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未用药的单相抑郁症和双相II型抑郁症患者的神经认知功能的不同特征。

Distinct profiles of neurocognitive function in unmedicated unipolar depression and bipolar II depression.

作者信息

Taylor Tavares Joana V, Clark Luke, Cannon Dara M, Erickson Kristine, Drevets Wayne C, Sahakian Barbara J

机构信息

Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, United Kingdom.

出版信息

Biol Psychiatry. 2007 Oct 15;62(8):917-24. doi: 10.1016/j.biopsych.2007.05.034. Epub 2007 Sep 7.

Abstract

BACKGROUND

Studies have demonstrated neuropsychological deficits across a variety of cognitive domains in depression. Few studies have directly compared depressed subjects with major depressive disorder (MDD) and bipolar disorder (BD), and many are confounded by medication status across subjects. In this study, we compared the performance of unmedicated currently depressed MDD and BD groups on a battery of neuropsychological tests that included measures of risk taking and reflection impulsivity.

METHODS

Twenty-two MDD, seventeen BDII, and 25 healthy control subjects (HC), matched for age and IQ, were assessed on a battery of neuropsychological tests.

RESULTS

The depressed groups showed comparable ratings of depression severity and age of illness onset. The MDD group was impaired on tests of spatial working memory and attentional shifting, sampled less information on a test of reflection impulsivity, and was oversensitive to loss trials on a decision-making test. The BDII subjects were generally intact and did not differ significantly from control subjects on any test.

CONCLUSIONS

These data indicate differing profiles of cognitive impairment in unmedicated depressed MDD versus BDII subjects. Moderately depressed BDII subjects displayed relatively intact cognitive function, whereas MDD subjects demonstrated a broader range of executive impairments. These cognitive deficits in depression were not attributable to current medication status.

摘要

背景

研究表明抑郁症患者在多种认知领域存在神经心理学缺陷。很少有研究直接比较重度抑郁症(MDD)和双相情感障碍(BD)的抑郁患者,而且许多研究因受试者的用药情况而混淆。在本研究中,我们比较了未用药的当前抑郁的MDD组和BD组在一系列神经心理学测试中的表现,这些测试包括冒险和反射冲动性测量。

方法

对22名MDD患者、17名II型双相情感障碍患者和25名年龄及智商匹配的健康对照者(HC)进行了一系列神经心理学测试。

结果

抑郁组的抑郁严重程度评分和发病年龄相当。MDD组在空间工作记忆和注意力转移测试中受损,在反射冲动性测试中获取的信息较少,并且在决策测试中对损失试验过度敏感。II型双相情感障碍受试者总体上功能正常,在任何测试中与对照受试者均无显著差异。

结论

这些数据表明未用药的抑郁MDD患者与II型双相情感障碍患者的认知障碍情况不同。中度抑郁的II型双相情感障碍受试者表现出相对完整的认知功能,而MDD患者表现出更广泛的执行功能障碍。抑郁症中的这些认知缺陷并非归因于当前的用药情况。

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