Bipolar Disord. 2014 Mar;16(2):159-71. doi: 10.1111/bdi.12154.
Although cognitive deficits are observed in the early stages of bipolar disorder, the longitudinal course of neuropsychological functioning during this period is unknown. Such knowledge could provide etiologic clues into the cognitive deficits associated with the illness, and could inform early treatment interventions. The purpose of the present study was to evaluate cognitive change in bipolar disorder in the first year after the initial manic episode.
From an initial pool of 65 newly diagnosed patients with bipolar disorder (within three months of the end of the first manic or mixed episode) and 36 demographically similar healthy participants, 42 patients [mean age 22.9 years, standard deviation (SD) = 4.0] and 23 healthy participants [mean age 22.9 years (SD = 4.9)] completed baseline, six-month, and one-year neuropsychological assessments of multiple domains including processing speed, attention, verbal and nonverbal memory, working memory, and executive function. Patients also received clinical assessments, including mood ratings.
Although patients showed consistently poorer cognitive performance than healthy individuals in most cognitive domains, patients showed a linear improvement over time in processing speed (p = 0.008) and executive function (p = 0.004) relative to the comparison group. Among patients, those without a history of alcohol/substance abuse or who were taken off an antipsychotic treatment during the study showed better improvement.
The early course of cognitive functioning in bipolar disorder is likely influenced by multiple factors. Nevertheless, patients with bipolar disorder showed select cognitive improvements in the first year after resolution of their initial manic episode. Several clinical variables were associated with better recovery, including absence of substance abuse and discontinuation of antipsychotic treatment during the study. These and other factors require further investigation to better understand their contributions to longitudinal cognitive functioning in early bipolar disorder.
尽管在双相情感障碍的早期阶段就观察到认知缺陷，但在此期间神经心理功能的纵向病程尚不清楚。这些知识可以为与该疾病相关的认知缺陷提供病因线索，并为早期治疗干预提供信息。本研究的目的是评估首发躁狂发作后第一年双相情感障碍的认知变化。
从最初的 65 名新诊断为双相情感障碍的患者（在首次躁狂或混合发作结束后三个月内）和 36 名人口统计学相似的健康参与者中，42 名患者[平均年龄 22.9 岁，标准差（SD）= 4.0]和 23 名健康参与者[平均年龄 22.9 岁（SD=4.9）]完成了基线、六个月和一年的多个领域的神经心理评估，包括处理速度、注意力、言语和非言语记忆、工作记忆和执行功能。患者还接受了临床评估，包括情绪评估。
尽管患者在大多数认知领域的认知表现均明显差于健康个体，但与对照组相比，患者在处理速度（p=0.008）和执行功能（p=0.004）方面表现出线性改善。在患者中，没有酒精/物质滥用史或在研究期间停用抗精神病药物的患者改善更好。
双相情感障碍的早期认知功能过程可能受到多种因素的影响。尽管如此，在首发躁狂发作缓解后的第一年，双相情感障碍患者的认知功能出现了一定程度的改善。几项临床变量与更好的恢复相关，包括无物质滥用和研究期间停用抗精神病药物。这些和其他因素需要进一步研究，以更好地了解它们对早期双相情感障碍纵向认知功能的贡献。
