Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, United States.
Mood and Psychosis Research Program, Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States.
J Affect Disord. 2020 Apr 1;266:194-200. doi: 10.1016/j.jad.2020.01.082. Epub 2020 Jan 21.
Evidence regarding the performance of Bipolar Disorder patients (BD) on Emotional Processing (EP) is conflicting, suggesting that heterogeneity within this population may exist. It is not completely understood if this impacts on clinical presentation and functional outcomes.
A total of 212 BD patients were recruited. Patients underwent MATRICS Consensus Cognitive Battery as well as a clinical evaluation to detect premorbid traits, comorbidities and clinical features. Performance on each basic emotion on the Emotional Recognition Task (ERT) and Reading the Mind in the Eyes Test were entered into hierarchical cluster analyses in order to determine the number of clusters and to assign subjects to specific clusters. We then compared subgroups on clinical factors and real-world community functioning.
No differences between BD patients as a group and controls were found in EP performance. Two clusters of BD patients were found, one with "intact" performance (71.2%) that performed as healthy controls (HC) and other with "impaired" performance (28.8%) performing worse than HC and schizophrenic patients on basic emotion recognition. Patients in the "impaired group" presented higher rates of childhood trauma, schizotypal traits, lower premorbid IQ and education, poor psychosocial functioning and cognitive performance.
Cross-sectional data which limits our ability to infer directionality of our findings.
These results suggest the presence of two subgroups regarding EP performance with unique clinical and neurodevelopmental profiles associated. Next steps will include using these data to identify a homogeneous group of patients to target these disabling symptoms with treatment.
关于双相情感障碍患者（BD）在情绪处理（EP）方面的表现，证据相互矛盾，这表明该人群中可能存在异质性。目前还不完全清楚这是否会影响临床表现和功能结果。
共招募了 212 名 BD 患者。患者接受了 MATRICS 共识认知电池测试以及临床评估，以检测前驱特质、共病和临床特征。将每个基本情绪在情绪识别任务（ERT）和“读心在眼”测试上的表现输入到层次聚类分析中，以确定聚类的数量，并将患者分配到特定的聚类中。然后，我们比较了临床因素和现实世界社区功能方面的亚组。
BD 患者组和对照组在 EP 表现方面没有差异。发现了两组 BD 患者，一组表现为“正常”（71.2%），表现与健康对照组（HC）相同，另一组表现为“受损”（28.8%），在基本情绪识别方面的表现比 HC 和精神分裂症患者差。“受损组”患者的童年创伤、类精神特质、较低的前驱智商和教育程度、较差的社会心理功能和认知表现发生率较高。
横断面数据限制了我们推断研究结果方向的能力。
这些结果表明，EP 表现存在两个亚组，具有独特的临床和神经发育特征。下一步将包括使用这些数据来识别一个同质的患者群体，以针对这些致残症状进行治疗。
