Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.
Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan.
Psychiatry Clin Neurosci. 2021 Apr;75(4):128-137. doi: 10.1111/pcn.13191. Epub 2021 Feb 10.
This study aimed to examine the cognitive performance of patients with bipolar disorder (BD) stratified by illness phase compared to that of patients with major depressive disorder (MDD) and healthy controls.
Participants were 139 patients with BD (55 euthymic and 84 depressed), 311 patients with MDD (88 euthymic and 223 depressed), and 386 healthy controls who underwent the Wechsler Adult Intelligence Scale-Revised or the Third Edition. They were non-elderly Japanese individuals with normal estimated premorbid intelligence quotient (IQ; >90), group-matched for age, sex, and premorbid IQ.
The depressed BD group showed significantly lower scores on verbal IQ, performance IQ, full-scale IQ, and three group indexes of perceptual organization, working memory, and processing speed when compared with healthy controls (all P < 0.001). All IQs and working memory index were also significantly lower than those of the depressed MDD group. The depressed MDD group scored significantly lower than controls in performance IQ (P < 0.001), full-scale IQ, and only in the index of processing speed (P < 0.001). The euthymic BD group scored significantly lower than controls in performance IQ (P = 0.004), whereas the euthymic MDD group scored significantly lower than controls only in processing speed (P = 0.030).
Patients with BD appear to have global and more intense cognitive impairments in depressed states compared with those with MDD whose impairments seem to be apparent only in processing speed in the Wechsler Adult Intelligence Scale. Attenuated impairments appear to exist in euthymic states of both patients.
本研究旨在比较疾病相分期的双相障碍(BD)患者与单相抑郁障碍(MDD)患者和健康对照者的认知表现。
共有 139 例 BD 患者(55 例病情稳定,84 例抑郁)、311 例 MDD 患者(88 例病情稳定,223 例抑郁)和 386 例健康对照者接受韦氏成人智力量表修订版或第三版评估。他们是非老年的日本个体,具有正常的预期病前智商(IQ;>90),年龄、性别和病前 IQ 相匹配。
与健康对照组相比,抑郁相 BD 组的言语 IQ、操作 IQ、全量表 IQ 以及知觉组织、工作记忆和加工速度的三个组间指标均显著降低(均 P<0.001)。所有 IQ 和工作记忆指数均明显低于抑郁相 MDD 组。抑郁相 MDD 组在操作 IQ(P<0.001)、全量表 IQ 以及仅在加工速度指数(P<0.001)方面的得分明显低于对照组。病情稳定的 BD 组在操作 IQ(P=0.004)方面的得分明显低于对照组,而病情稳定的 MDD 组仅在加工速度(P=0.030)方面的得分明显低于对照组。
与 MDD 患者相比,BD 患者在抑郁状态下似乎存在更广泛和更严重的认知障碍,而 MDD 患者的认知障碍似乎仅在韦氏成人智力量表的加工速度方面明显。在病情稳定状态下,两种患者的认知障碍似乎都有所减轻。