Nobile Benedicte, Maimoun Laurent, Jaussent Isabelle Danielle, Seneque Maude, Dupuis-Maurin Kathlyne, Lefebvre Patrick, Courtet Phillippe, Renard Eric, Guillaume Sebastien
Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France.
Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.
Front Psychiatry. 2021 May 17;12:658182. doi: 10.3389/fpsyt.2021.658182. eCollection 2021.
Growing evidences indicate that sex hormones have an effect on cognitive functions, and that Bulimia Nervosa (BN) is associated with cognitive impairment. The aim of this study was to determine the effect of hormonal contraception (HC) use on four cognitive functions that are impaired in patients with BN. This retrospective exploratory study included 103 women with a diagnosis of BN based on the DSM-5 criteria. Their age ranged from 15 to 45 years, and 46.6% were taking HC (oral, transdermal, or intrauterine). Cognition was assessed with the d2 test (attention), Iowa gambling task (IGT; decision making), Brixton spatial anticipation test (set shifting), and Rey-Osterrieth complex figure test (central coherence). Data were analyzed with logistic regression models to estimate the adjusted odds ratios (OR) and 95% confidence intervals (CI) of HC effect on the neuropsychological test scores. In the multivariate model, HC use was significantly associated with better scores for two d2 test indices: F-score [OR = 0.98, 95% CI = (0.95; 0.99)] and final total score ratio [OR = 0.87, 95% CI = (0.77; 0.99)]. HC was also associated with a better understanding of the IGT explicit rules. No difference between the two groups (HC and non-HC use) was detected for set shifting and central coherence. This exploratory study suggests that HC could have effects on the sustained attention and concentration in women with BN. More studies are needed to confirm these results.
越来越多的证据表明，性激素对认知功能有影响，且神经性贪食症（BN）与认知障碍有关。本研究的目的是确定使用激素避孕（HC）对BN患者受损的四项认知功能的影响。这项回顾性探索性研究纳入了103名根据《精神疾病诊断与统计手册》第5版（DSM-5）标准诊断为BN的女性。她们的年龄在15至45岁之间，46.6%的人正在使用HC（口服、经皮或宫内）。使用d2测试（注意力）、爱荷华赌博任务（IGT；决策）、布里克斯顿空间预期测试（定势转换）和雷-奥斯特里思复杂图形测试（中央连贯性）评估认知。使用逻辑回归模型分析数据，以估计HC对神经心理学测试分数影响的调整优势比（OR）和95%置信区间（CI）。在多变量模型中，使用HC与d2测试的两个指标得分更高显著相关：F分数[OR = 0.98，95% CI =（0.95；0.99）]和最终总分比[OR = 0.87，95% CI =（0.77；0.99）]。HC还与对IGT明确规则的更好理解有关。在定势转换和中央连贯性方面，两组（使用HC和未使用HC）之间未检测到差异。这项探索性研究表明，HC可能对BN女性的持续注意力和专注力有影响。需要更多研究来证实这些结果。
