Levy Boaz, Manove Emily, Weiss Roger D
Department of Counseling and School Psychology, University of Massachusetts, Boston, MA 02125, USA.
Ann Clin Psychiatry. 2012 May;24(2):143-54.
This study aimed to examine cognitive recovery in patients with co-occurring bipolar disorder (BD) and alcohol dependence (AD) during remission from an acute mood disturbance.
Fifty-five adult inpatients with bipolar I disorder (BD I) completed a neuropsychological battery, mood measures, and substance abuse measures upon discharge from the hospital and at a 3-month follow-up. Analyses provided group comparisons on these measures between patients who presented with co-occurring AD (n = 21) in the year prior to hospital admission and patients without a substance use disorder (SUD; n = 34).
Multivariate analyses of variance detected group differences on measures of visual memory, verbal memory, and executive functioning, using previous number of psychiatric admissions and age of onset of BD as covariates. These differences occurred both at discharge and follow-up. Between discharge and follow-up, the group without SUD exhibited more substantial gains than the group of dually diagnosed patients on free recall of verbal and visual materials and on a measure of cognitive flexibility.
Patients with co-occurring BD and AD may suffer from more severe cognitive dysfunction and less favorable recovery of cognitive deficits than patients without SUD over the course of remission from a mood episode.
本研究旨在探讨双相情感障碍（BD）与酒精依赖（AD）共病患者在急性情绪障碍缓解期的认知恢复情况。
55名成年双相I型障碍（BD I）住院患者在出院时及3个月随访时完成了一套神经心理学测试、情绪测量和物质滥用测量。分析比较了入院前一年出现共病AD的患者（n = 21）和无物质使用障碍（SUD；n = 34）的患者在这些测量指标上的差异。
多变量方差分析发现，以既往精神科住院次数和BD发病年龄作为协变量，在视觉记忆、言语记忆和执行功能测量指标上存在组间差异。这些差异在出院时和随访时均存在。在出院至随访期间，无SUD组在言语和视觉材料的自由回忆以及认知灵活性测量指标上的改善比双重诊断组更显著。
在情绪发作缓解过程中，与无SUD的患者相比，BD与AD共病的患者可能存在更严重的认知功能障碍，且认知缺陷的恢复情况更不理想。
