مقایسه کارکردهای اجرایی بیماران دوقطبی نوع I و افراد بهنجار با استفاده از آزمون های ویسکانسین و برج لندن

نوع مقاله: مقاله پژوهشی

نویسندگان

1 دانشیار روان‌شناسی عمومی،دانشگاه شهید باهنر کرمان، کرمان ، ایران.

2 دانشجوی دکتری روان‌شناسی عمومی، دانشگاه شهید باهنر کرمان، کرمان ، ایران.

3 کارشناسی ارشد روانشناسی عمومی، دانشگاه آزاد اسلامی واحد ساری، ساری ، ایران.

چکیده

مقدمه:عملکرد اجرایی،یک سیستم چند بعدی همراه با پردازش­های چندگانه است که در بیماران دوقطبی،صدمه دیده است، لذا هدف از مطالعه حاضر مقایسه کارکردهای اجرایی بیماران دوقطبی نوع I که به مدت 5 سال تحت درمان توانبخشی قرار داشتند و افراد بهنجار است.روش:پژوهش حاضر از نوع علی مقایسه­ ای است که روی دو گروه 30 نفره از بیماران مبتلا به اختلال دوقطبی نوع یک که از سال 91 تحت درمان توانبخشی بودند و یک گروه از افراد بهنجار که با بیماران دوقطبی همتاسازی شدند، انجام شد. ابزارهای مورد مطالعه نسخه کامپیوتری آزمون ویسکانسین و برج­ لندن بود. داده­ های به­ دست آمده با استفاده از روش تحلیل­ واریانس چندمتغیری مانوا مورد تحلیل قرار گرفت. یافته­ ها:نتایج نشان داد بین دو گروه در کارکردهای اجرایی تفاوت معناداری وجود دارد(88/0=partial h2 و00/0< P و 66/20=(21و8)F).نتیجه­ گیری:بر اساس نتایج به­دست آمده با وجود آن­که بیماران دوره­ های درمانی متعدد توانبخشی را در طول چندین سال گذرانده­ اند اما صدمات شناختی آن­ها همچنان پایدار بوده است.

کلیدواژه‌ها


عنوان مقاله [English]

Comparison of Executive Functions of Bipolar I Patients and Normal Subjects Using Wisconsin and London Tower Tests

نویسندگان [English]

  • masoud bagheri 1
  • farzaneh pooladi 2
  • fahimeh saadat 3
1 Associate Professor of General Psychology, Shahid Bahonar University of Kerman, Kerman, Iran
2 Ph.D Student, General Psychology, Shahid Bahonar University of Kerman, Kerman, Iran.
3 M . A in General Psychology, Islamic Azad University of Sari, Sari, Iran
چکیده [English]

Aim: :executive function is a multidimensional system with multiple processing that is damaged in bipolar patients. Therefore, the purpose of this study is to compare the executive function of bipolar I patients who received rehabilitation for 5 years and normal subjects.Method:The present study is a comparative causal study that was performed on two groups of 30 patients with bipolar I disorder who underwent rehabilitation therapy from year 1391 and a group of normal subjects who were matched to bipolar patients. The tools used were the computerized version of the Wisconsin Test and Tower of London. Data were analyzed using MANOVA Multivariate Analysis.Findings:The results showed that there is a significant difference between the two groups in the executive functions (F (8, 21) = 20/66 & P2 =0/88) Conclusion:Based on the results, although patients have undergone several rehabilitation therapy courses for several years, their cognitive impairments have remained stable.

کلیدواژه‌ها [English]

  • Executive Functions
  • bipolar I disorder
  • Wisconsin test
  • London towers test
جوانمرد، غ (1394). «مطالعه کارکردهای اجرایی در بیماران اسکیزوفرنیک دارای علائم منفی و مثبت و افراد سالم با استفاده از آزمون نوروسایکولوژیک دسته بندی کارت ویسکانسین (WCST)». فصلنامه عصب روانشناسی. 1(1). 16-7.

علی پور، ا.؛ حسن زاده پشنگ، س.؛ صابری، ا (1359). «مقایسه کارکرد اجرایی بیماران مبتلا به اسکیزوفرنی، دوقطبی نوع یک و افراد غیر بیمار در آزمون های نوروسایکولوژیک برج لندن و استروپ». فصلنامه عصب روانشناسی. 2(1)، 30-9.

قدیری، ف.؛ جزایری، ع.؛ عشایری، ح.؛ قاضی طباطبایی، م (1385). «نقائص کارکردهای اجرایی در بیماران اسکیزو – وسواسی». تازه های علوم شناختی. 8 (4)، 24- 11.

محمدی، ی.؛ پورمجیدی، ع (1395). «مقایسه سرعت یادگیری و انتقال اطلاعات در نیمکره های مغز بین افراد وابسته به مواد مخدر و افراد عادی در شهر تهران». فصلنامه عصب روانشناسی. 2(1)، 116-107.

