Translational Psychiatry Research Group Federal University of Ceará, Fortaleza, CE, Brazil.
Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
J Am Acad Child Adolesc Psychiatry. 2017 Apr;56(4):286-296. doi: 10.1016/j.jaac.2017.01.008. Epub 2017 Feb 2.
To perform a systematic review and meta-analysis of studies investigating neurocognition in euthymic youths with bipolar disorder (BD) compared to healthy controls (HCs).
A systematic literature search was conducted in the PubMed/MEDLINE, PsycINFO, and EMBASE databases from inception up until March 23, 2016, for original peer-reviewed articles that investigated neurocognition in euthymic youths with BD compared to HCs. Effect sizes (ES) for individual tests were extracted. In addition, results were grouped according to cognitive domain. This review complied with the PRISMA statement guidelines.
A total of 24 studies met inclusion criteria (N = 1,146; 510 with BD). Overall, euthymic youths with BD were significantly impaired in verbal learning, verbal memory, working memory, visual learning, and visual memory, with moderate to large ESs (Hedge's g 0.76-0.99); significant impairments were not observed for attention/vigilance, reasoning and problem solving, and/or processing speed. Heterogeneity was moderate to large (I ≥ 50%) for most ES estimates. Differences in the definition of euthymia across studies explained the heterogeneity in the ES estimate for verbal learning and memory. We also found evidence for other potential sources of heterogeneity in several ES estimates including co-occurring attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders, and the use of medications. In addition, the use of different neuropsychological tests appeared to contribute to heterogeneity of some estimates (e.g., attention/vigilance domain).
Euthymic youths with BD exhibit significant cognitive dysfunction encompassing verbal learning and memory, working memory, and/or visual learning and memory domains. These data indicate that for a subset of individuals with BD, neurodevelopmental factors may contribute to cognitive dysfunction.
系统评价和荟萃分析比较双相情感障碍（BD）的病情稳定青年和健康对照者（HCs）的神经认知研究。
从文献建立到 2016 年 3 月 23 日，在 PubMed/MEDLINE、PsycINFO 和 EMBASE 数据库中进行系统文献检索，以寻找比较 BD 病情稳定青年和 HCs 的神经认知的原始同行评审文章。提取个体测试的效应量（ES）。此外，根据认知域对结果进行分组。本综述符合 PRISMA 声明指南。
共有 24 项研究符合纳入标准（N=1146；510 例 BD）。总体而言，BD 的病情稳定青年在言语学习、言语记忆、工作记忆、视觉学习和视觉记忆方面明显受损，具有中到大量的 ES（Hedge's g 0.76-0.99）；在注意力/警觉性、推理和解决问题能力以及/或处理速度方面没有观察到明显的损伤。大多数 ES 估计的异质性为中到大（I≥50%）。由于研究中对病情稳定的定义不同，解释了言语学习和记忆 ES 估计的异质性。我们还发现，在几个 ES 估计中存在其他潜在的异质性来源的证据，包括注意力缺陷/多动障碍（ADHD）和焦虑障碍共病以及药物的使用。此外，不同神经心理学测试的使用似乎导致了一些估计的异质性（例如，注意力/警觉域）。
BD 的病情稳定青年表现出明显的认知功能障碍，包括言语学习和记忆、工作记忆和/或视觉学习和记忆域。这些数据表明，对于 BD 的一部分个体，神经发育因素可能导致认知功能障碍。
