共病边缘型人格障碍的双相情感障碍患者认知功能状况

Cognitive function of patients with comorbid borderline personality disorder and bipolar disorder

背景双相情感障碍与边缘型人格障碍(BPD)共病率高,共病患者认知功能受损更严重。目的探讨是否共病BPD的双相情感障碍患者认知功能的差异,为临床诊疗提供参考。方法采用简单随机抽样,选取2021年4月-2022年4月在河北医科大学第一医院治疗的共病BPD的双相情感障碍患者60例(共病组),其中双相抑郁患者33例,双相躁狂患者27例。同时选取双相情感障碍患者60例(未共病组),其中双相抑郁35例,双相躁狂25例。采用中文版神经心理状态测验(RBANS)和Stroop色词测验评估患者的认知功能。结果共病组RBANS中的即刻记忆、视觉广度、言语功能和总评分均低于未共病组,差异均有统计学意义(t=-2.356、-2.138、-3.306、-2.729,P<0.05或0.01),Stroop色词测验中的单字时间、单色时间、双字时间和双色时间均长于未共病组,差异均有统计学意义(t=4.808、3.341、5.249、5.167,P均<0.01)。共病BPD的双相抑郁患者RBANS中的即刻记忆、视觉广度、言语功能和总评分均低于未共病BPD的双相抑郁患者(t=-2.446、-2.407、-2.231、-2.078,P均<0.05),Stroop色词测验中的单字时间、单色时间、双字时间和双色时间均长于未共病组(t=3.652、3.035、4.406、5.016,P均<0.01)。共病组双相躁狂患者RBANS中的言语功能和总评分均高于未共病组(t=-2.777、-2.347,P<0.05或0.01),Stroop色词测验中的单字时间、单色时间、双字时间和双色时间均长于未共病组(t=3.600、2.658、2.943、4.337,P<0.05或0.01)。结论相较于未共病BPD的双相情感障碍患者,共病BPD的双相情感障碍患者认知功能受损更严重。

Background The comorbidity rate of bipolar disorder and borderline personality disorder(BPD)is high,and the cognitive impairment of comorbidity patients is more serious.Objective To explore the difference of cognitive function between bipolar disorder patients with BPD or not,so as to provide references for clinical diagnosis and treatment.Methods Using simple random sampling,60 patients with bipolar disorder comorbidity BPD treated in the First Hospital of Hebei Medical University from April 2021 to April 2022 were selected as the research group,including 33 patients with bipolar depression and 27 patients with bipolar mania.At the same time,60 patients with bipolar disorder were randomly selected as the control group,including 35 patients with bipolar depression and 25 patients with bipolar mania.The cognitive function of patients was evaluated by the Chinese version of Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)and the Stroop Color Word Test.Results The immediate memory,visual span,speech function and total score of RBANS in the comorbid group were lower than those in the non-comorbid group,and the differences were statistically significant(t=-2.356,-2.138,-3.306,-2.729,P<0.05 or 0.01).The single word time,single color time,double word time and double color time in Stroop Color Word Test in comorbid group were longer than those in non-comorbid group,and the differences were statistically significant(t=4.808,3.341,5.249,5.167,P<0.01).The immediate memory,visual span,speech function and total score in RBANS of bipolar depression patients with comorbid BPD were lower than those of bipolar depression patients without comorbid BPD(t=-2.446,-2.407,-2.231,-2.078,P<0.05),and the time of single word,single color,double word and double color in Stroop Color Word Test were longer than those of non-comorbid BPD patients(t=-3.652,3.035,4.406,5.016,P<0.01).The speech function and total score of RBANS in bipolar manic patients in comorbid group were higher than those in non-comorbid group(t=-2.777,-2.347,P<0.05 or 0.01),and the time of single word,single color,double word and double color in Stroop Color Word Test were longer than those in non-comorbid group(t=3.600,2.658,2.943,4.337,P<0.05 or 0.01).Conclusion The cognitive impairment of bipolar disorder patients comorbid with BPD is more severe than that of patients without comorbid with BPD.