Depp Colin A, Savla Gauri N, Moore David J, Palmer Barton W, Stricker John L, Lebowitz Barry D, Jeste Dilip V
Department of Psychiatry, University of California at San Diego, San Diego, CA 92161, USA.
Bipolar Disord. 2008 Sep;10(6):684-90. doi: 10.1111/j.1399-5618.2008.00601.x.
There are few longitudinal studies of neurocognition in bipolar disorder, and the short-term course of cognitive deficits in later-life bipolar disorder is unknown.
We administered a battery of neurocognitive tests, repeated 1-3 years after baseline, to 35 community-dwelling outpatients with bipolar disorder (mean age = 58), and compared their performance on a composite measure of cognitive functioning to that of demographically matched samples of normal comparison subjects (NCs; n = 35) and patients with schizophrenia (n = 35). Using regression analyses, we examined group differences in baseline performance, trajectory of change over time, and variability in performance across time. Within the bipolar group, we examined the impact of baseline severity and change in severity of psychiatric symptoms on intra-individual change in neurocognitive performance.
At baseline, the group with bipolar disorder differed in overall neurocognitive functioning from the NCs, but did not differ significantly from the schizophrenia group. The bipolar group did not differ from the NCs or schizophrenia group in the mean trajectory of change between time-points, but the bipolar patients showed more intra-individual variability over time than the NCs or schizophrenia group. In the bipolar group, change in neurocognitive function was not related to baseline or change in psychiatric symptom severity.
Middle-aged and older community-dwelling adults with bipolar disorder have greater short-term variability in level of neurocognitive functioning relative to NCs or people with schizophrenia. The developmental course of and risk factors for cognitive deficits in bipolar disorder should be examined in future longitudinal studies.
关于双相情感障碍神经认知的纵向研究较少，且老年双相情感障碍认知缺陷的短期病程尚不清楚。
我们对35名社区居住的双相情感障碍门诊患者（平均年龄 = 58岁）进行了一系列神经认知测试，并在基线后1 - 3年重复测试，将他们在认知功能综合测量上的表现与人口统计学匹配的正常对照样本（NCs；n = 35）和精神分裂症患者样本（n = 35）进行比较。通过回归分析，我们研究了基线表现、随时间变化的轨迹以及不同时间点表现的变异性方面的组间差异。在双相情感障碍组内，我们研究了基线严重程度和精神症状严重程度变化对神经认知表现个体内变化的影响。
在基线时，双相情感障碍组在整体神经认知功能上与NCs不同，但与精神分裂症组无显著差异。双相情感障碍组在各时间点之间的平均变化轨迹上与NCs或精神分裂症组无差异，但双相情感障碍患者随时间的个体内变异性比NCs或精神分裂症组更大。在双相情感障碍组中，神经认知功能的变化与基线或精神症状严重程度的变化无关。
相对于NCs或精神分裂症患者，社区居住的中老年双相情感障碍成年人在神经认知功能水平上具有更大的短期变异性。双相情感障碍认知缺陷的发展过程和危险因素应在未来的纵向研究中进行考察。
