured by the electrocardiogram measurement means;
When the value of the electrocardiogram RR interval variation coefficient after the load test calculated by the CVRR calculating means is smaller than the value of the electrocardiogram RR interval variation coefficient before the load test, it is determined that there is a possibility of mental illness. Determination means to perform,
Display means for displaying a determination result in the determination means;
It has.

  According to the present invention, in order to determine the presence or absence of mental illness from the comparison of the ECG RR interval variation coefficient values before and after the load test calculated based on the measured ECG data of the diagnosis subject, The presence or absence of mental illness can be diagnosed easily and conveniently.

In addition, another psychiatric disease diagnosis apparatus according to the present invention includes an accepting unit that receives electrocardiogram data of a diagnosis subject measured by an electrocardiograph.
Instructing means for instructing a load test for the diagnosed person,
CVRR calculating means for calculating an electrocardiogram RR interval variation coefficient based on the electrocardiogram data received by the receiving means;
When the value of the electrocardiogram RR interval variation coefficient after the load test calculated by the CVRR calculating means is smaller than the value of the electrocardiogram RR interval variation coefficient before the load test, it is determined that there is a possibility of mental illness. Determination means to perform,
Display means for displaying a determination result in the determination means;
It has.

  According to such another psychiatric disease diagnosis apparatus, it is not necessary to provide an electrocardiogram measurement device for measuring electrocardiographic data by providing the receiving means in the psychiatric disease diagnosis apparatus.

  Furthermore, in another psychiatric disease diagnosis apparatus of the present invention, when the determination means determines that there is a possibility of mental illness, an electrocardiogram RR interval variation coefficient before the load test calculated by the CVRR calculation means. If the value falls below the lower limit of the normal range, it may be determined that there is a possibility of depression.

  According to such another mental illness diagnosis device, when it is diagnosed that there is a possibility of a mental illness, it is possible to further diagnose whether or not the mental illness is depression.

  Furthermore, another mental illness diagnosis apparatus of the present invention may further include setting means for setting the normal range according to the age of the person being diagnosed.

[program]
The program of the present invention includes a step of measuring the electrocardiogram of the subject,
Calculating an electrocardiogram RR interval variation coefficient based on the measured electrocardiogram data;
Instructing a load test for the person to be diagnosed;
Measuring the electrocardiogram of the subject after the stress test;
Calculating an electrocardiogram RR interval variation coefficient based on the measured electrocardiogram data after the load test;
When the calculated ECG RR interval coefficient of variation after the load test is smaller than the ECG RR interval coefficient of variation before the load test, determining that there is a possibility of mental illness;
A step of displaying the judgment result;
Is executed on the computer.

In addition, another program of the present invention includes a step of receiving electrocardiographic data of a subject,
Calculating an electrocardiogram RR interval variation coefficient based on the received electrocardiogram data;
Instructing a load test for the person to be diagnosed;
Accepting electrocardiogram data after the stress test;
Calculating an electrocardiogram RR interval variation coefficient based on the received electrocardiogram data after the load test;
When the calculated ECG RR interval coefficient of variation after the load test is smaller than the ECG RR interval coefficient of variation before the load test, determining that there is a possibility of mental illness;
A step of displaying the judgment result;
To run on a computer

  Furthermore, in another program of the present invention, when it is determined that there is a possibility of mental illness, the calculated ECG R-R interval variation coefficient before the stress test falls below the lower limit of the normal range. A step of determining that there is a possibility of depression may be further executed by the computer.

  Furthermore, in another program of the present invention, the computer may further execute a step of setting the normal range according to the age of the patient.

  As described above, according to the present invention, it is possible to obtain an effect that the presence or absence of a mental illness can be objectively and easily diagnosed.

