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应用情感障碍认知简要评估方法区分双相情感障碍和单相抑郁。

Differentiating bipolar disorders from unipolar depression by applying the Brief Assessment of Cognition in Affective Disorders.

机构信息

Department of Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan.

Department of Child and Adolescent Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan.

出版信息

Psychol Med. 2018 Apr;48(6):929-938. doi: 10.1017/S003329171700229X. Epub 2017 Aug 22.

Abstract

BACKGROUND

Scholars continue to argue about whether bipolar disorders (BD) and unipolar depression (UD) are distinguishable with regard to neurocognitive function. This study aims to explore the cognitive profiles of UD and BD by applying the Brief Assessment of Cognition in Affective Disorders (BAC-A) for neuropsychological assessment.

METHOD

This cross-sectional study included 68 patients with UD, 67 patients with BD, and 135 healthy control subjects. We evaluated the participants' cognitive functions at euthymic status using the BAC-A, which is made up of six traditional cognitive subtests and the Affective Processing Test. We then used a discriminant function analysis (DFA) to determine whether cognitive performance can be used to distinguish these participant groups.

RESULTS

Healthy controls demonstrated better performance in all subtests of the BAC-A than both the UD and BD patients, with the exception of delayed recognition of affective interference. Compared with the BD group, the UD group exhibited better performance in working memory and emotion inhibition. Furthermore, using all BAC-A indexes, a total of 70% of participants could be correctly classified using a DFA model, and the discriminating validity between UD and BD was superior to using either the traditional cognitive domains or the Affective Processing Test alone.

CONCLUSIONS

We have found that UD patients may exhibit an intermediate performance between healthy subjects and BD patients in working memory and emotional inhibition tests. The BAC-A can potentially assist in differentiating BD patients from UD patients at euthymic status in clinical settings.

摘要

背景

学者们对于双相情感障碍(BD)和单相抑郁(UD)在神经认知功能方面是否可区分仍存在争议。本研究旨在通过应用Brief Assessment of Cognition in Affective Disorders(BAC-A)进行神经心理学评估,探讨 UD 和 BD 的认知特征。

方法

本横断面研究纳入了 68 例 UD 患者、67 例 BD 患者和 135 名健康对照者。我们在病情稳定时使用 BAC-A 评估参与者的认知功能,该测试由六个传统认知子测试和情感加工测试组成。然后,我们使用判别函数分析(DFA)来确定认知表现是否可用于区分这些参与者群体。

结果

健康对照组在 BAC-A 的所有子测试中均表现优于 UD 和 BD 患者,除了情感干扰的延迟识别。与 BD 组相比,UD 组在工作记忆和情绪抑制方面表现更好。此外,使用所有 BAC-A 指标,DFA 模型可正确分类 70%的参与者,并且 UD 和 BD 之间的判别有效性优于使用传统认知域或情感加工测试单独使用。

结论

我们发现 UD 患者在工作记忆和情绪抑制测试中可能表现出介于健康受试者和 BD 患者之间的中间表现。在临床环境中,BAC-A 可能有助于区分病情稳定的 BD 患者和 UD 患者。

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