İlhan Rifat Serav, Demirel Hilal, Şentürk-Cankorur Vesile
Turk Psikiyatri Derg. 2018 Fall;29(3):162-170.
The aim of this study was to investigate psychosocial functioning of euthymic Bipolar Disorder Type-II (BD-II) patients and the association between psychosocial functioning with cognitive functions and subclinical symptoms. The hypothesis was BD-II patients would have low level of psychosocial functioning comparing to healthy subjects and psychosocial functioning would be associated independently with cognitive dysfunction and subclinical symptoms.
Thirthy-three subjects who met criteria for BD-II according to Structured Clinical Interview for DSM-IV and thirty-five healthy subjects were included. Clinical symptoms were assessed by Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS); Hamilton Anxiety Rating Scale (HARS); psychosocial functioning was assessed by Functioning Assessment Short Test (FAST). Neurocognitive assessment battery was consisted of WAIS-R general information subtest; Wisconsin Card Sorting Test (WCST) perseverative errors, nonperseverative errors and category completed subtests; Trail Making Test-B (TMT-B); Stroop TBAG form; Trail Making Test-A(TMT-A) Auditory Consonant Trigrams (ACT) ACT; Wechsler Memory Scale Revised (WMS-R).
Clinical symptoms assessed by HDRS, HARS scores; psychosocial functioning scores assessed by FAST; neurocognitive functions assessed by WCST category completed and, TMT-B, Stroop test, TMT-A, ACT, and WMS-R scores were significantly different between the two groups. FAST scores were associated with ACT scores in BB-II group.
BB-II patients had cognitive dysfunctions and low level of psychosocial functioning even in their euthymic states. Working memory dysfunction was independently associated with psychosocial functioning of euthymic BB-II patients.
本研究旨在调查双相情感障碍II型(BD-II)病情缓解期患者的心理社会功能,以及心理社会功能与认知功能和亚临床症状之间的关联。研究假设为,与健康受试者相比,BD-II患者的心理社会功能水平较低,且心理社会功能会独立地与认知功能障碍和亚临床症状相关。
纳入33名根据《精神疾病诊断与统计手册》第四版结构化临床访谈符合BD-II标准的受试者和35名健康受试者。通过汉密尔顿抑郁评定量表(HDRS)、杨氏躁狂评定量表(YMRS)、汉密尔顿焦虑评定量表(HARS)评估临床症状;通过功能评估简短测试(FAST)评估心理社会功能。神经认知评估组套包括韦氏成人智力量表修订版(WAIS-R)一般信息分测验、威斯康星卡片分类测验(WCST)的持续性错误、非持续性错误和完成分类分测验、连线测验B(TMT-B)、斯特鲁普TBAG表格、连线测验A(TMT-A)、听觉辅音三联体(ACT)、韦氏记忆量表修订版(WMS-R)。
两组之间在通过HDRS、HARS评分评估的临床症状、通过FAST评估的心理社会功能评分、通过WCST完成分类以及TMT-B、斯特鲁普测验、TMT-A、ACT和WMS-R评分评估的神经认知功能方面存在显著差异。在BD-II组中,FAST评分与ACT评分相关。
BD-II患者即使在病情缓解期也存在认知功能障碍和较低水平的心理社会功能。工作记忆功能障碍与病情缓解期BD-II患者的心理社会功能独立相关。