Bora Emre, Pantelis Christos
Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Victoria, Australia
Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Victoria, Australia.
Schizophr Bull. 2015 Sep;41(5):1095-104. doi: 10.1093/schbul/sbu198. Epub 2015 Jan 23.
Neurocognitive deficits are evident both in established schizophrenia and bipolar disorder (BP). However, it has been suggested that schizophrenia, but not BP, is characterized by neurodevelopmental abnormalities that can lead to cognitive deficits at the earliest stages of the illness. The aim of this meta-analytic review was to compare neurocognitive deficits in first-episode BP (FEBP) with healthy controls and first-episode schizophrenia (FES) patients. The current meta-analysis included a total of 22 adult studies and involved comparisons of 533 FEBP patients with 1417 healthy controls and 605 FEBP and 822 FES patients. FEBP patients were significantly impaired in all cognitive domains (d = 0.26-0.80) and individual tasks (d = 0.22-0.66) investigated. FES patients significantly underperformed FEBP patients in most cognitive domains (d = 0.05-0.63) and on individual tasks (d = 0.13-0.77). Neuropsychological impairment, which is comparable to chronic BP, was evident in FEBP. Similar to chronic patients, cognitive functions in FEBP lie intermediate between FES and healthy controls. Neurodevelopmental factors are likely to play a significant role not only in schizophrenia but also in BP.
神经认知缺陷在已确诊的精神分裂症和双相情感障碍（BP）中均很明显。然而，有人提出，精神分裂症而非双相情感障碍的特征是神经发育异常，这种异常可在疾病的最早阶段导致认知缺陷。本荟萃分析综述的目的是比较首发双相情感障碍（FEBP）患者与健康对照以及首发精神分裂症（FES）患者的神经认知缺陷。当前的荟萃分析共纳入了22项成人研究，涉及533例FEBP患者与1417例健康对照以及605例FEBP患者与822例FES患者的比较。FEBP患者在所研究的所有认知领域（d = 0.26 - 0.80）和各个任务（d = 0.22 - 0.66）中均有显著损害。在大多数认知领域（d = 0.05 - 0.63）和各个任务（d = 0.13 - 0.77）中，FES患者的表现明显不如FEBP患者。FEBP患者存在与慢性双相情感障碍相当的神经心理学损害。与慢性患者相似，FEBP患者的认知功能介于FES患者和健康对照之间。神经发育因素可能不仅在精神分裂症中而且在双相情感障碍中都起着重要作用。
