Department of Psychological Medicine, University of Otago, Christchurch, 8011, New Zealand.
Specialist Mental Health Services, Canterbury District Health Board, Christchurch, 8024, New Zealand.
Bipolar Disord. 2023 Jun;25(4):263-277. doi: 10.1111/bdi.13321. Epub 2023 Mar 29.
Cognitive impairment is a core feature of mood disorders and has been identified as an important treatment target. A better understanding of the factors contributing to cognitive impairment in mood disorders would be beneficial in developing interventions to address cognitive impairment. One key factor is childhood trauma. The aim of this review was to systematically synthesise and review research examining associations between reported childhood trauma and cognitive functioning in mood disorders.
Studies in adult samples examining the relationship between objective cognitive function and reported childhood trauma in major depressive disorder and/or bipolar disorder (in-episode or euthymia) were identified. Searches were conducted on PubMed, Embase and PsycINFO until January 2022. A narrative review technique was used due to the heterogeneity of group comparisons, cognitive tests and data analysis across studies.
Seventeen studies met the criteria for inclusion (mood disorders N = 1723, healthy controls N = 797). Evidence for childhood trauma being related to poorer cognitive functioning was consistent across global cognitive functioning and executive function domains for euthymic patients and psychomotor speed for in-episode patients. There was mixed evidence for verbal learning and memory and executive function for in-episode patients. Identification of patterns within other domains was difficult due to limited number of studies.
Findings from this review suggest childhood trauma is associated with poorer cognitive functioning in people with mood disorders. Targeted interventions to improve cognition may be warranted for this group.
认知障碍是心境障碍的核心特征,已被确定为重要的治疗靶点。更好地了解导致心境障碍认知障碍的因素,将有助于开发针对认知障碍的干预措施。一个关键因素是儿童时期的创伤。本综述的目的是系统地综合和回顾研究,以检查报告的儿童期创伤与心境障碍患者认知功能之间的关系。
在 PubMed、Embase 和 PsycINFO 上进行了检索,以确定在成年样本中检查与重性抑郁障碍和/或双相障碍(发作期或缓解期)中客观认知功能和报告的儿童期创伤之间关系的研究。由于研究之间的组间比较、认知测试和数据分析存在异质性,因此使用叙述性综述技术。
符合纳入标准的研究有 17 项(心境障碍患者 N=1723,健康对照者 N=797)。在缓解期患者的整体认知功能和执行功能领域以及发作期患者的精神运动速度方面,儿童期创伤与认知功能较差相关的证据是一致的。对于发作期患者的词语学习和记忆以及执行功能,存在混合证据。由于研究数量有限,难以确定其他领域的模式。
本综述的结果表明,儿童期创伤与心境障碍患者的认知功能较差有关。对于这一群体,可能需要有针对性的认知干预措施。