Department of Psychiatry, Dou-Liou Branch, National Cheng Kung University Hospital, Yunlin, Taiwan.
Department of Psychology, College of Medical and Health Science, Asia University, Taichung City, Taiwan.
Brain Behav. 2020 Nov;10(11):e01813. doi: 10.1002/brb3.1813. Epub 2020 Aug 30.
Cases of patients with bipolar disorder (BD) having neuropsychological impairment have been reported, although inconsistently. The possibility of comorbidity with anxiety disorder (AD) has been suggested. The association between mood episodes and AD comorbidity on neuropsychological performance is unclear and thus was investigated in the current study.
All participants were informed about and agreed to participate in this study. Patients with BD were recruited from outpatient and inpatient settings, and healthy controls (HCs) were recruited as a comparison group. Six hundred and twenty-eight participants (175 HCs and 453 BD-56 BDI and 397 BDII) were studied based on their current mood episode, namely, depressive (BD ), manic/hypomanic (BDm), mixed (BDmix), and euthymic (BDeu), compared with/without AD comorbidity (164 with AD).
Compared to HCs, all BD groups had significantly more impaired neuropsychological profiles, but the BDeu group was found to have less impairment in memory and executive function than the episodic BD groups. The percentage of AD comorbidity in BDd, BDm, BDmix, and BDeu was 33.9%, 40.3%, 33.0%, and 35.6%, respectively (χ = 1.61, p > .05). The results show that AD plays a different role in neuropsychological impairment across various mood episodes in BD.
Memory impairment and executive dysfunction may be state-like cognitive phenotypes and are affected by AD comorbidity during mixed and depressive episodes in BD, while sustained attention deficiencies are more like trait markers, regardless of mood episodes, and persist beyond the course of the illness. The AD comorbidity effect on attentional deficit is greater when suffering from a manic episode.
尽管报道的结果并不一致，但有病例显示双相障碍（BD）患者存在神经认知障碍。也有研究提示双相障碍与焦虑障碍（AD）共病的可能性。心境发作与 AD 共病对神经认知表现的关联尚不清楚，因此本研究对此进行了调查。
所有参与者均被告知并同意参与本研究。BD 患者从门诊和住院环境中招募，健康对照者（HCs）作为对照组招募。根据当前的心境发作，即抑郁发作（BD ）、躁狂/轻躁狂发作（BDm）、混合发作（BDmix）和缓解期（BDeu），对 628 名参与者（175 名 HCs 和 453 名 BD-56 BDI 和 397 名 BDII）进行研究，并与/或不伴有 AD 共病（164 名 AD 共病）进行比较。
与 HCs 相比，所有 BD 组的神经认知评分均明显受损，但 BDeu 组在记忆和执行功能方面的损伤较发作性 BD 组轻。BDd、BDm、BDmix 和 BDeu 中 AD 共病的比例分别为 33.9%、40.3%、33.0%和 35.6%（χ ²=1.61，p>.05）。结果表明，AD 在 BD 的各种心境发作中对神经认知损害的作用不同。
记忆障碍和执行功能障碍可能是状态性认知表型，在 BD 的混合和抑郁发作期间受 AD 共病的影响，而持续性注意力缺陷更像是特质标记，与心境发作无关，并持续存在于疾病过程中。在患有躁狂发作时，AD 共病对注意力缺陷的影响更大。
