da Silva Rafael de Assis, Tancini Marcelo Baggi, Lage Renata, Nascimento Rodrigo L, Santana Cristina M T, Landeira-Fernandez J, Nardi Antonio Egidio, Cheniaux Elie, Mograbi Daniel C
Department of Psychology, Pontifícia Universidade Católica-Rio, Rio de Janeiro, Brazil.
School of Medicine and Surgery, Federal University of the State of Rio de Janeiro (Unirio), Rio de Janeiro, Brazil.
Front Psychiatry. 2021 May 7;12:641221. doi: 10.3389/fpsyt.2021.641221. eCollection 2021.
Autobiographical memory is essential to ground a sense of self-identity, contributing to social functioning and the development of future plans, and being an essential source for the psychiatric interview. Previous studies have suggested loss of autobiographical episodic specificity in unipolar depression, but relatively fewer investigations have been conducted in bipolar disorder (BD) patients, particularly across different mood states. Similarly, there is a scarcity of systematic investigations about mood-congruent and mood-dependent memory in relation to autobiographical memory in BD. Considering this, a total of 74 patients with BD (24 in euthymia, 26 in mania, and 24 in depression) responded with autobiographical memories to cue words belonging to four categories: mania, depression, BD, and neutral. Episodic specificity was scored according to the Autobiographical Interview, with high intra- and inter-rater reliability. Results indicated that patients in mania generally re-experience more episodic details than those in depression. Depressed bipolar patients reported fewer details of perception and less time integration of memories than those in euthymia or mania. Words linked to depression and BD induced greater episodic re-experiencing than neutral words, just as words about BD provided greater episodic re-experiencing and more details of emotion/thoughts than words about mania. Words linked to depression provoked more time details about the recalled episodes than words on BD or neutral themes. No mood-congruent or mood-dependent effects were observed. Current findings may improve the ability of clinicians to conduct psychiatric interviews and the diagnosis of BD, with special attention to how memory details are generated across different mood states of the condition. Additionally, interventions to foster autobiographical recollection in BD may be developed, similar to what has already been done in the context of schizophrenia.
自传体记忆对于建立自我认同感至关重要,有助于社会功能和未来计划的发展,并且是精神科访谈的重要信息来源。先前的研究表明,单相抑郁症患者存在自传体情节特异性丧失的情况,但针对双相情感障碍(BD)患者的研究相对较少,尤其是在不同情绪状态下的研究。同样,关于BD患者自传体记忆中情绪一致性和情绪依赖性记忆的系统研究也很匮乏。考虑到这一点,共有74名BD患者(24名处于心境正常期、26名处于躁狂期、24名处于抑郁期)对属于四类的提示词做出自传体记忆反应:躁狂、抑郁、BD和中性。根据自传体访谈对情节特异性进行评分,评分者内和评分者间的信度都很高。结果表明,躁狂期患者通常比抑郁期患者能重新体验到更多的情节细节。与心境正常期或躁狂期患者相比,抑郁的双相情感障碍患者报告的感知细节更少,记忆的时间整合也更少。与抑郁和BD相关联的词比中性词引发了更多的情节重新体验,正如关于BD的词比关于躁狂的词提供了更多的情节重新体验和更多的情感/思想细节。与抑郁相关联的词比关于BD或中性主题的词引发了更多关于回忆事件的时间细节。未观察到情绪一致性或情绪依赖性效应。目前的研究结果可能会提高临床医生进行精神科访谈和诊断BD的能力,尤其要关注在该疾病的不同情绪状态下记忆细节是如何产生的。此外,类似于在精神分裂症背景下已经开展的工作,可能会开发促进BD患者自传体回忆的干预措施。