Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China.
Sci Rep. 2018 Jan 30;8(1):1905. doi: 10.1038/s41598-018-20295-3.
Cognition dysfunction may reflect trait characteristics of bipolarity but cognitive effects of medications have confounded previous comparisons of cognitive function between bipolar II and unipolar depression, which are distinct clinical disorders with some overlaps. Therefore, we examined the executive function (WCST), attention, cognitive speed (TMT-A) and memory (CAVLT, WMS-Visual reproduction) of 20 treatment-naïve bipolar II patients (BPII), 35 treatment-naïve unipolar depressed (UD) patients, and 35 age/sex/education matched healthy controls. The subjects were young (aged 18-35), and had no history of psychosis or substance use, currently depressed and meeting either RDC criteria for Bipolar II Disorder or DSM-IV-TR criteria for Major Depressive Disorder. The patients were moderately depressed (MADRS) and anxious(HAM-A), on average within 3.44 years of illness onset. Sociodemographic data and IQ were similar between the groups. UD patients had significantly slower cognitive speed and cognitive flexibility (WCST perseverative error). BPII depressed patients showed relatively intact cognitive function. Verbal memory (CAVLT List A total) correlated with illness chronicity only in BPII depression, but not UD. In conclusion, young and treatment-naïve BPII depressed patients differed from unipolar depression by a relatively intact cognitive profile and a chronicity-cognitive correlation that suggested a stronger resemblance to Bipolar I Disorder than Unipolar Depression.
认知功能障碍可能反映了双相情感障碍的特质特征，但药物对认知的影响使之前对双相情感障碍 II 型和单相抑郁之间认知功能的比较变得复杂，这两种疾病是截然不同的临床障碍，有一些重叠。因此，我们检查了 20 名未经治疗的双相情感障碍 II 型患者（BPII）、35 名未经治疗的单相抑郁患者（UD）和 35 名年龄/性别/教育匹配的健康对照组的执行功能（WCST）、注意力、认知速度（TMT-A）和记忆（CAVLT、WMS-视觉再现）。受试者年龄在 18-35 岁之间，没有精神病或物质使用史，目前抑郁，符合双相情感障碍 II 型的 RDC 标准或 DSM-IV-TR 标准的单相抑郁障碍。患者平均处于发病后 3.44 年内，处于中度抑郁（MADRS）和焦虑（HAM-A）状态。社会人口统计学数据和智商在各组之间相似。UD 患者的认知速度和认知灵活性（WCST 持续错误）明显较慢。BPII 抑郁患者表现出相对完整的认知功能。言语记忆（CAVLT 列表 A 总数）仅与 BPII 抑郁的疾病慢性相关，而与 UD 无关。总之，年轻且未经治疗的 BPII 抑郁患者与单相抑郁的区别在于相对完整的认知特征，以及与疾病慢性相关的认知相关性，这表明与单相抑郁相比，与双相 I 型障碍更为相似。
