Reinares M, Martínez-Arán A, Colom F, Benabarre A, Salamero M, Vieta E
Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona.
Actas Esp Psiquiatr. 2000 Jul-Aug;28(4):231-8.
An increasing number of studies point to the persistence of cognitive deficits in a subpopulation of euthymic bipolar disorders. Atypical antipsychotics represent an interesting alternative treatment compared with conventional neuroleptics, because the former might cause lesser affection of cognitive functions. The objective of this study was to establish, for euthymic bipolar patients who need long-term antipsychotic treatment, the neuropsychological and outcome (occupational functioning) differences between the patients treated with risperidone and the patients treated with conventional neuroleptics.
A sample of twenty RDC bipolar I and II patients were assessed by means of the SADS. All of them were euthymic (HDRS < 8; YMRS < 6) for at least 6 months and treated with antipsychotics. Patients who received risperidone (N = 11) were compared with patients who received conventional neuroleptics (N = 9) with respect to their neuropsychological profile.
There were significant differences in Trail Making Test-part B (p = 0.038) and in occupational outcome (p = 0.024), favouring patients who were treated with risperidone. There were no significant differences in other neuropsychological tests, but the patients treated with risperidone tended to score higher in most measures of cognitive performance.
Among bipolar patients who need long-term antipsychotic treatment for preventing relapses, patients who receive risperidone show more cognitive flexibility and better occupational adaptation than patients treated with conventional neuroleptics.
越来越多的研究指出,在心境正常的双相情感障碍亚群体中存在认知缺陷的持续性。与传统抗精神病药物相比,非典型抗精神病药物是一种有趣的替代治疗方法,因为前者可能对认知功能的影响较小。本研究的目的是确定,对于需要长期抗精神病药物治疗的心境正常的双相情感障碍患者,接受利培酮治疗的患者与接受传统抗精神病药物治疗的患者在神经心理学和结局(职业功能)方面的差异。
采用情感障碍和精神分裂症系统评估(SADS)对20例研究诊断标准(RDC)双相I型和II型患者进行评估。他们所有人至少6个月心境正常(汉密尔顿抑郁量表<8;杨氏躁狂量表<6)且接受抗精神病药物治疗。将接受利培酮治疗的患者(N = 11)与接受传统抗精神病药物治疗的患者(N = 9)在神经心理学特征方面进行比较。
在连线测验B部分(p = 0.038)和职业结局方面(p = 0.024)存在显著差异,接受利培酮治疗的患者更具优势。在其他神经心理学测试中没有显著差异,但接受利培酮治疗的患者在大多数认知表现测量中得分往往更高。
在需要长期抗精神病药物治疗以预防复发的双相情感障碍患者中,接受利培酮治疗的患者比接受传统抗精神病药物治疗的患者表现出更大的认知灵活性和更好的职业适应性。