It is a block diagram which shows the structure of the mental disease diagnostic apparatus of one Embodiment of this invention. It is a flowchart which shows operation | movement of the mental disease diagnostic apparatus of one Embodiment of this invention. It is a figure which shows an example of the electrocardiogram waveform of the electrocardiogram data measured by the electrocardiogram monitor 14 in FIG. It is a flowchart which shows operation | movement of the mental disease determination process part 26 in FIG. It is a figure which shows an example of the upper limit of the normal range of CVRR according to each age, an average, and a lower limit. It is a figure which shows an example of the display shown on the display apparatus 22 in FIG. 1 when it is diagnosed that there is no possibility of a mental illness. It is a figure which shows an example of the display shown on the display apparatus 22 in FIG. 1 when it is diagnosed that there is a possibility of depression. It is a figure which shows an example of the display shown by the display apparatus 22 in FIG. 1 when it is diagnosed that there is a possibility of mental disorders other than depression.

  Next, embodiments of the present invention will be described in detail with reference to the drawings. FIG. 1 is a block diagram showing a configuration of a mental disease diagnosis apparatus according to an embodiment of the present invention.

  As shown in FIG. 1, the psychiatric disease diagnosis apparatus of the present embodiment includes an electrocardiogram monitor 14 for acquiring electrocardiogram data of a measurement subject, a control device 18, a storage device 20, diagnosis subject information, and The display device 22 is configured to display a diagnosis result, a CVRR (Coefficient of Variation of RR intervals) calculating unit 25, and a mental disease determination processing unit 26.

  The electrocardiogram monitor 14 wears a minus electrode, for example, at the throat of the subject, a plus electrode on the left flank, and a body ground on the right flank, obtains heart movement as an electrical signal and records it as electrocardiographic data.

  The CVRR calculation unit 25 calculates CVRR (electrocardiogram RR interval variation coefficient) based on the electrocardiogram data measured by the electrocardiogram monitor 14. A specific method for calculating the CVRR will be described later.

  The mental illness determination processing unit 26 compares the CVRR before the load test calculated by the CVRR calculation unit 25 with the CVRR after the load test. If the CVRR after the load test is smaller than the CVRR before the load test, a mental illness is possible. Judge that there is sex. Further, when it is determined that there is a possibility of mental illness, the mental illness determination processing unit 26 examines whether the CVRR before the stress test is within a normal CVRR range, and the calculated CVRR is normal. If the value falls below the lower limit of the range, it is determined that there is a possibility of depression. If the calculated CVRR is within the normal range, mental disorders other than depression (specifically, dementia, panic disorder, etc.) ).

  The control unit 18 is composed of a computer, for example, and sets the lower limit value of the normal range of CVRR in the mental disease determination processing unit 26 based on the input age of the diagnosed person. After the calculation by the CVRR calculation unit 25, the load test is instructed to the diagnosis subject, and the determination result obtained by the diagnosis information and the mental disease determination processing unit 26 is stored in the storage device 20, or the display device 22 is displayed.

  Specifically, the control device 18 first sets the lower limit value of the normal range of CVRR corresponding to the input age of the diagnosed person in the mental disease determination processing unit 26. When the psychiatric disorder determination processing unit 26 determines that the CVRR calculation unit 25 has received the CVRR at the time of the patient's rest, the control device 18 stands up as a load test on the patient via the display device 22. The display device 22 displays a determination result of whether or not the person to be diagnosed has a possibility of mental illness and whether or not the mental illness of the person to be diagnosed is depression obtained by performing a test. To display.

  Moreover, in this embodiment, although the control apparatus 18 is a structure which performs a standing-up test with respect to a to-be-diagnosed person, this invention is not limited to this. Examples of the load test performed by the control device 18 include physical or mental tests such as a load test that causes the patient to take a deep breath and a load test that causes the patient to stand up from a resting position. The present invention can be similarly applied even when a load test other than the standing-up test is performed, as long as it is a load test that gives a load to the person to be diagnosed.

  Next, the operation of the mental illness diagnosis apparatus of this embodiment will be described in detail with reference to FIG. FIG. 2 is a flowchart showing the operation of the mental disease diagnosis apparatus of the present embodiment.

  First, as an initial setting, before the diagnosis is started, the diagnosis apparatus information such as the name, age, ID number, sex, and past history (diabetes, vascular disorder, etc.) of the diagnosis person is input to the control device 18. . Then, the control device 18 sets the lower limit value of the normal range of CVRR corresponding to the age of the person to be diagnosed in the mental disease determination processing unit 26 (step S201).

