Buoli Massimiliano, Caldiroli Alice, Caletti Elisabetta, Zugno Elisa, Altamura A Carlo
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.
Compr Psychiatry. 2014 Oct;55(7):1561-6. doi: 10.1016/j.comppsych.2014.06.001. Epub 2014 Jun 7.
A number of studies showed cognitive impairment in bipolar patients but few researches have studied the impact of mood episodes or duration of illness on neuropsychological functioning.
Cognitive functioning was examined in 110 bipolar 1 outpatients with different mood state (mania, major depression, mixed episode and euthymia). The neuropsychological battery included The Visual Search Test, Trail Making Test, Corsi Test, Frontal Assessment Battery (FAB), Cognitive Estimation Task (CET) and Tower of London and it assessed attention, memory and executive/planning functions. Failures in the different cognitive tests were compared between groups using χ(2) tests with Bonferroni's corrections. Finally a binary logistic regression was performed in order to find an eventual association between age and duration of illness and CET bizarreness.
All the symptomatic patients (manic, depressed, mixed) failed more frequently The Visual Search Test in comparison with euthymics (χ(2)=9.882, df=3, p=0.017, phi=0.30; rate of failures: manic patients 32.2%, depressed patients 30.6%, euthymics 0%, mixed patients 18.2%). CET was performed worse by manic and euthymic patients (χ(2)=10.086, df=3, p=0.015, phi=0.31; rate of failures: manic patients 46.4%, depressed patients 22.9%, euthymics 52.1%, mixed patients 18.2%). Finally, a longer duration of illness was found to be predictive of more bizarreness at CET (OR=1.06, p=0.01).
Bipolar patients present impairment in different cognitive domains even in euthymic phases. Frontal dysfunction might be associated with a long duration of illness as shown by number of bizarreness at CET in chronic bipolar patients.
多项研究显示双相情感障碍患者存在认知功能损害，但很少有研究探讨情绪发作或病程对神经心理功能的影响。
对110例处于不同情绪状态（躁狂、重度抑郁、混合发作和心境正常）的双相I型门诊患者进行认知功能检查。神经心理测试组合包括视觉搜索测试、连线测验、科西测试、额叶评估量表（FAB）、认知估计任务（CET）和伦敦塔测验，评估注意力、记忆力和执行/计划功能。使用经邦费罗尼校正的χ(2)检验比较不同组在不同认知测试中的失败情况。最后进行二元逻辑回归分析，以确定年龄、病程与CET怪异程度之间是否存在最终关联。
与心境正常者相比，所有有症状的患者（躁狂、抑郁、混合发作）在视觉搜索测试中失败的频率更高（χ(2)=9.882，自由度=3，p=0.017，φ=0.30；失败率：躁狂患者32.2%，抑郁患者30.6%，心境正常者0%，混合发作患者18.2%）。躁狂和心境正常的患者在CET上表现更差（χ(2)=10.086，自由度=3，p=0.015，φ=0.31；失败率：躁狂患者46.4%，抑郁患者22.9%，心境正常者52.1%，混合发作患者18.2%）。最后发现，病程较长可预测CET中更多的怪异表现（比值比=1.06，p=0.01）。
双相情感障碍患者即使在心境正常阶段，在不同认知领域也存在损害。如慢性双相情感障碍患者CET中的怪异表现数量所示，额叶功能障碍可能与病程较长有关。
