Malloy-Diniz Leandro F, Neves Fernando Silva, Abrantes Suzana Silva Costa, Fuentes Daniel, Corrêa Humberto
Neurosciences And Neuropsychology Research Group, FUMEC University, Brazil.
J Affect Disord. 2009 Jan;112(1-3):231-6. doi: 10.1016/j.jad.2008.03.019. Epub 2008 May 16.
Neuropsychological deficits are often described in patients with bipolar disorder (BD). Some symptoms and/or associated characteristics of BD can be more closely associated to those cognitive impairments. We aimed to explore cognitive neuropsychological characteristics of type I bipolar patients (BPI) in terms of lifetime suicide attempt history.
We studied 39 BPI outpatients compared with 53 healthy controls (HC) matched by age, educational and intellectual level. All subjects were submitted to a neuropsychological assessment of executive functions, decision-making and declarative episodic memory.
When comparing BDI patients, regardless of suicide attempt history or HC, we observed that bipolar patients performed worse than controls on measures of memory, attention, executive functions and decision-making. Patients with a history of suicide attempt performed worse than non-attempters on measures of decision-making and there were a significant negative correlation between the number of suicide attempts and decision-making results (block 3 and net score). We also found significant positive correlation between the number of suicide attempts and amount of errors in Stroop Color Word Test (part 3).
The sample studied can be considered small and a potentially confounding variable - medication status - were not controlled.
Our results show the presence of neuropsychological deficits in memory, executive functions, attention and decision-making in BPI patients. Suicide attempts BPI scored worse than non-suicide attempt BPI on measures of decision-making. More suicide attempts were associated with a worse decision-making process. Future research should explore the relationship between the association between this specific cognitive deficits in BPIs, serotonergic function and suicide behavior in bipolar patients as well other diagnostic groups.
双相情感障碍（BD）患者常出现神经心理学缺陷。BD的一些症状和/或相关特征可能与这些认知障碍更为密切相关。我们旨在根据终生自杀未遂史探讨I型双相情感障碍患者（BPI）的认知神经心理学特征。
我们研究了39例BPI门诊患者，并与53名年龄、教育程度和智力水平相匹配的健康对照者（HC）进行比较。所有受试者均接受了执行功能、决策和陈述性情景记忆的神经心理学评估。
在比较BDI患者时，无论有无自杀未遂史或与HC相比，我们观察到双相情感障碍患者在记忆、注意力、执行功能和决策测量方面的表现均比对照组差。有自杀未遂史的患者在决策测量方面的表现比未尝试者差，且自杀未遂次数与决策结果（第3块和净得分）之间存在显著负相关。我们还发现自杀未遂次数与Stroop色词测验（第3部分）中的错误数量之间存在显著正相关。
所研究样本可能较小，且未控制一个潜在的混杂变量——用药状态。
我们的结果显示BPI患者在记忆、执行功能、注意力和决策方面存在神经心理学缺陷。在决策测量方面，有自杀未遂史的BPI患者得分比无自杀未遂史的BPI患者差。自杀未遂次数越多，决策过程越差。未来的研究应探讨双相情感障碍患者中这种特定认知缺陷与血清素能功能和自杀行为之间的关联，以及与其他诊断组之间的关系。