  When the diagnosis is started, the electrocardiogram data of the diagnosis subject is measured by the electrocardiogram monitor 14 (step S202). Then, the CVRR calculation unit 25 performs CVRR calculation to calculate CVRR that is an index indicating the degree of variation in the RR interval (step S203). Then, the control device 18 instructs the patient to stand (step S204), the electrocardiogram data of the patient after standing up is measured again by the electrocardiogram monitor 14 (step S205), and the electrocardiogram after standing up. Based on the data, the CVRR calculation unit 25 calculates the CVRR after standing (step S206).

  Next, the psychiatric disorder determination processing unit 26 determines whether the subject has mental illness and depression based on the CVRR before standing calculated by the CVRR calculating unit 25, the CVRR after standing, and the normal range of the CVRR. It is determined whether or not (step S207).

  The diagnosis result obtained by the mental illness determination processing unit 26 is stored in the storage device 20 by the control device 18 and displayed on the display device 22 (step S208), and the diagnosis ends.

Next, the details of the CVRR calculation method shown in steps S203 and S206 of FIG. 2 will be described.
CVRR is an index indicating the degree of variation in heart rate variability. The RR interval (the R wave of the electrocardiogram waveform) in the electrocardiogram waveform shown in FIG. 3B and an enlarged view of FIG. This is a coefficient indicating the degree of variation in the vertex interval. Specifically, this CVRR is calculated by the following equation.
CVRR = R−R interval standard deviation / R−R interval average × 100 (%)

  Here, the RR interval standard deviation is, for example, the standard deviation of the RR interval in a predetermined period of 1 minute or a predetermined number of heartbeats such as 100 beats. The RR interval average is, for example, an average of RR intervals in a predetermined period or a predetermined number of heartbeats.

  The CVRR calculation unit 25 calculates CVRR from the electrocardiogram data measured by the electrocardiogram monitor 14 based on the above formula.

  Next, the relationship between CVRR and mental illness will be described. If the person to be diagnosed is in a normal mental state, a change such as an increase in heart rate is caused by an autonomic response to physical or mental stress (load: standing test in this embodiment). Therefore, the variation in heart rate variability becomes large, and the CVRR after applying stress becomes larger than the CVRR before applying stress. However, if the subject's autonomic nerve is not working normally due to mental illness, there is no autonomic response even if stress is applied. As a result, the variation in heart rate variability is small, and the CVRR after applying stress is smaller than the CVRR before applying stress. In addition, when the subject is depressed, the autonomic response is constantly weak, so the CVRR after standing is smaller than the CVRR before standing, and the resting CVRR is less than the normal range. Get smaller.

  For the reasons described above, based on the change in CVRR before and after the standing test and the value of CVRR before the standing test, it is possible to diagnose the presence or absence of the subject's mental illness, particularly the presence or absence of depression.

  Next, the operation of the determination process in the mental illness determination processing unit 26 shown in step S207 of FIG. 2 will be described in detail with reference to FIG. FIG. 4 is a flowchart showing the operation of the mental disease determination processing unit 26 of the present embodiment.

  First, the mental illness determination processing unit 26 compares the CVRR before rising calculated by the CVRR calculating unit 25 with the CVRR after rising (step S301). The mental disease determination processing unit 26 determines that there is no abnormality when the CVRR after standing is larger than the CVRR before standing up (step S302), and when the CVRR after standing is smaller than the CVRR before standing up, some mental Determine that there is a possibility of disease. Next, when it is determined in step S301 that there is a possibility of a mental illness, the mental illness determination processing unit 26 compares the CVRR before standing with the lower limit value of the normal range set by the control device 18. (Step S303) If the CVRR before standing is within the normal range, it is determined that there is a possibility of a mental illness other than depression (Step S304), and the CVRR before standing is below the lower limit of the normal range It is determined that there is a possibility of depression (step S305).

