Aydemir Omer, Kaya Ender
Celal Bayar U Hastanesi, Psikiyatri AD, Manisa.
Turk Psikiyatri Derg. 2009 Winter;20(4):332-8.
Even in remission, cognitive deficits are frequently observed in bipolar disorder. Because these deficits are assessed with complex and comprehensive tests, they seem to be neglected in routine daily practice; however, assessing them with short self-rated questionnaires could be beneficial. This study aimed to investigate the correlation between objective and subjective cognitive assessment in bipolar disorder.
The study included 38 patients with bipolar disorder that were in remission for at least 6 months and 19 healthy controls. The Stroop Test and Auditory Verbal Learning Test were used for the objective assessment of cognitive functioning, and the cognitive functioning subscale of the Bipolar Disorder Functioning Questionnaire was used for the subjective assessment of cognitive functioning. Mood symptoms were assessed using the Hamilton Depression Rating Scale and Young Mania Rating Scale.
Based on objective assessment there were significant differences in all domains of the Auditory Verbal Learning Test between the bipolar patients and healthy controls, whereas there weren't any significant difference in Stroop Test results. Based on subjective assessment there were significant differences between the bipolar patients and healthy controls in terms of cognitive functioning subscale total score and first item score, but not in terms of the other items. When the correlation between the objective and subjective cognitive assessments was investigated, total score of the cognitive functioning subscale and 2 items--1. to run simple calculations in one's mind and 2. gathering and performing what one is asked to do--were moderately to weakly correlated with immediate recall, verbal learning, recognition, retrieval, and reading shape color. No correlation was observed between the other items of the cognitive functioning subscale.
Based on subjective assessment of cognitive functioning, the bipolar patients tended to over-estimate themselves. Furthermore, bipolar patients tended to report more deficits correlated with objective cognitive assessment when they had to display active performance, whereas they did not report cognitive deficits at this level when such a condition was not present.
即使在缓解期,双相情感障碍患者也常出现认知缺陷。由于这些缺陷需通过复杂全面的测试来评估,在日常临床实践中似乎常被忽视;然而,使用简短的自评问卷进行评估可能会有所帮助。本研究旨在探讨双相情感障碍患者客观认知评估与主观认知评估之间的相关性。
该研究纳入了38例处于缓解期至少6个月的双相情感障碍患者和19名健康对照者。采用斯特鲁普测验和听觉词语学习测验对认知功能进行客观评估,使用双相情感障碍功能问卷的认知功能分量表对认知功能进行主观评估。使用汉密尔顿抑郁量表和杨氏躁狂量表评估情绪症状。
基于客观评估,双相情感障碍患者与健康对照者在听觉词语学习测验的所有领域均存在显著差异,而在斯特鲁普测验结果方面无显著差异。基于主观评估,双相情感障碍患者与健康对照者在认知功能分量表总分和第一项得分方面存在显著差异,但在其他项目上无显著差异。在研究客观认知评估与主观认知评估之间的相关性时,认知功能分量表总分及其中两个项目(1. 在脑海中进行简单计算;2. 收集并完成所要求做的事情)与即刻回忆、词语学习、识别、提取及阅读形状颜色呈中度至弱度相关。认知功能分量表的其他项目之间未观察到相关性。
基于对认知功能的主观评估,双相情感障碍患者往往高估自己。此外,双相情感障碍患者在需要表现出积极表现时,往往报告更多与客观认知评估相关的缺陷,而在不存在这种情况时则未报告该水平的认知缺陷。