A 2-year naturalistic study on cognitive functioning in bipolar disorder
A 2-year naturalistic study on cognitive functioning in bipolar disorder
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DOI：
10.1111/j.1600-0447.2010.01601.x
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发表时间：
2011-03-01
影响因子：
6.7
通讯作者：
van Os, J.
中科院分区：
文献类型：
--
作者：
Arts, B.;Jabben, N.;van Os, J.
目的：双相情感障碍的认知改变可能反映遗传影响。然而，情绪、药物、甲状腺功能和其他因素对纵向认知功能的影响程度尚不清楚。方法：一组双相（谱）障碍患者（n = 76）在前瞻性、重复测量设计的2年期间，每月进行两次认知评估。回归模型用于研究与预测因子的关联，并对多重检验进行校正。结果：双相情感障碍患者在所有认知领域测试中的表现都比健康对照（n = 61）差。效应量很小，持续注意的最大效应值为-0.36。然而，在2年的随访中，认知表现发生了很大的变化，与主观认知抱怨和对功能的影响共同变化。随着时间的推移，持续注意力和运动速度的改变是唯一不变的损害。预测因子对认知时间变化的解释能力非常有限。使用第二代抗精神病药物对认知的负面影响最大，在运动速度和基本信息处理方面表现明显（-0.35 < β < -0.5）。结论：双相情感障碍患者的认知功能随时间变化显著，在很大程度上与临床因素无关。持续注意力的时间稳定性是例外，这表明它可能代表了一种可能的候选中间表型。
Objective:Cognitive alterations in bipolar disorder may reflect genetic influence. However, to what degree mood, medication, thyroid function and other factors impact on longitudinal cognitive functioning remains unclear.Method:A group of patients with bipolar (spectrum) disorder (n = 76) underwent two monthly cognitive assessments over a 2-year period in a prospective, repeated measures design. Regression models were used to investigate associations with predictors, corrected for multiple testing.Results:Patients with bipolar disorder performed worse than healthy controls (n = 61) on all cognitive domains tested. Effect sizes were small, with a maximum of -0.36 for sustained attention. However, cognitive performance varied substantially over the 2- year follow-up, co-varying with subjective cognitive complaints and impacting on functioning. Alterations in sustained attention and motor speed were the only impairments that were invariant over time. Predictors had very limited explanatory power on temporal variation in cognition. Use of second-generation antipsychotics was associated with the largest negative effects on cognition, which were evident in the areas of motor speed and basic information processing (-0.35 < beta < -0.5).Conclusion:Cognitive function in bipolar disorder varies significantly over time, largely independent of clinical factors. The temporal stability of sustained attention is the exception, suggesting it may represent a possible candidate intermediary phenotype.