Cognitive functions in a mixed episode of bipolar affective disorder

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Abstract

Summary. According to various meta-analyzes, most patients with bipolar affective disorder have neurocognitive dysfunction even in remission. In recent studies, moderate to severe impairments have been found in attention, verbal learning and memory, and executive function. Whereas premorbid intelligence remains unchanged. The main body of research is devoted to the study of cognitive impairment in the first episode of bipolar affective disorder, in manic, depressive episodes, and euthymia. At the same time, the features of cognitive dysfunction in mixed forms of bipolar affective disorder remain poorly understood. The aim of the study was to study the characteristics of cognitive functions in patients with a mixed episode of bipolar affective disorder. Materials and methods. With the help of a battery of tests (a test for remembering ten unrelated words; a Ray-Osterritz test; a verbal speed test; a digital character substitution test; a symbol linking test), the cognitive features of 25 patients with a mixed episode, 16 patients with a manic episode, and 15 patients with a depressive episode of bipolar affective disorder. Results and conclusions. Deviations in cognitive function were found in all patients regardless of the type of affective symptomatology. In the form of a wide range of psychopathological phenomena which manifested themselves to a greater extent in patients with a mixed episode of bipolar affective disorder. The peculiarities of the phenomenological structure of cognitive impairment in patients with mixed phase of bipolar affective disorder are manifested in the form of a more pronounced deterioration of verbal memory, information processing speed; more pronounced violations of spatial representations, deterioration of visual memory, verbal associative performance and executive functions; a decrease in attention and a violation of its distribution. The findings suggest that the leading role in the formation of these disorders is played by the presence of depressive symptoms in the clinical structure of affective disorders.
双相情感障碍混合性发作的认知功能
总结。根据各种荟萃分析,大多数双相情感障碍患者即使在缓解期也存在神经认知功能障碍。在最近的研究中,在注意力、语言学习和记忆以及执行功能方面发现了中度到重度的损伤。而病前智力是不变的。研究主体致力于双相情感障碍首发期、躁狂期、抑郁期和心境期的认知损伤研究。与此同时,双相情感障碍混合形式的认知功能障碍的特征仍然知之甚少。本研究的目的是研究双相情感障碍混合性发作患者的认知功能特征。材料和方法。在一系列测试的帮助下(记住十个不相关单词的测试;Ray-Osterritz检验;语言速度测试;数字字符替换测试;符号连接测试),25名混合发作患者,16名躁狂发作患者和15名抑郁发作双相情感障碍患者的认知特征。结果和结论。无论情感症状类型如何,所有患者均发现认知功能偏差。以广泛的精神病理现象的形式,在双相情感障碍混合发作的患者中表现得更大程度。双相情感障碍混合期患者认知障碍的现象学结构的特殊性表现为言语记忆、信息处理速度的显著下降;更明显的违反空间表征,视觉记忆,语言联想表现和执行功能的恶化;注意力的减少和对其分布的破坏研究结果表明,在这些障碍的形成中起主导作用的是情感障碍临床结构中抑郁症状的存在。
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