Guangzhou Huiai Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China.
J Affect Disord. 2019 Jan 15;243:55-61. doi: 10.1016/j.jad.2018.05.040. Epub 2018 May 31.
Bipolar disorder (BD) II is more likely to be misdiagnosed as major depressive disorder (MDD) than other types of BD, leading to incorrect treatment and poor outcomes. Previous studies have shown inconsistent results regarding the differences in cognitive deficits between the two disorders. To eliminate the compounding effects of medication and aging, we sought to investigate changes in cognitive function in medication-naïve, non-late-life patients with BDII and MDD.
Three subject groups were enrolled: 30 depressed BDII patients, 30 depressed MDD patients and 30 healthy controls. All subjects underwent a battery of cognitive tests to assess 8 cognitive domains. The cognitive domains were compared between the three subject groups. In BDII and MDD, the effect sizes were computed as evaluation parameters, weighing the degree of the cognitive deficits and the correlations between cognitive test deficits and clinical variables were also computed.
Compared with the controls, the BDII and MDD patients were characterized by similar deficits in psychomotor speed, working memory, visual memory, attention switching and verbal fluency. Moderate to severe deficits in the majority of cognitive tests were observed in the BDII and MDD patients. Furthermore, correlations between the modified Wisconsin Card Sorting Test total errors and age of onset in the BDII patients and between correct digit span responses (backward and total) and depressive severity were found in the MDD patients.
Our findings suggest that BDII and MDD patients may suffer from similar profiles of cognitive domain deficits that may not assist in distinguishing between the two disorders. In addition, cognitive deficits may be correlated with the age of onset and depressive severity in mood disorders.
与其他类型的双相情感障碍（BD）相比，双相情感障碍 II 型（BD II）更有可能被误诊为重度抑郁症（MDD），导致治疗不当和预后不良。先前的研究表明，这两种疾病在认知缺陷方面存在不一致的结果。为了消除药物和衰老的复合作用，我们试图研究未经药物治疗的非老年期 BD II 和 MDD 患者认知功能的变化。
招募了三组受试者：30 名抑郁的 BD II 患者、30 名抑郁的 MDD 患者和 30 名健康对照者。所有受试者均接受了一系列认知测试，以评估 8 个认知领域。比较了三组受试者的认知领域。在 BD II 和 MDD 中，计算了效应量作为评估参数，衡量认知缺陷的程度，并计算了认知测试缺陷与临床变量之间的相关性。
与对照组相比，BD II 和 MDD 患者在精神运动速度、工作记忆、视觉记忆、注意力转换和言语流畅性方面表现出相似的缺陷。BD II 和 MDD 患者的大多数认知测试均表现出中度至重度缺陷。此外，在 BD II 患者中，威斯康星卡片分类测试总错误与发病年龄之间以及在 MDD 患者中，正确数字跨度反应（正向和总）与抑郁严重程度之间存在相关性。
我们的研究结果表明，BD II 和 MDD 患者可能患有相似的认知领域缺陷，这些缺陷可能无法帮助区分这两种疾病。此外，认知缺陷可能与心境障碍的发病年龄和抑郁严重程度相关。
