Neurocognitive functioning in bipolar depression: a component structure analysis
Neurocognitive functioning in bipolar depression: a component structure analysis
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DOI：
10.1017/s0033291713001487
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发表时间：
2014-04-01
影响因子：
6.9
通讯作者：
Ferrier, I. N.
中科院分区：
文献类型：
--
作者：
Gallagher, P.;Gray, J. M.;Ferrier, I. N.
背景以往对双相情感障碍（BD）神经认知表现的研究主要集中在心境方面。在这项研究中，我们旨在比较抑郁的双相障碍患者与健康对照者的神经认知特征，并探讨这些人群中神经认知过程的组成结构。方法对53例经scid证实的双相障碍抑郁症患者和47例健康对照者进行注意力和执行功能、即时记忆、言语和视觉空间学习记忆和精神运动速度的认知测试。以统计学显著性、效应大小和百分位站立性来评估测试表现。采用主成分分析（PCA）探讨潜在的认知因素结构。结果多因素分析显示了整体组效应，抑郁症患者的表现明显差于对照组。患者在18/26项测试中表现明显较差，在处理速度、言语学习和特定执行/工作记忆过程测试中具有较大的效应量（d >.8）。几乎所有的测试都产生了至少一项结果测量，其中约25-50%的BD样本比对照平均值低1个标准差（s.d）以上。20%至34%的患者在工作记忆、语言学习和记忆以及精神运动/处理速度方面的表现达到或低于对照组的第五百分位数。PCA强调了两组之间的总体差异，提取的成分较少，患者特异性较低。总的来说，抑郁时BD患者的神经认知测试成绩显著降低。强调了分析认知表现的不同方法的使用，以及过程之间的关系，为未来的研究指明了重要方向。
Background Previous studies of neurocognitive performance in bipolar disorder (BD) have focused predominantly on euthymia. In this study we aimed to compare the neurocognitive profile of BD patients when depressed with healthy controls and explore the component structure of neurocognitive processes in these populations.Method Cognitive tests of attention and executive function, immediate memory, verbal and visuospatial learning and memory and psychomotor speed were administered to 53 patients with a SCID-verified diagnosis of BD depression and 47 healthy controls. Test performance was assessed in terms of statistical significance, effect size and percentile standing. Principal component analysis (PCA) was used to explore underlying cognitive factor structure.Results Multivariate analysis revealed an overall group effect, depressed BD patients performing significantly worse than controls. Patients performed significantly worse on 18/26 measures examined, with large effect sizes (d>0.8) on tests of speed of processing, verbal learning and specific executive/working memory processes. Almost all tests produced at least one outcome measure on which approximate to 25-50% of the BD sample performed at more than 1 standard deviation (s.d.) below the control mean. Between 20% and 34% of patients performed at or below the fifth percentile of the control group in working memory, verbal learning and memory, and psychomotor/processing speed. PCA highlighted overall differences between groups, with fewer extracted components and less specificity in patients.Conclusions Overall, neurocognitive test performance is significantly reduced in BD patients when depressed. The use of different methods of analysing cognitive performance is highlighted, along with the relationship between processes, indicating important directions for future research.