Glahn David C, Bearden Carrie E, Barguil Marcela, Barrett Jennifer, Reichenberg Abraham, Bowden Charles L, Soares Jair C, Velligan Dawn I
Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229-3900, USA.
Biol Psychiatry. 2007 Oct 15;62(8):910-6. doi: 10.1016/j.biopsych.2007.02.001. Epub 2007 Jun 1.
Psychotic bipolar disorder may represent a neurobiologically distinct subgroup of bipolar affective illness. We sought to ascertain the profile of cognitive impairment in patients with bipolar disorder and to determine whether a distinct profile of cognitive deficits characterizes bipolar patients with a history of psychosis.
Sixty-nine outpatients with bipolar I disorder (34 with a history of psychotic symptoms and 35 with no history of psychosis) and 35 healthy comparison subjects underwent a comprehensive neurocognitive battery. All three groups were demographically matched.
Despite preserved general intellectual function, bipolar I patients overall showed moderate impairments on tests of episodic memory and specific executive measures (average effect size = .58), and moderate to severe deficits on attentional and processing speed tasks (average effect size = .82). Bipolar I patients with a history of psychosis were impaired on measures of executive functioning and spatial working memory compared with bipolar patients without history of psychosis.
Psychotic bipolar disorder was associated with differential impairment on tasks requiring frontal/executive processing, suggesting that psychotic symptoms may have neural correlates that are at least partially independent of those associated with bipolar I disorder more generally. However, deficits in attention, psychomotor speed, and memory appear to be part of the broader disease phenotype in patients with bipolar disorder.
精神病性双相情感障碍可能代表双相情感障碍中一个神经生物学上独特的亚组。我们试图确定双相情感障碍患者的认知障碍特征，并确定具有精神病病史的双相情感障碍患者是否具有独特的认知缺陷特征。
69例双相I型障碍门诊患者（34例有精神病症状病史，35例无精神病症状病史）和35名健康对照者接受了全面的神经认知测试。三组在人口统计学上相匹配。
尽管总体智力功能保持完好，但双相I型障碍患者在情景记忆测试和特定执行功能测试中总体表现出中度损害（平均效应量=.58），在注意力和处理速度任务中表现出中度至重度缺陷（平均效应量=.82）。与无精神病症状病史的双相情感障碍患者相比，有精神病症状病史的双相I型障碍患者在执行功能和空间工作记忆测量中存在损害。
精神病性双相情感障碍与需要额叶/执行功能处理的任务中的差异性损害相关，这表明精神病症状可能具有至少部分独立于更普遍的双相I型障碍相关神经关联的神经关联。然而，注意力、精神运动速度和记忆方面的缺陷似乎是双相情感障碍患者更广泛疾病表型的一部分。
