Dittmann Sandra, Hennig-Fast Kristina, Gerber Sonja, Seemüller Florian, Riedel Michael, Emanuel Severus W, Langosch Jens, Engel Rolf R, Möller Hans-Jürgen, Grunze Heinz C
Department of Psychiatry and Psychotherapy, Ludwigs-Maximilians-University, Nussbaumstr. 7, Munich 80336, Germany.
Bipolar Disord. 2008 Dec;10(8):877-87. doi: 10.1111/j.1399-5618.2008.00640.x.
There is growing evidence of cognitive impairment as a trait factor in bipolar disorder. The generalizability of this finding is limited because previous studies have either focussed exclusively on bipolar I disorder or have analysed mixed patient groups. Thus, it is still largely unknown whether bipolar II patients perform differently from bipolar I patients on measures of cognitive functioning.
A total of 65 patients with bipolar I disorder, 38 with bipolar II disorder, and 62 healthy controls participated in the study. Patients had to be euthymic for at least one month. Clinical and demographic variables were collected in a clinical interview and with the Structured Clinical Interview for DSM-IV. Cognitive functioning was assessed using a neuropsychological battery. Univariate and multivariate analyses of variance were conducted for analyzing possible differences between the groups.
The multivariate analysis of covariance (MANCOVA) indicated overall differences in neuropsychological performance between the three groups (Pillai Spur: F 1.96, p = 0.003). Post hoc comparisons revealed that patients with bipolar I disorder showed significantly lower scores in psychomotor speed, working memory, verbal learning, delayed memory, and executive functions than healthy controls. Patients with bipolar II disorder showed significant deficits in psychomotor speed, working memory, visual/constructional abilities, and executive functions compared to controls, but not on verbal learning and delayed memory. The two patient groups did not differ significantly from each other on any domain tested.
These results support a similar pattern of cognitive deficits in both subtypes of bipolar disorder.
越来越多的证据表明认知障碍是双相情感障碍的一个特质因素。这一发现的普遍性有限,因为之前的研究要么只专注于双相I型障碍,要么分析的是混合患者群体。因此,双相II型患者在认知功能测量方面与双相I型患者的表现是否不同在很大程度上仍不清楚。
共有65例双相I型障碍患者、38例双相II型障碍患者和62名健康对照者参与了该研究。患者必须至少有一个月的心境正常期。通过临床访谈和《精神疾病诊断与统计手册》第四版(DSM-IV)的结构化临床访谈收集临床和人口统计学变量。使用一套神经心理学测试评估认知功能。进行单因素和多因素方差分析以分析组间可能存在的差异。
多因素协方差分析(MANCOVA)表明三组在神经心理学表现上存在总体差异( Pillai检验值:F 1.96,p = 0.003)。事后比较显示,双相I型障碍患者在心理运动速度、工作记忆、言语学习、延迟记忆和执行功能方面的得分显著低于健康对照者。与对照组相比,双相II型障碍患者在心理运动速度、工作记忆、视觉/构建能力和执行功能方面存在显著缺陷,但在言语学习和延迟记忆方面没有。在任何测试领域,这两组患者之间均无显著差异。
这些结果支持双相情感障碍两种亚型存在相似的认知缺陷模式。