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近期被诊断为双相障碍个体的认知主诉:一项横断面研究。

Cognitive complaints in individuals recently diagnosed with bipolar disorder: A cross-sectional study.

机构信息

Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.

Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil.

出版信息

Psychiatry Res. 2021 Jun;300:113894. doi: 10.1016/j.psychres.2021.113894. Epub 2021 Mar 21.

Abstract

AIM

To assess the differences in subjective cognitive dysfunction between major depressive disorder (MDD) and recently diagnosed Bipolar Disorder (BD) across euthymia and mood episodes.

METHODS

This is a cross-sectional study corresponding to the second wave of a longitudinal study. The first wave consisted of subjects aged between 18 and 60 diagnosed with MDD. In the follow up after three years (second wave), conversion from MDD to BD diagnosis was assessed by qualified psychologists using the Mini International Neuropsychiatric Interview (MINI-Plus). Subjects were categorized in four diagnostic groups: euthymic MDD, MDD in a current mood episode, euthymic BD, and BD in a current mood episode. All subjects completed the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA), an instrument specifically designed for detecting subjective cognitive deficits in BD.

RESULTS

The total sample (n = 468) included 410 subjects with MDD and 58 individuals recently diagnosed with BD. We subdivided the 2 groups based on their current mood state, and found a significant difference in COBRA total scores between euthymic BD individuals (median 17.00 [IQR: 8.75 - 20.75]) and euthymic MDD subjects (median 8.00 [IRQ: 5.00 - 14.00], p = 0.002), showing higher subjective cognitive dysfunction in individuals recently diagnosed with BD. The differences remained significant after adjusting for the presence of lifetime psychotic symptoms. We found no differences between MDD and BD during an acute mood episode.

LIMITATION

The small sample size of individuals with BD.

CONCLUSION

The findings suggest a higher presence of subjective cognitive complaints among individuals recently diagnosed with BD in comparison to individuals with MDD during euthymia.

摘要

目的

评估在心境稳定期和心境发作期,重度抑郁症(MDD)和近期诊断的双相情感障碍(BD)之间主观认知功能障碍的差异。

方法

这是一项横断面研究,对应于一项纵向研究的第二波。第一波包括年龄在 18 至 60 岁之间被诊断为 MDD 的受试者。在三年后的随访(第二波)中,通过合格的心理学家使用迷你国际神经精神访谈(MINI-Plus)评估从 MDD 向 BD 诊断的转换。受试者分为四个诊断组:心境稳定期 MDD、当前心境发作期 MDD、心境稳定期 BD 和当前心境发作期 BD。所有受试者均完成了专门用于检测 BD 中主观认知缺陷的双相情感障碍认知主诉评定量表(COBRA)。

结果

总样本(n=468)包括 410 名 MDD 受试者和 58 名近期诊断为 BD 的个体。我们根据他们当前的心境状态将这 2 组细分,发现心境稳定期 BD 个体(中位数 17.00 [IQR:8.75-20.75])和心境稳定期 MDD 受试者(中位数 8.00 [IRQ:5.00-14.00])的 COBRA 总分存在显著差异,p=0.002,提示近期诊断为 BD 的个体主观认知功能障碍更高。调整了终生精神病症状的存在后,差异仍然显著。我们在急性心境发作期间未发现 MDD 和 BD 之间存在差异。

局限性

BD 个体的样本量小。

结论

研究结果表明,在心境稳定期,与 MDD 相比,近期诊断为 BD 的个体更易出现主观认知主诉。

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