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轻躁期单相抑郁障碍和双相障碍的神经心理学特征。 比较研究的系统文献回顾。

Neuropsychological profiles of major depressive disorder and bipolar disorder during euthymia. A systematic literature review of comparative studies.

机构信息

Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; Hospital de Emergencias Psiquiátricas Torcuato de Alvear, Buenos Aires, Argentina; Department of Pharmacology, University of Buenos Aires, Buenos Aires, Argentina.

Hospital de Emergencias Psiquiátricas Torcuato de Alvear, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.

出版信息

Psychiatry Res. 2017 Feb;248:127-133. doi: 10.1016/j.psychres.2016.12.031. Epub 2016 Dec 24.

Abstract

Bipolar disorder and major depressive disorder have been shown to be associated with neurocognitive abnormalities during periods of clinical remission. However, at present, there is no consensus on whether these disorders have distinctive cognitive profiles. The aim of this study was to provide an updated systematic review of studies comparing neuropsychological functioning between bipolar disorder and major depressive disorder during remission. Main findings included the following: 1) no differences regarding performances in measures of attention and processing speed, executive functions and theory of mind were found between both patient groups and 2) regarding verbal memory, preliminary evidence points towards a more defective performance in patients with bipolar disorder than those with major depressive disorder. However, several variables with negative impact on cognition (medication status, age at onset, premorbid IQ, bipolar subtype, among others) were not adequately controlled in most studies. In conclusion, evidence from studies exploring neuropsychological profiles in bipolar disorder and major depressive disorder could not provide clues to differentiate these mood disorders. Larger studies with adequate control of confounding variables would be necessary to elucidate if the finding of more defective verbal memory performance in bipolar disorder is truly explained by distinct underlying mechanisms.

摘要

双相情感障碍和重度抑郁症在临床缓解期表现出与神经认知异常相关。然而,目前尚不清楚这些障碍是否具有独特的认知特征。本研究旨在对比较双相情感障碍和重度抑郁症缓解期神经心理功能的研究进行更新的系统评价。主要发现包括:1)在注意力和处理速度、执行功能和心理理论的测量中,两组患者之间没有差异;2)在言语记忆方面,初步证据表明双相情感障碍患者的表现比重度抑郁症患者更差。然而,大多数研究没有充分控制对认知有负面影响的几个变量(药物状态、发病年龄、学前智商、双相情感障碍亚型等)。总之,对双相情感障碍和重度抑郁症神经心理特征进行研究的证据不能为区分这些心境障碍提供线索。需要更大规模的研究,充分控制混杂变量,以阐明双相情感障碍患者言语记忆表现更差的发现是否真的由不同的潜在机制所解释。

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