Cognitive impairment in first-episode mania: a systematic review of the evidence in the acute and remission phases of the illness.
Cognitive impairment in first-episode mania: a systematic review of the evidence in the acute and remission phases of the illness.
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DOI：
10.1186/s40345-015-0024-2
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发表时间：
2015
影响因子：
4
通讯作者：
Berk M
中科院分区：
文献类型：
--
作者：
Daglas R;Yücel M;Cotton S;Allott K;Hetrick S;Berk M
有证据表明，在双相情感障碍的缓解期持续存在认知障碍;然而，从首次发作的障碍发生的缺陷的程度仍然不清楚。这是第一次对双相I型障碍早期阶段的认知功能进行系统综述。这项研究的目的是确定模式和程度的认知障碍，存在从第一次发作躁狂症。系统检索了3个电子数据库（MEDLINE、PsycINFO和PubMed）中1980年1月至2014年6月发表的研究。合格的研究分为两组：急性和缓解。Newcastle-Ottawa质量评估量表用于衡量纳入研究的质量。共有7项研究（3项急性和4项缓解），包括230名首次发作的躁狂症患者和345名健康对照参与者，符合审查条件。急性期的研究仅检查了执行功能的各个方面，在认知灵活性方面发现了损伤，但相对于健康对照组，在反应抑制和语言流畅性方面没有发现损伤。在缓解期最一致的发现是工作记忆的缺陷，而在其他领域，结果是模棱两可的。非语言记忆和语言流畅性在首次发作躁狂缓解期不受影响。总之，缺陷是目前在一些但不是所有领域的认知功能在早期阶段的双相I障碍。进一步的研究是必要的，以了解从首发躁狂症的变化的纵向轨迹。本文的在线版本（doi：10.1186/s40345-015-0024-2）包含补充材料，可供授权用户使用。
There is evidence of cognitive impairment that persists in the remission phase of bipolar disorder; however, the extent of the deficits that occur from the first onset of the disorder remains unclear. This is the first systematic review on cognitive functioning in the early stages of bipolar I disorder. The aim of the study was to identify the patterns and degree of cognitive impairment that exists from first-episode mania. Three electronic databases (MEDLINE, PsycINFO and PubMed) were systematically searched for studies published from January 1980 to June 2014. Eligible studies were separated into two groups: acute and remission. The Newcastle-Ottawa quality assessment scale was utilised to measure the quality of the included studies. A total of seven studies (three acute and four remission), including 230 first-episode mania and 345 healthy control participants, were eligible for the review. The studies in the acute phase only examined aspects of executive functioning, with impairments identified in cognitive flexibility, though not in response inhibition and verbal fluency relative to healthy controls. The most consistent finding during the remission phase was a deficit in working memory, whereas in the other domains, the findings were equivocal. Non-verbal memory and verbal fluency were not impacted in remission from first-episode mania. In conclusion, deficits are present in some but not all areas of cognitive functioning during the early stages of bipolar I disorder. Further research is warranted to understand the longitudinal trajectory of change from first-episode mania. The online version of this article (doi:10.1186/s40345-015-0024-2) contains supplementary material, which is available to authorized users.