Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Viale Europa, Catanzaro 88100, Italy.
Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Viale Europa, Catanzaro 88100, Italy.
J Affect Disord. 2018 Aug 1;235:1-6. doi: 10.1016/j.jad.2018.03.010. Epub 2018 Mar 29.
The comorbidity of bipolar disorder (BD) and obsessive-compulsive disorder (OCD) has been widely described. Several studies have investigated the cognitive profiles of BD and OCD patients, but studies that compare BD, BD-OCD, and OCD patients in neuropsychological domains do not exist. The purpose of this study was to compare set-shifting, decision making, and central coherence among BD, BD-OCD, and OCD patients.
A battery of neuropsychological tests was administered to 68 patients (22 BD, 26 BD-OCD, 20 OCD). The Young Mania Rating Scale and Hamilton Depression Rating Scale were used to evaluate manic and depressive symptoms, and OCD severity was assessed with the Yale Brown Obsessive Compulsive Scale.
No significant differences emerged in decision-making and cognitive flexibility, whereas BD patients had lower scores in the Accuracy Index on Rey-Osterrieth Complex Figure Test and poor response speed on Hayling Sentence Completion Test Part A than OCD patients.
The small sample size with different BD patients, the cross-sectional design, and the study clinical nature.
The most striking result is that, contrary to our hypothesis, comorbidity does not further impair the neurocognitive profile. The clinical relevance of our work could be a shift from the current cognitive rehabilitation model focusing on individualized pathways towards a new overlapping model for all three patient groups. This could make the cognitive rehabilitation faster and less costly. Notwithstanding, these disorders do not only need cognitive training but also various psycho-educative approaches and treatment according to their different clinical profile.
双相情感障碍（BD）和强迫症（OCD）的共病现象已被广泛描述。多项研究调查了 BD 和 OCD 患者的认知特征，但在神经心理学领域比较 BD、BD-OCD 和 OCD 患者的研究尚未开展。本研究旨在比较 BD、BD-OCD 和 OCD 患者在定势转移、决策和中枢连贯方面的差异。
对 68 名患者（22 名 BD、26 名 BD-OCD、20 名 OCD）进行了一系列神经心理学测试。使用 Young 躁狂评定量表和 Hamilton 抑郁评定量表评估躁狂和抑郁症状，使用耶鲁布朗强迫症量表评估 OCD 严重程度。
在决策和认知灵活性方面无显著差异，而 BD 患者在 Rey-Osterrieth 复杂图形测试的准确性指数和 Hayling 句子完成测试 A 部分的反应速度方面的得分均低于 OCD 患者。
样本量小，BD 患者存在异质性，采用的是横断面设计，且研究具有临床性质。
最引人注目的结果是，与我们的假设相反，共病并没有进一步损害神经认知特征。本研究的临床意义可能是从当前侧重于个体化途径的认知康复模式向针对所有三组患者的新重叠模式转变。这可能会使认知康复更快、更经济。然而，这些疾病不仅需要认知训练，还需要根据其不同的临床特征采用各种心理教育方法和治疗。
