Department of Psychology and Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.
Department of Psychiatry, University of California San Diego, La Jolla, California.
Bipolar Disord. 2018 Nov;20(7):604-613. doi: 10.1111/bdi.12654. Epub 2018 May 18.
Schizophrenia and bipolar disorder overlap considerably. Schizophrenia is a primary psychotic disorder, whereas approximately half of people with bipolar disorder will experience psychosis. In this study, we examined the extent to which cognitive and functional impairments are related to the presence and history of psychosis across the two disorders.
A total of 633 participants with bipolar disorder I, schizophrenia, and schizoaffective disorder were recruited for a study on the genetics of cognition and functioning in bipolar disorder and schizophrenia. Participants were classified into five groups: bipolar disorder with current psychosis (N = 30), bipolar disorder with a history of psychosis (N = 162), bipolar disorder with no history of psychosis (N = 92), schizophrenia with current psychosis (N = 245), and schizophrenia with past psychosis (N = 104).
Cognitive profiles of all groups were similar in pattern; however, both current psychosis (P < .02) and a diagnosis of schizophrenia (P < .03) were associated with greater impairment. Schizophrenia with current psychosis was also associated with a superimposed severe impairment in processing speed. Both psychosis (P < .03) and schizophrenia diagnosis (P < .01) were associated with poorer functional competence. Individuals with bipolar disorder and schizophrenia experienced similar impairments in real-world functioning if they were experiencing current psychosis (P = .32).
The presence of active psychosis is an important cross-diagnostic factor in cognition and functioning in both schizophrenia and bipolar disorder. Characterization and treatment of cognition and functional deficits in bipolar disorder should consider the effects of both current and history of psychosis.
精神分裂症和双相情感障碍有很大的重叠。精神分裂症是一种原发性精神病，而大约一半的双相情感障碍患者会出现精神病。在这项研究中，我们研究了认知和功能障碍在两种疾病中的严重程度与精神病的存在和病史之间的关系。
共招募了 633 名患有 I 型双相情感障碍、精神分裂症和分裂情感障碍的参与者，参加一项关于双相情感障碍和精神分裂症认知和功能遗传学的研究。参与者分为五组：目前患有精神病的双相情感障碍（N=30）、有精神病病史的双相情感障碍（N=162）、无精神病病史的双相情感障碍（N=92）、目前患有精神病的精神分裂症（N=245）和过去患有精神病的精神分裂症（N=104）。
所有组的认知模式相似；然而，目前的精神病（P<0.02）和精神分裂症的诊断（P<0.03）都与更大的损伤有关。目前患有精神病的精神分裂症也与处理速度的严重损伤有关。精神病（P<0.03）和精神分裂症的诊断（P<0.01）都与较差的功能能力有关。如果目前患有精神病，双相情感障碍和精神分裂症患者在现实生活中的功能方面经历了类似的障碍（P=0.32）。
活跃精神病的存在是精神分裂症和双相情感障碍中认知和功能障碍的一个重要的跨诊断因素。在双相情感障碍中，对认知和功能缺陷的特征描述和治疗应考虑到当前和既往精神病的影响。