  Next, an example of the normal range of CVRR for each age is shown in FIG. The control device 18 calculates the normal range of the corresponding CVRR in FIG. 5 based on the age of the input person to be diagnosed, and sets the lower limit value of the normal range of the CVRR before standing up in the mental disease determination processing unit 26. . For example, when the age of the person to be diagnosed input to the control device 18 is 25 years old, the control device 22 first sets the lower limit value of the normal range of CVRR of the mental disease determination processing unit 26 to 20 in FIG. Set to 2.5 (%), which is the lower limit of the normal range of CVRR of ˜29 years old. When the mental disease determination unit 26 determines that the CVRR after standing is smaller than the CVRR before standing, if the CVRR before standing is less than 2.5 (%), there is a possibility of depression. If CVRR before standing is 2.5 (%) or more, it is determined that there is a possibility of a mental illness other than depression.

  As described above, according to the present embodiment, the CVRR is calculated based on the electrocardiogram data obtained from the electrocardiograph, and the magnitude of the CVRR before the load test and the CVRR after the load test is calculated. In addition, by comparing whether or not the CVRR before the stress test is lower than the lower limit of the normal range of CVRR corresponding to the age of the patient, objective and simple mentality of the patient It becomes possible to diagnose the presence or absence of a disease and whether or not there is a possibility of depression.

  Next, display examples of the display device 22 in the mental disease diagnosis apparatus of the present embodiment are shown in FIGS. In FIGS. 6 to 8, the measurement results at rest in the sitting position, the measurement results immediately after standing up, and the measurement results in standing one minute after standing up are displayed in order from the left in the drawings.

  FIG. 6 is a display example on the display device 22 when the mental disease determination processing unit 26 determines that there is no abnormality. In FIG. 6, the age of the diagnosis subject input to the control device 18 is 25 years old, the CVRR before standing calculated by the CVRR calculating unit 25 is 4.2 (%), and the CVRR after standing is 5.1 ( %), And the CVRR after standing is larger than the CVRR before standing, and the display device 22 displays that there is no possibility of mental illness. Specifically, on the display device 22, the characters “There is no possibility of mental illness” are displayed at the top of the screen, and CVRR numbers and a graph are displayed at the bottom of the screen. The display device 22 displays the heart rate obtained from the electrocardiographic data of the diagnosed person, together with the CVRR measurement result.

  Similarly, when the mental disease determination processing unit 26 determines that there is a possibility of depression, the display device 22 performs the display shown in FIG. In FIG. 7, the age of the diagnosis subject input to the control device 18 is 32 years old, the CVRR before standing calculated by the CVRR calculating unit 25 is 2.0 (%), and the CVRR after standing is 1.8 ( The CVRR after standing is smaller than the CVRR before standing, and the CVRR before standing is below the lower limit of 2.1 (%) of the normal range of 30 to 39 years in FIG. Because it is indicated that there is a possibility of depression. Specifically, when the mental illness determination processing unit 26 diagnoses that there is a possibility of depression, the display device 22 displays a character “There is a possibility of depression” at the upper part of the screen. In the lower part, CVRR numbers and graphs are displayed. Further, in FIG. 7, in the CVRR graph at the bottom of the screen, the graph below the lower limit value of the normal range is filled, and the display is different from the CVRR graph in the normal range.

  Further, when it is determined that there is a possibility of a mental illness other than depression, the display device 22 displays as shown in FIG. In FIG. 8, the age of the diagnosis subject input to the control device 18 is 51 years old, the CVRR before standing up calculated by the CVRR calculating unit 25 is 2.6 (%), and the CVRR after standing up is 2.4 ( The CVRR after standing is smaller than the CVRR before standing, but the CVRR before standing is 1.4 (%) or more, which is the lower limit of the normal range of 50 to 59 years in FIG. The display device 22 displays that there is a possibility of a mental illness other than depression. Specifically, when the mental disease determination processing unit 26 diagnoses that there is a possibility of a mental illness other than depression, the display device 22 says “There is a possibility of other mental illness” at the top of the screen. Characters are displayed, and CVRR numbers and graphs are displayed at the bottom of the screen. Further, in FIG. 8, the graph of CVRR after standing is filled, and the display is different from CVRR before standing.

