Cardoso Taiane, Bauer Isabelle E, Meyer Thomas D, Kapczinski Flavio, Soares Jair C
Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, 1941 East Road, Houston, TX, 77054, USA.
Curr Psychiatry Rep. 2015 Sep;17(9):75. doi: 10.1007/s11920-015-0605-x.
Bipolar disorder (BD) has been associated with impairments in a range of cognitive domains including attention, verbal learning, and mental flexibility. These deficits are increased during the acute phases of the illness and worsen over the course of BD. This review will examine the literature in relation to potential mechanisms associated with cognitive decline in BD. Scopus (all databases), Pubmed, and Ovid Medline were systematically searched with no language or year restrictions, up to January 2015, for human studies that collected cross-sectional and longitudinal cognitive data in adults with BD and matched healthy controls (HC). Selected search terms were "bipolar," "cognitive," "aging," "illness duration," "onset," and "progression." Thirty-nine studies satisfied the criteria for consideration. There is evidence that cognitive function in BD is negatively associated with features of illness progression such as number of mood episodes, illness duration, and hospitalizations. Aging does not appear to affect cognitive functioning to a greater extent than in HC. Furthermore, the small number of longitudinal studies in this field does not allow to reaching firm conclusion in terms of which sub-populations would be more prone to cognitive decline in BD. The decline in cognitive abilities over the course of the BD seems to be associated with the number of episodes and number of hospitalizations. No meaningful interaction of age and bipolar disorder has been found in terms of cognitive decline. Future large-scale longitudinal studies are necessary to confirm these findings and assist in the development of preventive interventions in vulnerable individuals.
双相情感障碍（BD）与一系列认知领域的损害有关，包括注意力、言语学习和心理灵活性。这些缺陷在疾病的急性期会增加，并在双相情感障碍的病程中恶化。本综述将研究与双相情感障碍认知衰退相关的潜在机制的文献。对Scopus（所有数据库）、Pubmed和Ovid Medline进行了系统检索，无语言或年份限制，截至2015年1月，检索对象为收集双相情感障碍成年患者及匹配的健康对照（HC）的横断面和纵向认知数据的人体研究。选定的检索词为“双相”、“认知”、“衰老”、“病程”、“发病”和“进展”。39项研究符合纳入标准。有证据表明，双相情感障碍的认知功能与疾病进展特征如情绪发作次数、病程和住院次数呈负相关。衰老对认知功能的影响似乎并不比健康对照更大。此外，该领域少量的纵向研究无法就哪些亚群在双相情感障碍中更易出现认知衰退得出确凿结论。双相情感障碍病程中的认知能力下降似乎与发作次数和住院次数有关。在认知衰退方面，未发现年龄与双相情感障碍之间有有意义的相互作用。未来需要进行大规模的纵向研究来证实这些发现，并协助制定针对易感个体的预防性干预措施。
