RESUMO
OBJECTIVE: To perform a systematic review and meta-analysis of executive functions (EF) and episodic memory in bipolar disorder (BD). METHODS: A literature search was conducted on three electronic databases. Results were combined using random-effects meta-analysis. RESULTS: A total of 126 studies (6424 patients with BDI, 702 with BDII, and 8276 controls) were included. BDI was associated with moderate to large impairments across all cognitive functions and BDII with small-to-medium impairments. Small significant differences were identified between BDI and BDII on all cognitive functions except inhibition. The Trail Making Test (TMT) (g = 0.74, 95% CI: 0.67-0.80), Hayling Test (g = 0.58, 95% CI: 0.34-0.81), Digit Span Total (g = 0.79, 95% CI: 0.57-1.01), and Category Fluency (g = 0.59, 95% CI: 0.45-0.72) tasks were most sensitive to cognitive impairment in BDI. The TMT (g = 0.65, 95% CI: 0.50-0.80) and Category Fluency (g = 0.56, 95% CI: 0.37-0.75) were also sensitive to cognitive alterations in patients with BDII. CONCLUSION: BD type I was associated with more severe and widespread impairments than BDII, which showed smaller impairments on all functions except inhibition, where impairments were larger. Education and (hypo)manic symptoms should be further investigated in future studies due to their possible influence on the neuropsychological profile of BD. The instruments identified in this review should be considered for inclusion in cognitive assessment batteries in BD.
Assuntos
Transtorno Bipolar/psicologia , Disfunção Cognitiva/psicologia , Função Executiva , Memória Episódica , Transtorno Bipolar/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Humanos , Inibição Psicológica , Testes Neuropsicológicos , Teste de Sequência AlfanuméricaRESUMO
OBJECTIVE: This study aimed to examine the accuracy in identifying facial expressions and the perceived intensity of emotions of happiness, sadness, disgust, anger, fear, surprise in bipolar disorder (BD), and major depressive disorder (MDD). METHOD: Ninety-three adult participants (n = 30 BD, 80% female; n = 18 MDD, 72.2% female; n = 45 C, 46.7% female) completed a facial expression task. Stimuli in the task were first presented for 200 ms, followed by 500 ms, and 1000 ms. Participants were asked to identify the emotion expressed by each face and judge its intensity on a Likert scale. Accuracy and perceived intensity of expressions corresponding to each emotion were compared between groups using a repeated measures ANCOVA, with length of stimulus presentation as a within-subjects variable. RESULTS: Expressions of sadness were rated more intensely by patients with BD, and expressions of anger by those with MDD, than control participants. Subjects with BD were less accurate than control participants in identifying expressions of disgust. An interaction effect was also identified for the detection of sadness, whereby patients with BD were significantly less accurate when expressions were shown for 200 ms. CONCLUSIONS: The increased intensity with which emotions were perceived by patients with BD and MDD has important repercussions for patient functioning and clinical practice. A tendency to overestimate the intensity of certain facial expressions in mood disorders may lead patients to interpret social cues erroneously and engage in dysfunctional behaviors and cognitive patterns. Future studies should focus on this variable in addition to the accuracy of emotion identification.
Assuntos
Transtorno Bipolar/psicologia , Transtorno Depressivo Maior/psicologia , Emoções , Expressão Facial , Percepção , Adulto , Feminino , Humanos , Masculino , Testes NeuropsicológicosRESUMO
Este estudo avaliou as associações e dissociações encontradas entre déficits de memória episódica em relação aos de funções executivas e verificou se estes déficits encontrados eram primários ou secundários. Os 81 pacientes pós-Traumatismo Cranioencefálico (TCE) foram avaliados por meio do Teste de Aprendizagem Auditivo-Verbal de Rey e do Teste Hayling. Os resultados sugerem que prejuízo na velocidade de controle inibitório pode contribuir para déficit na memória episódica e que as velocidades de iniciação e inibição parecem ser complementares, mas a primeira precede a segunda. Nossos achados ressaltam que os prejuízos executivos provavelmente sejam primários em nossa amostra de pacientes pós-TCE e que estes prejuízos podem causar déficits na memória episódica (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Traumatismos Craniocerebrais/psicologia , MemóriaRESUMO
Este estudo avaliou as associações e dissociações encontradas entre déficits de memória episódica em relação aos de funções executivas e verificou se estes déficits encontrados eram primários ou secundários. Os 81 pacientes pós-Traumatismo Cranioencefálico (TCE) foram avaliados por meio do Teste de Aprendizagem Auditivo-Verbal de Rey e do Teste Hayling. Os resultados sugerem que prejuízo na velocidade de controle inibitório pode contribuir para déficit na memória episódica e que as velocidades de iniciação e inibição parecem ser complementares, mas a primeira precede a segunda. Nossos achados ressaltam que os prejuízos executivos provavelmente sejam primários em nossa amostra de pacientes pós-TCE e que estes prejuízos podem causar déficits na memória episódica
The present study evaluated the presence of associations and dissociations between impairments in episodic memory and executive functions in patients with traumatic brain injury (TBI), and verified whether these deficits were primary or secondary. Eighty-one patients with TBI were assessed using the Rey Auditory Verbal Learning Test and the Hayling Test. The results suggest that impairments in inhibition speed may contribute to deficits in episodic memory, and that initiation and inhibition abilities may be complementary and the first precedes the second. Our findings highlighted that primary executive impairment following TBI may lead to episodic memory deficits