Division of Geriatric Psychiatry, University Hospitals of Geneva and Faculty of Medicine of the University of Geneva, 2 chemin du Petit Bel-Air, 1225 Chêne-Bourg, Switzerland.
J Neurol Sci. 2010 Dec 15;299(1-2):24-9. doi: 10.1016/j.jns.2010.08.045. Epub 2010 Sep 18.
Previous studies revealed that acute depressive episodes are associated with both cognitive deficits and modified personality patterns in late life. Whether or not these psychological changes are present after remission remains a matter of debate. To date, no study provided concomitant assessment of cognition and psychological functions in this particular clinical setting.
Using a cross-sectional design, 58 remitted outpatients (36 with unipolar early-onset depression (EOD) and 22 with bipolar disorder (BD)) were compared to 62 healthy controls. Assessment included detailed neurocognitive measures and evaluation of the five factor personality dimensions (NEO-Personality Inventory).
Group comparisons revealed significant slower processing speed, working and episodic memory performances in BD patients. EOD patients showed cognitive abilities comparable to those of elderly controls. In NEO PI assessment, both BD and EOD patients displayed higher Depressiveness facet scores. In addition, the EOD but not BD group had lower Extraversion factor, and Warmth and Positive Emotion facet scores than controls.
After remission from acute affective symptoms, older BD patients show significant impairment in several cognitive functions while neuropsychological performances remained intact in elderly patients with EOD. Supporting a long-lasting psychological vulnerability, EOD patients are more prone to develop emotion-related personality trait changes than BD patients.
先前的研究表明，急性抑郁发作与晚年的认知缺陷和人格模式改变有关。这些心理变化在缓解后是否存在仍然存在争议。迄今为止，没有研究在这种特殊的临床环境中同时评估认知和心理功能。
采用横断面设计，将 58 名缓解的门诊患者（36 名单相早发性抑郁（EOD）和 22 名双相障碍（BD）患者）与 62 名健康对照者进行比较。评估包括详细的神经认知测量和五个因素人格维度（NEO 人格量表）的评估。
组间比较显示，BD 患者的处理速度、工作记忆和情景记忆表现明显较慢。EOD 患者的认知能力与老年对照组相当。在 NEO PI 评估中，BD 和 EOD 患者的抑郁性因子评分均较高。此外，EOD 组而非 BD 组的外向性因子以及温暖和积极情绪因子评分低于对照组。
在急性情感症状缓解后，老年 BD 患者在几种认知功能上存在明显的损害，而 EOD 老年患者的神经心理学表现仍保持完整。支持长期存在的心理脆弱性，EOD 患者比 BD 患者更容易出现与情绪相关的人格特质变化。
