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双相情感障碍 II 型的神经认知障碍和社会心理功能。

Neurocognitive impairment and psychosocial functioning in bipolar II disorder.

机构信息

Bipolar Disorders Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Spain.

出版信息

Acta Psychiatr Scand. 2012 Apr;125(4):309-17. doi: 10.1111/j.1600-0447.2011.01759.x. Epub 2011 Aug 17.

Abstract

OBJECTIVE

There is a growing body of evidence on neurocognitive impairment in euthymic bipolar patients, but this issue has been studied mostly in bipolar I disorder, data on bipolar II (BD-II) are scant and discrepant. The two aims of this study were to ascertain whether strictly defined euthymic BD-II patients would present neurocognitive disturbances and to evaluate their impact on functional outcome.

METHOD

Forty-three BD-II patients and 42 demographically and educationally matched healthy subjects were assessed with a comprehensive neuropsychological test battery and with the Social and Occupational Functioning Assessment Scale (SOFAS). The euthymia criteria were reduced (Hamilton Rating Scale for Depression score ≤6 and a Young Mania Rating Scale score ≤6) to minimize the influence of subdepressive symptomatology on cognition and functioning.

RESULTS

BD-II patients showed a significantly lower performance on several measures of attention, learning and verbal memory, and executive function compared with healthy controls. The presence of subthreshold depressive symptomatology and one measure related to executive function (Trail Making Test, part B) was the variables that best predicted psychosocial functioning measured with the SOFAS.

CONCLUSION

This report provides further evidence that euthymic BD-II patients present cognitive impairment which may impact psychosocial functioning.

摘要

目的

越来越多的证据表明,轻躁期双相情感障碍患者存在神经认知障碍,但这一问题主要在双相情感障碍 I 型(BD-I)中得到研究,BD-II 的数据较少且存在差异。本研究的两个目的是确定严格定义的轻躁期 BD-II 患者是否会出现神经认知障碍,并评估其对功能结果的影响。

方法

对 43 名 BD-II 患者和 42 名在人口统计学和教育程度上相匹配的健康对照者进行了全面的神经心理学测试和社会和职业功能评估量表(SOFAS)评估。为了最大限度地减少亚抑郁症状对认知和功能的影响,将轻躁期标准降低(汉密尔顿抑郁评定量表评分≤6 和 Young 躁狂评定量表评分≤6)。

结果

BD-II 患者在注意力、学习和言语记忆以及执行功能的几个测量指标上的表现明显低于健康对照组。亚阈值抑郁症状的存在和一项与执行功能相关的测量(Trail Making Test,B 部分)是预测 SOFAS 测量的社会心理功能的最佳变量。

结论

本报告进一步证明,轻躁期 BD-II 患者存在认知障碍,可能会影响社会心理功能。

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