双相情感障碍Ⅰ型、Ⅱ型缓解期患者的认知功能对照研究

Control study on cognitive function of patients with bipolarⅠandⅡin remission stage

目的分析双相情感障碍Ⅰ型和Ⅱ型缓解期患者的认知功能损害的差异。方法选取2020年1—12月在北京回龙观医院门诊就诊及住院的患者为研究对象,根据DSM-5诊断标准,分为双相情感障碍Ⅰ型和Ⅱ型组,每组30例,同时纳入性别、年龄、受教育程度相匹配的健康对照者35名(对照组)。采用一般情况调查表、杨氏躁狂量表、汉密尔顿抑郁量表、中文版精神分裂症认知功能成套测验(MCCB)对3组研究对象进行测评。采用Spearman相关分析双相情感障碍患者认知功能与临床资料的相关性。结果双相情感障碍Ⅰ型组、双相情感障碍Ⅱ型组及对照组比较,言语学习和记忆得分[(51.07±9.75)分比(57.07±9.67)分比(57.66±6.96)分]、视觉学习和记忆得分[(46.17±12.03)分比(53.80±6.39)分比(55.57±7.47)分]、推理与问题解决能力得分[(49.80±10.24)分比(55.03±5.44)分比(55.80±7.33)分]、MCCB总分[(48.33±8.55)分比(53.10±6.97)分比(55.86±5.11)分],差异有统计学意义(F=5.333、9.885、5.336、9.636;P<0.05)。双相情感障碍组患者与对照组的处理速度得分[(52.00±8.94)分比(60.74±7.50)分]、言语学习和记忆得分[(54.07±10.09)分比(57.66±6.96)分]、视觉学习和记忆得分[(49.98±10.30)分比(55.57±7.48)分]、推理与问题解决能力得分[(52.42±8.55)分比(55.80±7.33)分]、MCCB总分[(50.72±8.10)分比(55.86±5.11)分]比较,差异有统计学意义(t=4.871、1.861、2.806、2.040、3.379;P<0.05)。Spearman相关性分析显示,轻躁狂发作次数和视觉学习和记忆呈正相关,躁狂发作次数和推理与问题解决能力呈负相关,发作次数与注意/警觉呈负相关(P<0.05)。结论双相情感障碍Ⅰ型比Ⅱ型缓解期患者的认知功能受损重,双相情感障碍缓解期患者的认知功能受损。

Objective To analyze the difference of cognitive impairment between bipolar disorderⅠandⅡpatients in remission stage.Methods The patients in the outpatient and inpatient department of Beijing Huilongguan Hospital from January to December 2020 were selected as the research subjects.According to the diagnostic criteria of DSM-5,the patients were assigned into Bipolar disorderⅠandⅡgroup,with 30 cases in each group.At the same time,35 healthy controls matched for gender,age,education background were recruited.The general situation questionnaire,Young's Mania Scale,Hamilton Depression Scale and MATRICS Consensus Cognitive Battery(MCCB)test were applied in the investigation.Spearman correlation was used to analyze the correlation between cognitive function and clinical data in patients with bipolar disorder.Results Comparing among the 3 groups,the differences in verbal learning[(51.07±9.75)vs(57.07±9.67)vs(57.66±6.96)],visual learning[(46.17±12.03)vs(53.80±6.39)vs(55.57±7.47)],reasoning problem solving[(49.80±10.24)vs(55.03±5.44)vs(55.80±7.33)]and total MCCB scores[(48.33±8.55)vs(53.10±6.97)vs(55.86±5.11)]were statistically significant(F=5.333,9.885,5.336,9.636;P<0.05).Comparing between bipolar disorder group and control group,the differences in processing speed[(52.00±8.94)vs(60.74±7.50)],speech learning[(54.07±10.09)vs(57.66±6.96)],visual learning[(49.98±10.30)vs(55.57±7.48)],reasoning problem solving ability[(52.42±8.55)vs(55.80±7.33)]and total MCCB scores[(50.72±8.10)vs(55.86±5.11)]were statistically significant(t=4.871,1.861,2.806,2.040,3.379;P<0.05).Spearman correlation analysis showed that the number of episodes of hypomania was positively correlated with visual learning and memory,the number of episodes of mania and reasoning was negatively correlated with problem solving ability,and the number of episodes was negatively correlated with attention/vigilance(P<0.05).Conclusions Cognitive impairment was greater in patients with bipolarⅠthan in patients with bipolarⅡ,and the cognitive impairment remained in patients with bipolar who in remission stage.