Bertschy Gilles, Martz Emilie, Weibel Sebastien, Weiner Luisa
Pôle de Psychiatrie, santé mentale & addictologie des Hôpitaux Universitaires de Strasbourg, Strasbourg, F-67000, France.
INSERM U1114, Strasbourg, F-67000, France.
Neuropsychiatr Dis Treat. 2023 May 11;19:1153-1168. doi: 10.2147/NDT.S401330. eCollection 2023.
In the present study, we propose a review and a synthesis of the work of our group about the phenomenology and the cognitive mechanisms of racing thoughts in bipolar disorder (BD) and ADHD. Contrary to the mainstream idea according to which racing thoughts are pathognomonic of BD, our work suggests that racing thoughts are enhanced in ADHD compared to hypomanic episodes of BD, whereas in euthymic episodes of BD self-reported racing thoughts are similar to the rates reported by healthy controls. Using verbal fluency tasks, we found many similarities between bipolar and ADHD subjects with one clear difference: lexical search strategy in hypomania is based on phonemic similarities rather than semantic-relatedness. However, this distinction observed in this cognitive task is certainly difficult to grasp during a clinical interview aiming to differentiate mild hypomania from combined ADHD presentation. The main landmark to distinguish them remains the episodic nature of bipolar disorders as opposed to the lifelong presentation of ADHD symptoms, a dichotomous view that is not so clear-cut in clinical practice.
在本研究中，我们对本团队关于双相情感障碍（BD）和注意力缺陷多动障碍（ADHD）中思维奔逸的现象学及认知机制的研究工作进行了回顾与总结。与思维奔逸是双相情感障碍的特征这一主流观点相反，我们的研究表明，与双相情感障碍的轻躁狂发作相比，注意力缺陷多动障碍中的思维奔逸更为明显，而在双相情感障碍的心境正常发作期，自我报告的思维奔逸发生率与健康对照组报告的发生率相似。通过言语流畅性任务，我们发现双相情感障碍患者和注意力缺陷多动障碍患者之间存在许多相似之处，但有一个明显的差异：轻躁狂发作时的词汇搜索策略基于语音相似性而非语义相关性。然而，在旨在区分轻度轻躁狂和合并注意力缺陷多动障碍表现的临床访谈中，很难把握在这一认知任务中观察到的这种差异。区分它们的主要标志仍然是双相情感障碍的发作性本质，与注意力缺陷多动障碍症状的终身表现形成对比，这种二分法观点在临床实践中并非如此清晰明确。
