Neuropsychological task performance in bipolar spectrum illness: genetics, alcohol abuse, medication and childhood trauma

被引:78
作者
Savitz, Jonathan B. [1 ]
van der Merwe, Lize [2 ]
Stein, Dan J. [3 ]
Solms, Mark [4 ,5 ]
Ramesar, Rajkumar S. [1 ]
机构
[1] Univ Cape Town, Inst Infect Dis & Mol Med, Div Human Genet, ZA-7700 Rondebosch, South Africa
[2] Univ Cape Town, Biostat Unit, Med Res Council S Africa, ZA-7925 Cape Town, South Africa
[3] Univ Cape Town, Dept Psychiat, ZA-7925 Cape Town, South Africa
[4] Univ Cape Town, Dept Psychol, ZA-7925 Cape Town, South Africa
[5] Univ Cape Town, Dept Neurol, ZA-7925 Cape Town, South Africa
关键词
alcohol abuse; bipolar disorder; childhood trauma; cognition; genetics; major depression; medication; memory; neuropsychology;
D O I
10.1111/j.1399-5618.2008.00591.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Introduction: Impaired executive and memory function is a putative genetic trait marker of bipolar I disorder (BPD I). Although executive/memory function has been posited to be an endophenotype of BPD I, it is unclear whether this extends to bipolar spectrum illness. It is also unclear to what extent non-genetic factors such as childhood abuse, alcoholism and medication influence neurocognitive function. We assessed the neuropsychological performance of a large cohort of bipolar disorder probands and their affectively ill and healthy family members, while controlling for self-reported childhood sexual and emotional abuse, emotional neglect, alcohol abuse and medication. Methods: A total of 230 largely euthymic participants from 47 families, comprising 49 subjects with BPD I, 19 with bipolar II disorder (BPD II), 44 with recurrent major depression (MDE-R), 33 with a single lifetime episode of depression (MDE-S), 20 with other DSM-IV diagnoses and 65 unaffected relatives, were assessed with a battery of neuropsychological tasks. Results: Sexual abuse, emotional abuse and emotional neglect scores were associated with poorer cognitive performance. After controlling for childhood trauma, the BPD I group performed worse than unaffected relatives on tests of visual recall memory as well as verbal recall and recognition memory. In contrast, individuals with BPD II and bipolar spectrum illness did not differ significantly from unaffected relatives. Treatment with lithium and antipsychotic medication was associated with reduced executive and verbal recognition memory function. After controlling for medication and other covariates, only verbal recall memory was significantly impaired in the BPD I cohort. Conclusions: Verbal recall deficits may be one manifestation of a genetically driven dysfunction of frontal-striatal cortical networks in BPD I.
引用
收藏
页码:479 / 494
页数:16
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