评估双相情感障碍个体未受影响亲属的认知功能：一项荟萃分析。
Evaluating cognitive function in unaffected relatives of individuals with bipolar disorders: A meta-analysis.
机构信息
Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON, Canada.
Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
出版信息
J Psychiatr Res. 2022 Aug;152:289-295. doi: 10.1016/j.jpsychires.2022.06.003. Epub 2022 Jun 13.
BACKGROUND
Available studies have evaluated cognition in the unaffected relatives of bipolar disorder patients; however, to our knowledge, there has been no quantitative analysis evaluating the foregoing association. Herein, this meta-analysis aims to provide a quantitative synthesis of the extant literature reporting on the association between performance in cognitive domains (i.e., executive function, attention, learning and memory or global cognition) amongst unaffected individuals of probands with bipolar disorders.
METHODS
Online databases (i.e., PubMed, PsycINFO) and Google Scholar were searched from inception to 20 September 2021. Studies with unaffected, first-degree relatives of individuals with DSM-IV or DSM-5 defined bipolar disorders were included. The risk of bias was assessed using the ROBINS-1 tool, and the quality of the sources was evaluated using GRADE criteria. The results of the studies were quantitatively synthesized using Cohen's d effect sizes via a random-effects meta-analytic approach on JASP.
RESULTS
A total of 15 studies were included in the final review. Overall, results indicate that cognitive performance across all domains is moderately impaired in unaffected relatives of individuals with bipolar disorders (d = 0.488). Sub-analysis suggests there is a higher level of impairment in executive functioning (d = 0.612).
DISCUSSION
The identification of cognitive deficits in unaffected relatives of probands with bipolar disorders indicates that cognitive impairment is endophenotypic and a core disturbance in persons with bipolar disorders; future studies should endeavour to target cognition as a potential pre-emptive and prevention strategy of bipolar disorders.
背景
已有研究评估了双相障碍患者未受影响亲属的认知情况；然而，据我们所知，尚无定量分析评估上述关联。在此，本荟萃分析旨在对现有文献中关于双相障碍患者未受影响个体在认知领域（即执行功能、注意力、学习和记忆或整体认知）表现之间的关联进行定量综合。
方法
从建库至 2021 年 9 月 20 日，在线检索数据库（即 PubMed、PsycINFO）和谷歌学术。纳入研究对象为符合 DSM-IV 或 DSM-5 定义的双相障碍患者的未受影响的一级亲属。使用 ROBINS-1 工具评估偏倚风险，并使用 GRADE 标准评估来源质量。使用 JASP 中的随机效应荟萃分析方法，通过 Cohen's d 效应大小对研究结果进行定量综合。
结果
最终综述共纳入 15 项研究。总体而言，结果表明，双相障碍患者未受影响亲属在所有认知领域的表现均存在中度受损（d=0.488）。亚分析表明，执行功能受损程度更高（d=0.612）。
讨论
在双相障碍患者未受影响亲属中发现认知缺陷表明，认知障碍是双相障碍患者的内表型和核心障碍；未来的研究应努力将认知作为双相障碍的潜在预防和预防策略。
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