Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Eur Neuropsychopharmacol. 2021 Oct;51:71-83. doi: 10.1016/j.euroneuro.2021.05.003. Epub 2021 Jun 4.
Patients with mood disorders show heterogeneity in non-emotional cognition. However, it is unclear whether emotional cognition (EC) is characterised by similar heterogeneity. We aimed to investigate the heterogeneity in EC among remitted patients with mood disorders and explore its association with familial risk. Data from 269 partially or fully remitted patients with mood disorders, 87 of their unaffected relatives (UR) and 203 healthy controls (HC) were pooled from two cohort studies. Hierarchical cluster analysis was conducted using the EC data from patients. UR were categorised into groups consistent with their affected relatives' cluster assignment. Clusters were compared to HC on EC, non-emotional cognition, clinical characteristics and functioning. We identified three clusters: an 'emotionally preserved' (57%), an 'emotionally blunted' (26%) and an 'emotionally volatile' cluster (17%). 'Emotionally blunted' and 'emotionally volatile' patients also presented more deficits in non-emotional cognition (global cognition read z=-0.3 and -0.5 respectively). Relatives of 'emotionally preserved' patients were more successful at dampening negative emotions (p=.01, d=0.39, 95% CI [-0.76,-0.09]), whereas UR of 'emotionally impaired' patients underperformed in verbal fluency (p=.03, d=0.46, 95% CI [.03, 0.68]) compared to HC. The existence of impaired EC groups in remitted mood disorder highlights a need to screen for and treat EC in mood disorders. Improved ability to dampen emotions in UR of 'emotionally preserved' patients may reflect a resilience marker while impaired verbal fluency in UR of 'emotionally impaired' patients may reflect distinct genetic risk profiles in these EC subgroups.
心境障碍患者在非情感认知方面存在异质性。然而，情感认知（EC）是否具有相似的异质性尚不清楚。我们旨在调查缓解期心境障碍患者 EC 的异质性，并探讨其与家族风险的关系。来自两项队列研究的 269 名部分或完全缓解的心境障碍患者、87 名未受影响的亲属（UR）和 203 名健康对照者的数据被汇总。使用患者的 EC 数据进行分层聚类分析。将 UR 分为与受影响亲属聚类分配一致的组。在 EC、非情感认知、临床特征和功能方面，将聚类与 HC 进行比较。我们确定了三个聚类：一个“情感保留”（57%）、一个“情感迟钝”（26%）和一个“情感不稳定”聚类（17%）。“情感迟钝”和“情感不稳定”患者的非情感认知也存在更多缺陷（整体认知读值分别为-0.3 和-0.5）。“情感保留”患者的亲属在抑制负面情绪方面更成功（p=.01，d=0.39，95%置信区间[-0.76，-0.09]），而“情感受损”患者的 UR 在言语流畅性方面表现不佳（p=.03，d=0.46，95%置信区间[.03，0.68]）与 HC 相比。缓解期心境障碍患者存在受损的 EC 组，这突出表明需要在心境障碍中筛查和治疗 EC。“情感保留”患者的 UR 抑制情绪的能力提高可能反映了一种恢复力标志物，而“情感受损”患者的 UR 的言语流畅性受损可能反映了这些 EC 亚组中独特的遗传风险特征。
