Department of Psychiatry, University of Oxford, Warneford Hospital, UK.
Bipolar Disord. 2010 Sep;12(6):606-15. doi: 10.1111/j.1399-5618.2010.00859.x.
Bipolar disorder is associated with abnormalities in emotional processing that persist into periods of remission. However, studies of euthymic bipolar disorder patients may be confounded by the experience of mood episodes and medication. We therefore assessed an adolescent group for vulnerability markers associated with the bipolar phenotype.
The Mood Disorder Questionnaire (MDQ) is a screening tool for bipolar disorder that targets mood-elevation symptoms. We selected 32 high-scoring students (≥ 7 symptoms) with the adolescent bipolar phenotype and 30 low-scoring controls (≤ 3 symptoms) and screened them with the Mini International Neuropsychiatric Interview-Plus for bipolar disorder and other psychiatric disorders. We investigated emotional processing by assessing facial expression recognition, emotional memory, emotion-potentiated startle, and a dot-probe task.
Of the high-MDQ participants, 12 were in remission from bipolar disorder defined by DSM-IV-TR and interview (bipolar II disorder/bipolar disorder not otherwise specified) and 3 from major depressive disorder. High-MDQ participants had higher levels of neuroticism, low mood, and lifetime anxiety comorbidity and alcohol dependence compared with low-MDQ participants. The high-MDQ group showed facilitated recognition of surprised and neutral facial expressions and enhanced processing of positive versus negative information in emotional recognition memory and emotion-potentiated startle. There were no effects on emotional categorisation/recall memory or attentional bias in the dot-probe task.
These results suggest that students with the common adolescent bipolar phenotype show positive emotional processing biases despite increased levels of neuroticism, low mood, and anxiety. Such effects may represent a psychological vulnerability marker associated with the bipolar phenotype.
双相情感障碍与情绪处理异常有关，这些异常在缓解期仍持续存在。然而，双相情感障碍缓解期患者的研究可能受到情绪发作和药物治疗经历的影响。因此，我们评估了一组青少年患者，以寻找与双相情感障碍表型相关的易患标记物。
心境障碍问卷（MDQ）是一种用于筛查双相情感障碍的工具，其目标是情绪升高症状。我们选择了 32 名具有青少年双相情感障碍表型的高得分学生（≥ 7 项症状）和 30 名低得分对照者（≤ 3 项症状），并用 Mini 国际神经精神访谈-Plus 对他们进行双相情感障碍和其他精神障碍的筛查。我们通过评估面部表情识别、情绪记忆、情绪增强的惊跳反应和点探测任务来研究情绪处理。
在高 MDQ 参与者中，12 人符合 DSM-IV-TR 和访谈定义的缓解期双相情感障碍（双相 II 障碍/未特定的双相情感障碍），3 人符合缓解期重性抑郁障碍。与低 MDQ 参与者相比，高 MDQ 参与者具有更高的神经质、低情绪、终生焦虑共病和酒精依赖水平。高 MDQ 组在识别惊讶和中性面部表情方面表现出更高的识别能力，在情绪识别记忆和情绪增强的惊跳反应中表现出对正性信息的加工增强。在点探测任务中，没有情绪分类/回忆记忆或注意力偏向的影响。
这些结果表明，具有常见青少年双相情感障碍表型的学生尽管存在神经质、低情绪和焦虑水平升高，但表现出积极的情绪处理偏向。这些效应可能代表与双相情感障碍表型相关的心理易患标记物。
