Fountoulakis Konstantinos N
3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos str (1st Parodos Ampelonon str.), Pylaia, 55535 Thessaloniki, Greece.
Ann Gen Psychiatry. 2020 Sep 23;19:54. doi: 10.1186/s12991-020-00304-4. eCollection 2020.
The current paper briefly summarizes the literature on the neurocognitive deficit and its treatment in BD patients.
The material was chosen on the basis of previous systematic reviews the author has taken part in.
The data so far suggest that the deficit is qualitatively similar but quantitatively milder in comparison to schizophrenia, it is present already since the first episode, is weakly related to mood symptoms and somewhat stronger to psychotic symptoms, it probably determines much of the disability and treatment is problematic. This deficit is also present during periods of euthymia. The possible adverse effect of psychotropic medication is rather small if any at all and is confounded by the specific clinical symptoms, for which medication is used for their treatment. This is especially true concerning antipsychotics and psychotic symptoms. The origin and the etiopathogenesis of the core neurocognitive impairment remain elusive. The presence of a neurodegenerative and of a neurodevelopmental component has both data in favor and against and they are both the focus of debate.
Treatment of the neurocognitive deficit and restoration of functioning is problematic. The data are limited and treatment options are few and with a weak overall effect. Pharmacological treatments, ECT and rTMS present some hard data, while the literature is inconclusive concerning psychotherapeutic interventions.
本文简要总结了关于双相情感障碍（BD）患者神经认知缺陷及其治疗的文献。
材料是根据作者之前参与的系统评价选取的。
目前的数据表明，与精神分裂症相比，该缺陷在性质上相似，但在程度上较轻，自首次发作起就已存在，与情绪症状的关联较弱，与精神病性症状的关联稍强，它可能是导致大部分残疾的原因，且治疗存在问题。这种缺陷在心境正常期也存在。精神药物的潜在不良反应即便有也相当小，并且与使用药物治疗的特定临床症状相互混淆。在抗精神病药物和精神病性症状方面尤其如此。核心神经认知障碍的起源和病因仍不明确。神经退行性和神经发育成分的存在都有支持和反对的数据，且二者均是争论的焦点。
神经认知缺陷的治疗及功能恢复存在问题。数据有限，治疗选择少且总体效果不佳。药物治疗、电休克治疗（ECT）和重复经颅磁刺激（rTMS）有一些确切的数据，而关于心理治疗干预的文献尚无定论。
