Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
Psychol Med. 2020 Aug;50(11):1808-1819. doi: 10.1017/S0033291719001867. Epub 2019 Aug 28.
Patients with bipolar disorder (BD) experience persistent impairments in both affective and non-affective cognitive function, which is associated with a worse course of illness and poor functional outcomes. Nevertheless, the temporal progression of cognitive dysfunction in BD remains unclear and the identification of objective endophenotypes can inform the aetiology of BD.
The present study is a cross-sectional investigation of cognitive baseline data from the longitudinal Bipolar Illness Onset-study. One hundred seventy-two remitted patients newly diagnosed with BD, 52 of their unaffected relatives (UR), and 110 healthy controls (HC) were compared on a large battery of behavioural cognitive tasks tapping into non-affective (i.e. neurocognitive) and affective (i.e. emotion processing and regulation) cognition.
Relative to HCs, patients with BD exhibited global neurocognitive deficits (ps < 0.001), as well as aberrant emotion processing and regulation (ps ⩽ 0.011); including decreased emotional reactivity to positive social scenarios, impaired ability to down-regulate positive emotion, as well as a specific deficit in the ability to recognise surprised facial expressions. Their URs also showed a trend towards difficulties identifying surprised faces (p = 0.075). No other differences in cognitive function were found for URs compared to HCs.
Neurocognitive deficits and impairments within emotion processing and regulation may be illness-related deficits of BD that present after illness-onset, whereas processing of emotional faces may represent an early risk marker of BD. However, longitudinal studies are needed to examine the association between cognitive impairments and illness progression in BD.
双相情感障碍（BD）患者在情感和非情感认知功能方面均存在持续受损，这与疾病病程恶化和功能结局较差相关。然而，BD 认知功能障碍的时间进展仍不清楚，客观内表型的识别可以为 BD 的病因提供信息。
本研究是对纵向双相情感障碍发病研究中认知基线数据的横断面调查。比较了 172 名新诊断为 BD 的缓解期患者、52 名未受影响的亲属（UR）和 110 名健康对照者（HC）在一系列行为认知任务上的表现，这些任务涉及非情感（即神经认知）和情感（即情绪处理和调节）认知。
与 HC 相比，BD 患者表现出整体神经认知缺陷（p<0.001），以及异常的情绪处理和调节（p⩽0.011）；包括对积极社交场景的情绪反应降低、无法下调积极情绪的能力受损，以及识别惊讶面部表情的特定能力缺陷。他们的 UR 也表现出识别惊讶面孔的困难趋势（p=0.075）。与 HC 相比，UR 在认知功能方面没有其他差异。
神经认知缺陷和情绪处理与调节中的缺陷可能是 BD 的疾病相关缺陷，在疾病发病后出现，而对面部情绪的处理可能代表 BD 的早期风险标志物。然而，需要进行纵向研究来检查 BD 中认知损伤与疾病进展之间的关联。
