Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Mithatpaşa Cad. No:1606 Inciraltı Yerleskesi 35340 Balcova, Izmir, Turkey; Department of Neuroscience, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey; Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne, Australia.
Department of Psychiatry, Mardin State Hospital, Mardin, Turkey.
J Affect Disord. 2019 Oct 1;257:130-135. doi: 10.1016/j.jad.2019.07.015. Epub 2019 Jul 5.
Bipolar disorder (BD) is associated with significant cognitive heterogeneity. In recent years, a number of studies have investigated cognitive subgroups in BD using data-driven methods and found that BD includes several subgroups including a severely impaired and a neurocognitively intact cluster. Studies in offspring of BD (BDoff) are particularly important to establish the timing of emergence of cognitive subgroups but studies investigating cognitive heterogeneity in BDoff are lacking. Our aim was to investigate cognitive heterogeneity in BDoff and the relationship between cognitive heterogeneity and putative clinical stages of BD.
Seventy-one euthymic BDoff and 50 healthy controls were assessed using clinical measures and a battery of neuropsychological tests. Neurocognitive subgroups were investigated using latent class analysis.
Three neurocognitive subgroups, including a severe impairment group, a good performance cluster, and a subgroup characterized by intermediate/selective impairment was found. Both severe and intermediate level impairment subgroups underperformed healthy controls in processing speed, verbal fluency, visual memory and working memory. Deficits in verbal memory and executive functions were only evident in severe impairment subgroup. The putative stage of the illness had no significant effect on cognitive clustering of BDoff. Trait impulsivity scores were significantly increased in severe and intermediate impairment clusters but not in the cognitively good functioning subgroup of BDoff.
The cross-sectional nature of the study was the main consideration.
These results suggest that cognitive heterogeneity is premorbid characteristic of BD and cognitive subgroups of BDoff emerge prior to the onset of illness and prodromal symptoms.
双相障碍（BD）与显著的认知异质性相关。近年来，许多研究使用数据驱动的方法研究了 BD 中的认知亚组，发现 BD 包括几个亚组，包括严重受损和神经认知完整的亚组。BD 患者后代（BDoff）的研究对于确定认知亚组出现的时间特别重要，但缺乏对 BDoff 认知异质性的研究。我们的目的是调查 BDoff 中的认知异质性，以及认知异质性与 BD 假定临床阶段之间的关系。
对 71 名病情稳定的 BDoff 和 50 名健康对照者进行了临床评估和一系列神经心理测试。使用潜在类别分析研究认知亚组。
发现了三个神经认知亚组，包括严重受损组、表现良好的聚类组和以中间/选择性受损为特征的亚组。严重和中度受损亚组在处理速度、言语流畅性、视觉记忆和工作记忆方面的表现均低于健康对照组。在严重受损亚组中仅出现言语记忆和执行功能的缺陷。疾病的假定阶段对 BDoff 的认知聚类没有显著影响。严重和中度受损聚类的特质冲动分数显著增加，但在认知良好的 BDoff 亚组中则没有。
研究的横断面性质是主要考虑因素。
这些结果表明，认知异质性是 BD 的一种先存特征，BDoff 的认知亚组在疾病和前驱症状出现之前就已经出现。
