Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
CNNP Lab, Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, UK.
Bipolar Disord. 2024 Mar;26(2):109-128. doi: 10.1111/bdi.13396. Epub 2023 Nov 16.
Cognitive impairment is a core feature of bipolar disorder (BD) and major depressive disorder (MDD). Deficits in processing speed (PS) and sustained attention (SA) may be particularly impaired and may underpin a broader profile of deficits, however current knowledge of the nature of these impairments is limited by heterogeneous results in the literature. Few reviews to date have attempted to disentangle sources of heterogeneity to assess the presence and magnitude of impairments in PS and SA in BD and MDD.
One hundred and three studies were reviewed to examine performance in tests of PS and SA in BD (n = 3452) and MDD (n = 5461) compared to healthy controls (n = 8016). Neuropsychological methodology used in the literature was summarised. Data were meta-analysed to assess impairments in PS and SA for each neuropsychological test separately. Subgroup analysis was performed across mood states to investigate sources of heterogeneity.
Impairments were found across most neuropsychological tests, with small to large effect sizes for BD (range: d = 0.19-0.96) and MDD (range: d = 0.29-0.86). Impairments were present in symptomatic states and euthymia in most cases. Some outcome measures were not impaired in euthymia. Heterogeneity was observed for most neuropsychological tests and remained after separating by mood state. There inadequate data to meta-analyse some outcome measures, particularly for symptomatic groups.
Impairments in PS and SA in BD and MDD can be observed across most neuropsychological tests. Future research should further investigate the nature of these impairments across mood states, controlling for clinical confounds.
认知障碍是双相情感障碍（BD）和重性抑郁障碍（MDD）的核心特征。处理速度（PS）和持续注意力（SA）缺陷可能特别受损，并可能构成更广泛的缺陷谱，但目前对这些缺陷性质的了解受到文献中异质性结果的限制。迄今为止，很少有综述试图厘清异质性的来源，以评估 BD 和 MDD 中 PS 和 SA 的损伤的存在和程度。
共回顾了 103 项研究，以检查 PS 和 SA 测试在 BD（n=3452）和 MDD（n=5461）中的表现，并与健康对照组（n=8016）进行比较。总结了文献中使用的神经心理学方法。分别对每个神经心理学测试进行荟萃分析，以评估 PS 和 SA 的损伤。进行亚组分析，以调查情绪状态的异质性来源。
大多数神经心理学测试中都发现了损伤，BD（范围：d=0.19-0.96）和 MDD（范围：d=0.29-0.86）的效应大小为小到中等。大多数情况下，在症状性状态和轻躁狂中都存在损伤。在某些情况下，一些结果指标在轻躁狂中没有受损。大多数神经心理学测试都存在异质性，且在按情绪状态进行分离后仍然存在。对于一些结果指标，特别是对于症状性组，没有足够的数据进行荟萃分析。
BD 和 MDD 中的 PS 和 SA 缺陷可以在大多数神经心理学测试中观察到。未来的研究应进一步在情绪状态之间调查这些缺陷的性质，同时控制临床混杂因素。
