Daban Claire, Martinez-Aran Anabel, Torrent Carla, Tabarés-Seisdedos Rafael, Balanzá-Martínez Vicent, Salazar-Fraile Jose, Selva-Vera Gabriel, Vieta Eduard
Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain.
Psychother Psychosom. 2006;75(2):72-84. doi: 10.1159/000090891.
More and more epidemiological, genetic and neuroimaging studies show similarities between bipolar disorder (BD) and schizophrenia (SZ). Cognitive functions are known to be highly impaired in SZ and are increasingly studied in BD. When both populations are compared, the conclusions appear to be contradictory. The purpose of this review is to help define the profile of cognitive deficits in BD and in SZ.
A systematic review of the literature of neuropsychological studies comparing BD and SZ was made, beginning in January 1990 and ending in January 2005. Thirty-eight studies met the required quality criteria and were included in this review.
Bipolar patients exhibit extensive cognitive abnormalities with a pattern of deficits that is not unique to this disease. However, when compared to schizophrenic patients, bipolar patients demonstrate a lesser degree of deficits, particularly concerning premorbid and current intelligence quotient and perhaps attention, verbal memory and executive functions. When looking into effect sizes, there seem to be different profiles even in studies finding no significant differences.
The neuropsychological differences reported between both groups could be due to the presence of psychotic features, to environmental factors (stressful events, duration of the disease and number of hospitalisations) and could also be related to differences during the neurodevelopmental phase. Further studies should confirm whether these results are truly related to different neurobiological backgrounds.
越来越多的流行病学、遗传学和神经影像学研究表明双相情感障碍（BD）与精神分裂症（SZ）之间存在相似性。众所周知，精神分裂症患者的认知功能严重受损，双相情感障碍患者的认知功能也越来越受到研究。当对这两类人群进行比较时，结论似乎相互矛盾。本综述的目的是帮助明确双相情感障碍和精神分裂症患者认知缺陷的特征。
对1990年1月至2005年1月间比较双相情感障碍和精神分裂症的神经心理学研究文献进行系统综述。38项研究符合所需的质量标准并纳入本综述。
双相情感障碍患者表现出广泛的认知异常，其缺陷模式并非该疾病所特有。然而，与精神分裂症患者相比，双相情感障碍患者的缺陷程度较轻，尤其是在病前和当前智商方面，可能还包括注意力、言语记忆和执行功能。在研究效应大小时，即使在未发现显著差异的研究中，似乎也存在不同的特征。
两组之间报告的神经心理学差异可能归因于精神病性特征的存在、环境因素（应激事件、病程和住院次数），也可能与神经发育阶段的差异有关。进一步的研究应证实这些结果是否真的与不同的神经生物学背景有关。
