Institute of Cognitive Neurology, Buenos Aires, Argentina.
Psychiatry Res. 2011 Apr 30;186(2-3):261-6. doi: 10.1016/j.psychres.2010.08.007. Epub 2010 Sep 15.
Bipolar disorder (BD) and adult attention deficit hyperactivity disorder (ADHD) usually manifest with shared clinical symptoms, proving quite challenging to thoroughly differentiate one from another. Previous research has characterized these two disorders independently, but no study compared both pathologies from a neuropsychological perspective. The aim of this study was to compare the neuropsychological profile of adult ADHD and BD with each other and against a control group, in order to understand the way in which comprehensive cognitive assessment can contribute to their discrimination as distinct clinical entities as well as their differential diagnosis. All groups were successfully matched for age, sex, years of education, and premorbid IQ. Participants were assessed with an extensive neuropsychological battery evaluating multiple domains. Compared to controls, BD patients had a poorer performance on immediate verbal memory tasks. Both clinical groups exhibited significantly lower scores than controls on the recognition phase of verbal and non-verbal memory tasks, as well as on a task of executive functioning with high working memory demand. Noticeably, however, ADHD had significantly better performance than BD on the recognition phase of both the Rey list memory task and the Rey Figure. The better performance of ADHD patients over BD may reflect the crucial role of the executive component on their memory deficits and gives empirical support to further differentiate the neuropsychological profile of BD and adult ADHD patients in clinical practice.
双相情感障碍 (BD) 和成人注意缺陷多动障碍 (ADHD) 通常表现出共同的临床症状,这使得彻底区分两者变得极具挑战性。之前的研究已经独立地对这两种疾病进行了特征描述,但没有研究从神经心理学的角度对这两种疾病进行比较。本研究旨在比较成人 ADHD 和 BD 的神经心理学特征,以了解全面认知评估如何有助于区分这两种不同的临床实体,并对其进行鉴别诊断。所有组在年龄、性别、受教育年限和预患病智商方面均成功匹配。参与者接受了广泛的神经心理学测试,评估了多个领域。与对照组相比,BD 患者在即时言语记忆任务上的表现较差。两个临床组在言语和非言语记忆任务的再认阶段以及需要高工作记忆的执行功能任务上的得分均显著低于对照组。值得注意的是,ADHD 在 Rey 列表记忆任务和 Rey 图的再认阶段的表现明显优于 BD。ADHD 患者的表现优于 BD 可能反映了执行成分对其记忆缺陷的关键作用,并为进一步区分 BD 和成人 ADHD 患者的神经心理学特征提供了临床实践中的实证支持。