Olvet Doreen M, Burdick Katherine E, Cornblatt Barbara A
Zucker Hillside Hospital, Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, New York, NY, USA.
Cogn Neuropsychiatry. 2013;18(1-2):129-45. doi: 10.1080/13546805.2012.724193. Epub 2012 Nov 9.
The importance of early intervention strategies has recently been recognised in the field of psychiatry. Although early intervention strategies in schizophrenia have been extensively studied, recent efforts to identify individuals who are at increased risk for other disorders, such as bipolar disorder, have gained significant interest. There is some available data to suggest that cognitive deficits may precede the onset of mania; therefore, it would be beneficial to identify cognitive predictors of bipolar disorder in an effort to facilitate early intervention.
We conducted a literature review of conscript, cohort, high-risk, family-based and first-episode mania studies that assessed neurocognition in order to ascertain potential cognitive predictors of bipolar disorder.
There is little evidence that individuals at risk for bipolar disorder exhibit deficits in global measures of neurocognition, such as IQ. However, deficits in specific neurocognitive domains, including verbal memory and executive function, appear to represent potential predictors of bipolar disorder.
These conclusions are preliminary; however, they provide a starting point for future work. Additional efforts towards understanding both the clinical and cognitive prodrome will be important in elucidating the pathophysiology of bipolar disorder.
早期干预策略在精神病学领域的重要性最近已得到认可。尽管精神分裂症的早期干预策略已得到广泛研究,但最近识别其他疾病(如双相情感障碍)风险增加个体的努力引起了极大关注。有一些现有数据表明认知缺陷可能先于躁狂发作;因此,识别双相情感障碍的认知预测因素以促进早期干预将是有益的。
我们对评估神经认知的征兵、队列、高危、基于家庭和首发躁狂研究进行了文献综述,以确定双相情感障碍的潜在认知预测因素。
几乎没有证据表明双相情感障碍风险个体在神经认知的整体测量(如智商)方面存在缺陷。然而,特定神经认知领域的缺陷,包括言语记忆和执行功能,似乎代表了双相情感障碍的潜在预测因素。
这些结论是初步的;然而,它们为未来的工作提供了一个起点。进一步努力理解临床和认知前驱症状对于阐明双相情感障碍的病理生理学将很重要。