Srivastava Chhitij, Bhardwaj Anupam, Sharma Mukul, Kumar Sanjay
Department of Child and Adolescent Psychiatry, Cambridge and Peterborough Foundation Trust, Cambridge.
Woodlands Resource Centre-Fylde Adult Community Mental Health Team, Lancashire Care NHS Trust, Lytham St Annes.
J Nerv Ment Dis. 2019 Feb;207(2):100-105. doi: 10.1097/NMD.0000000000000920.
Cognitive deficits have been demonstrated in people in the euthymic phase of bipolar disorder. This cross-sectional study compared euthymic bipolar disorder patients (n = 30) with never psychiatrically ill controls (n = 30) on a neuropsychological test battery containing tasks of executive function, the Wisconsin Card Sorting Test (WCST), attention and working memory, digits forward and backward, and speed of information processing digit symbol. Scores on the Mini-Mental State Examination (MMSE) and vocabulary test did not differ between the groups. The bipolar group was significantly impaired compared with controls on various indices of executive function on the WCST and on the digit tests. The impaired performance on the digit tests, but not the WCST, was significantly associated with medication status, notably prescribed benzodiazepines. There was no significant effect of severity or course of illness on performance. The findings support the hypothesis that impairments in executive function are present between illness episodes in bipolar disorder, and so they are not simply state markers.
在双相情感障碍的心境正常阶段，人们已被证实存在认知缺陷。这项横断面研究在一组包含执行功能任务（威斯康星卡片分类测验，即WCST）、注意力和工作记忆（顺背和倒背数字）以及信息处理速度（数字符号）的神经心理测试组合上，对30名心境正常的双相情感障碍患者和30名从未患过精神疾病的对照者进行了比较。两组在简易精神状态检查表（MMSE）和词汇测试中的得分没有差异。与对照组相比，双相情感障碍组在WCST的各种执行功能指标以及数字测试上明显受损。数字测试中的表现受损（而非WCST）与用药情况显著相关，尤其是开具的苯二氮䓬类药物。疾病的严重程度或病程对表现没有显著影响。这些发现支持了这样一种假设，即双相情感障碍在发作间期存在执行功能障碍，因此它们并非仅仅是状态标记物。
