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首页> 外文期刊>The journal of clinical psychiatry >Neurocognitive functioning in patients with bipolar I disorder recently recovered from a first manic episode.
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Neurocognitive functioning in patients with bipolar I disorder recently recovered from a first manic episode.

机译：I型双相情感障碍患者的神经认知功能最近从第一次躁狂发作中恢复。

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OBJECTIVE: Although cognitive impairment is an important clinical feature of bipolar disorder, it is unknown whether deficits are present at illness onset. The purpose of this study was to determine whether neuropsychological impairments are present in clinically stable patients with bipolar disorder shortly after resolution of their first manic episode. METHOD: Within a large university medical center, 45 recently diagnosed (DSM-IV-TR) patients with bipolar disorder type I were evaluated after resolution of their first manic episode, along with 25 matched healthy comparison subjects. Participants were administered a neuropsychological battery evaluating 5 broad cognitive domains, including verbal/premorbid intellectual functioning, learning/memory, spatialonverbal reasoning, attention/processing speed, and executive function. Data were collected from July 2004 to August 2007. RESULTS: Relative to controls, patients showed broad impairments in learning/memory, spatialonverbal reasoning, executive function, and some aspects of attention (all P < .01). Specifically, deficits were evident on tests assessing sustained attention, attentional and mental set shifting, spatial working memory, nonverbal reasoning, and verbal learning and recall (all P < .01). Cognitive impairments in patients could not be fully attributed to substance abuse, medication status, or residual mood symptoms. CONCLUSIONS: Results indicate that core neuropsychological deficits in sustained attention, learning and recall, spatialonverbal reasoning, and several aspects of executive function are present at illness onset. Cognitive deficits in bipolar disorder are, thus, most likely not exclusively attributable to progressive decline associated with increased illness burden, cumulative treatment effects, or chronicity of illness. These findings may provide etiologic clues into the illness and identify clinical targets for early treatment.
机译：目的：尽管认知障碍是双相情感障碍的重要临床特征，但尚不清楚疾病发作时是否存在缺陷。这项研究的目的是确定在首次躁狂发作消退后不久，临床稳定的躁郁症患者是否存在神经心理学障碍。方法：在一个大型大学医学中心内，对第一例躁狂发作解决后的45例最近诊断为（DSM-IV-TR）的I型双相情感障碍患者以及25名匹配的健康对照受试者进行了评估。对参与者进行神经心理学评估，评估5个广泛的认知领域，包括语言/病态智力功能，学习/记忆，空间/非语言推理，注意力/处理速度和执行功能。从2004年7月至2007年8月收集了数据。结果：与对照组相比，患者在学习/记忆，空间/非语言推理，执行功能以及注意力的某些方面表现出广泛的障碍（所有P <.01）。具体而言，在评估持续注意力，注意力和思维方式转变，空间工作记忆，非语言推理以及言语学习和记忆能力的测试中，缺陷明显（所有P <.01）。患者的认知障碍不能完全归因于药物滥用，用药状况或残留的情绪症状。结论：结果表明，疾病发作时持续注意力，学习和回忆，空间/非语言推理以及执行功能的多个方面存在核心神经心理学缺陷。因此，躁郁症的认知缺陷最有可能并非完全归因于与疾病负担增加，累积治疗效果或疾病慢性相关的进行性下降。这些发现可能为疾病提供病因线索，并确定早期治疗的临床目标。

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