Affective symptoms and intra-individual variability in the short-term course of cognitive functioning in bipolar disorder.
Affective symptoms and intra-individual variability in the short-term course of cognitive functioning in bipolar disorder.
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DOI：
10.1017/s0033291711002662
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发表时间：
2012-07
影响因子：
6.9
通讯作者：
Palmer, B. W.
中科院分区：
文献类型：
--
作者：
Depp, C. A.;Savla, G. N.;de Dios, L. A. Vergel;Mausbach, B. T.;Palmer, B. W.
关键词：
很少有研究探讨双相情感障碍 (BD) 认知障碍的短期过程。关键问题是症状的轨迹是否与认知功能共变，以及双相情感障碍是否与个体内认知能力变异性增加有关。 42 名 BD 门诊患者和 49 名正常对照 (NC) 受试者在基线、第 6、12 和 26 周接受了一系列神经心理学测试，同时对抑郁和躁狂症状的严重程度进行了评级。混合效应回归用于模拟时间、诊断和症状严重程度与综合认知表现之间的关系。计算每个受试者随时间变化的认知功能的人内差异。 BD 患者在不同时间点的认知能力表现明显较差，但两组患者的认知表现在重复评估中均表现出显着改善（与预期的实践效果一致）。与 NC 相比，BD 与认知能力的个体内部变异性显着相关； BD 受试者的个体差异与基线认知能力呈负相关，但 NC 受试者则不然。情感症状随时间的变化并不能预测认知能力的变化。 BD 患者情感症状的中度变化与认知能力不相关。 BD 个体内变异性升高的发现可能会降低观察和治疗研究中估计认知能力轨迹的能力。
Few studies have examined the short-term course of cognitive impairments in bipolar disorder (BD). Key questions are whether trajectories in symptoms covary with cognitive function and whether BD is associated with increased intra-individual variability in cognitive abilities. Forty-two out-patients with BD and 49 normal comparison (NC) subjects were administered a battery of neuropsychological tests at baseline, 6, 12 and 26 weeks, along with concurrent ratings of depressive and manic symptom severity. Mixed-effects regressions were used to model relationships between time, diagnosis and symptom severity on composite cognitive performance. Within-person variance in cognitive functioning across time was calculated for each subject. BD patients had significantly worse performance in cognitive ability across time points, but both groups showed significant improvement in cognitive performance over repeated assessments (consistent with expected practice effects). BD was associated with significantly greater intra-individual variability in cognitive ability than NCs; within-person variation was negatively related to baseline cognitive ability in BD but not NC subjects. Changes in affective symptoms over time did not predict changes in cognitive ability. Moderate changes in affective symptoms did not covary with cognitive ability in BD. The finding of elevated intra-individual variability in BD may reduce capacity to estimate trajectories of cognitive ability in observational and treatment studies.