Cognitive functioning in euthymic bipolar I and bipolar II patients
Cognitive functioning in euthymic bipolar I and bipolar II patients
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DOI：
10.1111/j.1399-5618.2008.00640.x
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发表时间：
2008-12-01
影响因子：
5.4
通讯作者：
Grunze, Heinz C.
中科院分区：
文献类型：
--
作者：
Dittmann, Sandra;Hennig-Fast, Kristina;Grunze, Heinz C.
越来越多的证据表明，认知障碍是双相情感障碍的一个特征因素。这一发现的概括性是有限的，因为以前的研究要么专门关注双相I型障碍，要么分析了混合患者群体。因此，双相II患者在认知功能方面的表现是否与双相I患者不同仍是一个很大的未知数。共有65名双相I障碍患者、38名双相II障碍患者和62名健康对照参与了这项研究。患者必须保持至少一个月的欣快感。临床和人口统计学变量是在临床访谈和DSM-IV结构化临床访谈中收集的。认知功能是使用神经心理学组件进行评估的。多变量协方差分析显示三组患者的神经心理表现总体上存在差异(Pillai spur：F1.96，p=0.003)。事后比较发现，双相I型障碍患者在精神运动速度、工作记忆、言语学习、延迟记忆和执行功能方面的得分显著低于健康对照组。与对照组相比，双相II型障碍患者在精神运动速度、工作记忆、视觉/结构能力和执行功能方面有明显的缺陷，但在语言学习和延迟记忆方面没有明显的缺陷。这两组患者在测试的任何领域都没有显著差异。这些结果支持双相情感障碍两种亚型的认知缺陷相似的模式。
There is growing evidence of cognitive impairment as a trait factor in bipolar disorder. The generalizability of this finding is limited because previous studies have either focussed exclusively on bipolar I disorder or have analysed mixed patient groups. Thus, it is still largely unknown whether bipolar II patients perform differently from bipolar I patients on measures of cognitive functioning.A total of 65 patients with bipolar I disorder, 38 with bipolar II disorder, and 62 healthy controls participated in the study. Patients had to be euthymic for at least one month. Clinical and demographic variables were collected in a clinical interview and with the Structured Clinical Interview for DSM-IV. Cognitive functioning was assessed using a neuropsychological battery. Univariate and multivariate analyses of variance were conducted for analyzing possible differences between the groups.The multivariate analysis of covariance (MANCOVA) indicated overall differences in neuropsychological performance between the three groups (Pillai Spur: F 1.96, p = 0.003). Post hoc comparisons revealed that patients with bipolar I disorder showed significantly lower scores in psychomotor speed, working memory, verbal learning, delayed memory, and executive functions than healthy controls. Patients with bipolar II disorder showed significant deficits in psychomotor speed, working memory, visual/constructional abilities, and executive functions compared to controls, but not on verbal learning and delayed memory. The two patient groups did not differ significantly from each other on any domain tested.These results support a similar pattern of cognitive deficits in both subtypes of bipolar disorder.