Tatay-Manteiga Amparo, Correa-Ghisays Patricia, Cauli Omar, Kapczinski Flavio P, Tabarés-Seisdedos Rafael, Balanzá-Martínez Vicent
Department of Psychiatry, General University Hospital Consortium of Valencia, Valencia, Spain.
Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
Front Psychiatry. 2018 Dec 19;9:709. doi: 10.3389/fpsyt.2018.00709. eCollection 2018.
Bipolar disorder (BD) is associated with significant neurocognitive and functional impairment, which may progress across stages. The 'latent stage' of BD remains understudied. This cross-sectional study assessed staging, neurocognition and social functioning among BD patients and their healthy siblings. Four groups were included: euthymic type I BD patients in the early ( = 25) and late ( = 23) stages, their healthy siblings (latent stage; = 23) and healthy controls ( = 21). All 92 subjects underwent a comprehensive neuropsychological battery of processing speed, verbal learning/memory, visual memory, working memory, verbal fluency, executive cognition, and motor speed. Social functioning was assessed using the FAST scale. Siblings' social functioning was identical to that of controls, and significantly better than both early- ( < 0.005) and late- ( < 0.001) stage patients. Although all patients were strictly euthymic, those at late stages had a significantly worse social functioning than early-stage patients ( < 0.001). Compared to controls, increasingly greater neurocognitive dysfunction was observed across stages of BD ( = 1.59; = 0.005). Healthy siblings' performance lied between those of controls and patients, with deficits in tasks of processing speed, executive attention, verbal memory/learning, and visual memory. Both early- and late-stage patients had a more severe and widespread dysfunction than siblings, with no significant differences between them. Genetic vulnerability to BD-I seems to be associated with neurocognitive impairments, whereas social dysfunction would be the result of the clinical phenotype. Staging models of BD should take into account these divergent findings in the latent stage.
双相情感障碍（BD）与显著的神经认知和功能损害相关，且这种损害可能会在各个阶段进展。BD的“潜在阶段”仍未得到充分研究。这项横断面研究评估了BD患者及其健康同胞的分期、神经认知和社会功能。研究纳入了四组：处于早期（n = 25）和晚期（n = 23）的I型双相情感障碍心境正常患者、他们的健康同胞（潜在阶段；n = 23）以及健康对照者（n = 21）。所有92名受试者都接受了一套全面的神经心理学测试，包括处理速度、言语学习/记忆、视觉记忆、工作记忆、言语流畅性、执行认知和运动速度。使用功能评估筛查量表（FAST）评估社会功能。同胞的社会功能与对照组相同，且显著优于早期（p < 0.005）和晚期（p < 0.001）阶段的患者。尽管所有患者均处于严格的心境正常状态，但晚期患者的社会功能明显比早期患者差（p < 0.001）。与对照组相比，在BD的各个阶段观察到越来越严重的神经认知功能障碍（F = 1.59；p = 0.005）。健康同胞的表现介于对照组和患者之间，在处理速度、执行注意力、言语记忆/学习和视觉记忆任务方面存在缺陷。早期和晚期患者都比同胞有更严重、更广泛的功能障碍，且两者之间无显著差异。BD-I的遗传易感性似乎与神经认知障碍有关，而社会功能障碍则是临床表型的结果。BD的分期模型应考虑潜在阶段的这些不同发现。
