Suwalska A, Borkowska A, Rybakowski J
Kliniki Psychiatrii Dorosłych AM w Poznaniu.
Psychiatr Pol. 2001 Jul-Aug;35(4):657-68.
Cognitive deficits have been viewed as being characteristic features of schizophrenia. Neuropsychological impairment has been also identified in depression and mania. Recent studies have suggested that patients with bipolar disorder do not make full recovery between episodes of illness and that neuropsychological dysfunction may persist beyond these episodes. Remitted bipolar patients performed worse on Wisconsin Card Sorting Test, Verbal fluency and Stroop Test than healthy controls, the results of the patients with affective disorders with psychotic features were comparable with those of schizophrenics. Some studies suggest an association between the course of illness and the intensity of cognitive deficits, this link was not confirmed in other reports. Imaging studies have shown the presence of white matter lesions and other abnormalities in the brains of bipolar patients. The relative reduction in cerebral tissue may contribute to neuropsychological impairment in subgroup of bipolar patients. Results of studies on the role of white matter lesions are inconsistent. Recent studies point to an association between decreased prefrontal cortex volume and cognitive disturbances. Attention is focused on hippocampus volume as well, since it is associated with cognitive deficits in bipolar disorder. Further studies are needed to elucidate whether a severe course of illness is associated with more pronounced cognitive disorders and whether presence of psychotic symptoms during the acute phase of the illness is a predictor of the occurrence of cognitive deficits in patients with bipolar affective disorder.
认知缺陷一直被视为精神分裂症的特征性表现。在抑郁症和躁狂症中也发现了神经心理学损害。最近的研究表明，双相情感障碍患者在疾病发作期间无法完全康复，并且神经心理学功能障碍可能在这些发作之后持续存在。缓解期的双相情感障碍患者在威斯康星卡片分类测验、言语流畅性和斯特鲁普测验中的表现比健康对照组差，伴有精神病性特征的情感障碍患者的结果与精神分裂症患者相当。一些研究表明疾病进程与认知缺陷的严重程度之间存在关联，但其他报告并未证实这种联系。影像学研究显示双相情感障碍患者大脑中存在白质病变和其他异常。脑组织的相对减少可能导致双相情感障碍患者亚组出现神经心理学损害。关于白质病变作用的研究结果并不一致。最近的研究指出前额叶皮质体积减小与认知障碍之间存在关联。海马体体积也受到关注，因为它与双相情感障碍中的认知缺陷有关。需要进一步研究以阐明严重的疾病进程是否与更明显的认知障碍相关，以及疾病急性期出现的精神病性症状是否是双相情感障碍患者发生认知缺陷的预测指标。
