مقایسه‌ی عملکردهای اجرایی بین فازهای مختلف در بیماران مبتلا به اختلال دو قطبی نوع یک و افراد عادی

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد روان‌شناسی عمومی، عضو باشگاه پژوهشگران جوان و نخبگان، واحد اصفهان (خوراسگان)، دانشگاه آزاد اسلامی، اصفهان، ایران

2 دانشیار، گروه روان‌پزشکی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: اختلال دو قطبی، یک بیماری پیچیده و مزمن با اپیزودهای مانیا و افسردگی است. با توجه به احتمال وجود نقص در عملکردهای عصب روان‌شناختی در بیماران مبتلا به اختلال دو قطبی، هدف از انجام مطالعه‌ی حاضر، تعیین میانگین نمره‌ی عملکردهای اجرایی (انعطاف‌پذیری شناختی و حافظه‌ی کاری) در فازهای مانیا، یوتایمیا و افسردگی در اختلال دو قطبی نوع یک و مقایسه‌ی آن با افراد عادی بود.روش‌ها: در یک مطالعه‌ی علی- مقایسه‌ای در سال 1395، 41 بیمار مبتلا به اختلال دو قطبی نوع یک مراجعه کننده به اورژانس، بخش‌ها و درمانگاه‌های روان‌پزشکی دانشگاه علوم پزشکی اصفهان با تشخیص روان‌پزشک بر اساس Diagnostic and statistical manual of mental disorders-5 (DSM-5)، مقیاس مانیای Young و افسردگی Hamilton و 18 فرد سالم بر اساس پرسش‌نامه‌های Symptom checklist-90-Revised V.4.1 (SCl-90-R V.4.1) و Short form Health Survey-36 (SF-36) با نمونه‌گیری در دسترس به پژوهش وارد شدند. این افراد با آزمون‌های کامپیوتری Wisconsin (Wisconsin card sorting test-version 3 یا WCST-V3) و حافظه‌ی کاری Wechsler (Working Memory WIS Software V-4 یا WMW V-4) مقایسه شدند.یافته‌ها: در شاخص‌های عملکردهای اجرایی، بیماران در فازهای بیماری تفاوت معنی‌داری نداشتند، اما در مقایسه با گروه شاهد، در شاخص‌های انعطاف‌پذیری شناختی در آزمون Wisconsin، تعداد طبقات صحیح کمتر (004/0 = P)، تعداد خطای درجاماندگی بیشتر (0001/0 > P)، تعداد کوشش‌های بیشتر (001/0 = P)، پاسخ‌های نادرست بیشتر (003/0 = P) و مدت زمان اجرای آزمون طولانی‌تر (002/0 = P) داشتند. عملکرد گروه مانیا در مقایسه با گروه شاهد در تمامی شاخص‌های حافظه‌ی کاری، به طور معنی‌داری ضعیف‌تر بود (050/0 > P). بیماران یوتایمیک نسبت به گروه شاهد در شاخص‌های تکرار ارقام رو به جلوی دیداری (001/0 > P) و جمع حافظه‌ی دیداری (0001/0 > P) عملکرد ضعیف‌تری داشتند.نتیجه‌گیری: اختلال دو قطبی با نقایص شناختی همراه است و نقص عملکردهای اجرایی در فاز مانیا بیشتر مشهود است. این نقایص، حتی در طول دوره‌های یوتایمیا ادامه می‌یابد. با توجه به یافته‌های متناقض، انجام مطالعات بیشتر ضروری به ‌نظر می‌رسد.

کلیدواژه‌ها

عنوان مقاله [English]

Comparison of Executive Functions in Different Phases of Bipolar I Disorder in Patients and General Population

نویسندگان [English]

  • Sabra Mousavizadegan 1
  • Mohsen Maroufi 2
1 MA Student in Psychology, Young Researchers and Elite Club, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
2 Associate Professor, Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Bipolar I disorder (BID) is a complex and chronic disorder characterized by episodes of mania and depression. Considering the possibility of neuropsychological function deficit in patients with bipolar disorder, the purpose of this study was to determine the mean scores of executive functions (cognitive flexibility and working memory) in mania, euthymia, and depression in bipolar I disorder and compare them with controls.Methods: In a causal-comparative study in 2016, 41 patients with bipolar I disorder referring to emergency rooms, psychiatric departments, and clinics of Isfahan University of Medical Sciences, Iran, with psychiatrist’s diagnosis based on Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5), Young Mania Scale, and Hamilton Depression Scale, and 18 healthy controls based on Symptom Checklist-90-Revised V.4.1 (SCl-90-R V.4.1) and Short Form Health Survey-36 (SF-36) questionnaires were selected to participate in the study through convenience sampling. The participants were compared using Computerized Wisconsin Card Sorting Test-Version 3 (WCST-V3) and Working Memory WIS Software V-4 (WMW V-4).Findings: In indices of executive functions, there were no significant differences among patients, but compared to the controls, in the Wisconsin test, patients had less number of correct categories (P = 0.004), more perseveration error (P < 0.001), more attempts (P = 0.001), more false responses (P = 0.003), and longer test implementation time (P = 0.002). Performance of the mania group in all indices of working memory was significantly lower than controls (P < 0.05o for all). Euthymic patients had a weaker performance in comparison to controls in visual forward digit-span (P < 0.001), and total visual memory (P < 0.001).Conclusion: Bipolar disorder is associated with cognitive deficits, and executive function deficit is more evident in the mania phase. These deficits are found even during the euthymic phase. Considering controversial findings, further studies seem to be necessary.

کلیدواژه‌ها [English]

  • Bipolar disorder
  • Mania
  • Depression
  • Executive function

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مجله دانشکده پزشکی اصفهان
دوره 35، شماره 462 - شماره پیاپی 462
بهمن و اسفند 1396
صفحه 1892-1901

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سابقه مقاله

  • تاریخ دریافت: 12 آذر 1396
  • تاریخ بازنگری: 08 اردیبهشت 1403
  • تاریخ پذیرش: 17 فروردین 1401

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