Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine Shanghai 200030, PR China.
Department of Psychology, Provincial Hospital Affiliated to Shandong University, Jinan 250021, PR China.
J Affect Disord. 2018 Oct 1;238:412-417. doi: 10.1016/j.jad.2018.05.051. Epub 2018 May 29.
The aims of this study were to investigate the differences in executive function and the relationship with clinical factors between drug-naïve patients with bipolar depression (BDD) and unipolar depression (UPD).
Drug-naïve patients with BDD, UPD and healthy controls (HC) were recruited (30 cases in each group). All patients were assessed with Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Rating Scale for Depression-17 (HAM-D), and Young Mania Rating Scale (YMRS). Executive function was evaluated by Stroop color-word test (CWT) and Wisconsin Card Sorting Test (WCST).
In the BDD group, only the CWT number of missing was higher than HCs (P = 0.047). In the UDP group, CWT number of correct was lower, CWT number of missing was higher, and the WCST indices were worse than the HC group (P < 0.05). The WCST percentage of errors (PE) and percentage of conceptual level responses (PCLR) in the UPD group were worse than the BDD group (P < 0.05). In the BDD group, no correlations between CWT and WCST indices and clinical features were detected after correcting for multiple comparisons (P > 0.05). In the UDP group, the WCST PE, PCLR, number of categories completed (CC), and the percentage of perseverative responses (PPR) were correlated to the number of mood episodes (P < 0.01).
This was a small-sample cross-sectional study. The possibility of UPD transforming to bipolar disorder (BD) in future could not be ruled out.
Our results suggested only small differences in executive function between drug-naïve patients with BDD and UPD, but in this sample only the UPD group showed differences with HCs. The executive function of drug-naïve BDD patients may be associated with duration of current depressive episode, while for UDP patients executive function indices were significantly correlated with number of mood episodes.
本研究旨在探讨初诊未用药的双相情感障碍抑郁发作（BDD）与单相抑郁障碍（UPD）患者在执行功能方面的差异及其与临床因素的关系。
招募了初诊未用药的 BDD、UPD 患者和健康对照者（HC）（每组 30 例）。所有患者均接受汉密尔顿焦虑量表（HAM-A）、汉密尔顿抑郁量表-17 项（HAM-D）和 Young 躁狂评定量表（YMRS）评估。采用 Stroop 色词测验（CWT）和威斯康星卡片分类测验（WCST）评估执行功能。
BDD 组仅 CWT 漏数高于 HC（P=0.047）。UDP 组 CWT 正确数较低，CWT 漏数较高，WCST 指标均较 HC 差（P<0.05）。UDP 组 WCST 错误率（PE）和概念化水平应答率（PCLR）较 BDD 组差（P<0.05）。BDD 组经多重比较校正后，CWT 和 WCST 指标与临床特征之间无相关性（P>0.05）。UDP 组 WCST 的 PE、PCLR、完成分类数（CC）和持续应答率（PPR）与心境发作次数呈正相关（P<0.01）。
这是一项小样本横断面研究。未来 UPD 发展为双相障碍（BD）的可能性不能排除。
我们的研究结果表明，初诊未用药的 BDD 和 UPD 患者之间的执行功能仅存在微小差异，但在本样本中仅 UPD 组与 HC 存在差异。BDD 患者的执行功能可能与当前抑郁发作的持续时间有关，而对于 UPD 患者，执行功能指标与心境发作次数显著相关。