[Modification]
In the present embodiment, the case where the electrocardiogram monitor 14 for measuring electrocardiogram data is provided in the mental disease diagnosis apparatus of the present invention has been described. However, the present invention is limited to such a form. is not. Without providing the electrocardiogram monitor 14, an accepting unit for accepting external electrocardiogram data may be provided inside the mental illness diagnosis apparatus, and the accepting unit may calculate CVRR from the electrocardiogram data accepted from the outside. it can. With this configuration, the psychiatric disease diagnosis apparatus does not need to be provided with an electrocardiogram measurement device such as the electrocardiogram monitor 14.

14 ECG Monitor 18 Control Device 20 Storage Device 22 Display Device 25 CVRR Calculation Unit 26 Psychiatric Disease Determination Processing Unit S201 to S208 Steps S301 to S305 Steps

Claims (6)

An electrocardiogram measuring means for measuring the electrocardiogram of the subject;
Instructing means for instructing a load test for the diagnosed person,
CVRR calculation means for calculating an electrocardiogram RR interval variation coefficient based on the electrocardiogram data measured by the electrocardiogram measurement means;
When the value of the electrocardiogram RR interval variation coefficient after the load test calculated by the CVRR calculating means is smaller than the value of the electrocardiogram RR interval variation coefficient before the load test, it is determined that there is a possibility of mental illness. Determination means to perform,
Display means for displaying a determination result in the determination means;
Equipped with a,
When the determination means determines that there is a possibility of a mental illness, it is depressed when the electrocardiogram RR interval variation coefficient before the load test calculated by the CVRR calculation means falls below the lower limit of the normal range. A device for diagnosing mental illness that determines that there is a possibility of illness . Receiving means for receiving the electrocardiogram data of the diagnosis subject measured by the electrocardiograph;
Instructing means for instructing a load test for the diagnosed person,
CVRR calculating means for calculating an electrocardiogram RR interval variation coefficient based on the electrocardiogram data received by the receiving means;
When the value of the electrocardiogram RR interval variation coefficient after the load test calculated by the CVRR calculating means is smaller than the value of the electrocardiogram RR interval variation coefficient before the load test, it is determined that there is a possibility of mental illness. Determination means to perform,
Display means for displaying a determination result in the determination means;
Equipped with a,
When the determination means determines that there is a possibility of a mental illness, it is depressed when the electrocardiogram RR interval variation coefficient before the load test calculated by the CVRR calculation means falls below the lower limit of the normal range. A device for diagnosing mental illness that determines that there is a possibility of illness . The normal range, further comprising setting means for setting in accordance with the age of the diagnostician claim 1 or 2 mental disease diagnosis apparatus according. Measuring the electrocardiogram of the subject,
Calculating an electrocardiogram RR interval variation coefficient based on the measured electrocardiogram data;
Instructing a load test for the person to be diagnosed;
Measuring the electrocardiogram of the subject after the stress test;
Calculating an electrocardiogram RR interval variation coefficient based on the measured electrocardiogram data after the load test;
When the calculated ECG RR interval coefficient of variation after the load test is smaller than the ECG RR interval coefficient of variation before the load test, determining that there is a possibility of mental illness;
When it is determined that there is a possibility of mental illness, it is determined that there is a possibility of depression when the calculated ECG R-R interval variation coefficient before the stress test falls below the lower limit of the normal range. Steps,
A step of displaying the judgment result;
A psychiatric disease diagnosis program for running a computer. Receiving the electrocardiogram data of the subject,
Calculating an electrocardiogram RR interval variation coefficient based on the received electrocardiogram data;
Instructing a load test for the person to be diagnosed;
Accepting electrocardiogram data after the stress test;
Calculating an electrocardiogram RR interval variation coefficient based on the received electrocardiogram data after the load test;
When the calculated ECG RR interval coefficient of variation after the load test is smaller than the ECG RR interval coefficient of variation before the load test, determining that there is a possibility of mental illness;
When it is determined that there is a possibility of mental illness, it is determined that there is a possibility of depression when the calculated ECG R-R interval variation coefficient before the stress test falls below the lower limit of the normal range. Steps,
A step of displaying the judgment result;
A psychiatric disease diagnosis program for running a computer. The psychiatric disorder diagnosis program according to claim 4 or 5 , further causing the computer to execute the step of setting the normal range according to the age of the patient.

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