Anderson, S.W., Damasio, H., Jones, R.D., & Tranel, D. (1991). Wisconsin Card Sorting Test performance as a measure of frontal lobe damage. J Clin Exp Neuropsychol, 13(6), 909-22.

Andreoua, C., & Bozikas, V.P. (2013). The predictive significance of neurocognitive factors for functional outcome in bipolar disorder. Curr. Opin. Psychiatry, 26(1), 54–59.

Blakemore, S.J., & Choudhury, S. (2006). Development of the adolescent brain: implications for executive function and social cognition. J Child Psychol Psychiatry, 47(3-4), 296-312.

Bora, E., Bartholomeusz, C., & Pantelis, C. (2016). Meta-analysis of Theory of Mind (ToM) impairment in bipolar disorder. Psychol. Med, 46(2), 253–264.

Bora, E., & Pantelis, C. (2015). Meta-analysis of Cognitive Impairment in First-Episode Bipolar Disorder: Comparison With First-Episode Schizophrenia and Healthy Controls. Schizophr.Bull, 41(5), 1095–1104.

 Bor, J., Brunelin, J., d’Amato, T., Costes, N.,  Suaud-Chhagny, M.F., Saoud, M., & et al. (2011). How can cognitive remediation therapy modulate brain activations in schizophrenia? An fMRI study. Psychiatry Res,192(3), 160–166.

Bourne, C., Aydemir, O¨., Balanza´-Martı´nez, V., Bora, E., Brissos, S., & et al. (2013). Neuropsychological testing of cognitive impairment in euthymic bipolar disorder: an individual patient data meta-analysis. Acta Psychiatr Scand, 128(3),149–62.

Braw, Y., Erez, G., Sela, T., Gvirts, H.Z., Hare, E.V., Bloch, Y., Levkovitz, Y. (2013). A longitudinal study of cognition in asymptomatic and mildly symptomatic bipolar disorder patients. Psychiatry Res, 210(3), 842–9.

Culbertson, W.C., Zillmer, E.A. (1998). The tower of London DX: A standardized approach to assessing executive functioning in children. Arch clin Neurophysiol, 13(3), 285-301.

Dickerson, F., Boronow, J., Stallings, G., Origoni, A., Cole, S., Yolken, R. (2004). Association between cognitive functioning and employment status of persons with bipolar disorder. Psychiatr Serv, 55(1), 54–58.

 Eack, S.M., Hogarty, G.E., Cho, R.Y., Prasad, K.M., Greenwald, D.P., Hogarty, S.S., & et al. (2010). Neuroprotective effects of cognitive enhancement therapy against gray matter loss in early schizophrenia: results from a 2-year randomized controlled trial. Arch. Gen. Psychiatry, 67(7), 674–682.

Gruber, S.A., Dahlgren, M.K., Sagar, K.A., Gonenc, A., Norris, L., Cohen, B.M., & et al. (2017). Decreased Cingulate Cortex activation during cognitive control processing in bipolar disorder. Journal of Affective Disorders, 213, 86–95.

 Gvirts, H.Z., Braw, Y., Harari, H., Lozin, M., Bloch, Y., Fefer, K., & et al. (2015). Executive dysfunction in bipolar disorder and borderline personality disorder. European Psychiatry, 30(8), 959–964.

Iverson, G.L., Brooks, B.L., Langenecker, S.A., Young, A.H. (2011). Identifying a cognitive impairment subgroup in adults with mood disorders. J. Affect. Disord, 132(3), 360–367.

Kurtz, M.M., & Gerraty, R.T. (2009). A meta-analytic investigation of neurocognitive deficits in bipolar illness: profile and effects of clinical state. Neuropsychology, 23(5), 551–562.

Lee, R.S.C., Hermens, D.F., Porter, M.A., Redoblado-Hodge, M.A. (2012). A meta-analysis of cognitive deficits in first-episode Major Depressive Disorder. J Affect Disord, 140(2), 113–24.

Leung, M.M.W., Lui, S.S.Y., Wang, Y., Tsui, C.F., Au, A.C.W., Yeung, H.K.H., & et al. (2016). Patients with bipolar disorder show differential executive dysfunctions: A case-control study. Psychiatry Research, 238, 129–136.

Lewandowski, K.E., Cohen, B.M., Keshavan, M.S., Sperry, S.H., & Ongur, D. (2013). Neuropsychological functioning predicts community outcomes in affective and nonaffective psychoses: a 6-month follow-up. Schizophr. Res, 148(1–3), 34–37.

Lezak, M.D., Howieson, D.B., & Loring, D.W. (Eds). Neuropsychological Assessment. New York: Oxford Uni press 2004.

Okasha, T.A., Sheikh, M.M., Missiry, A.A., Missiry, M.A., Serafi, D., Kholy, S., & et al. (2014). Cognitive functions in euthymic Egyptian patients with bipolar disorder: Are they different from healthy controls?. Journal of Affective Disorders, 166, 14–21.

Passarotti, A.M., Trivedi, N., & Patel, M. (2016). Executive Function in Adolescent Bipolar Disorder With and Without ADHD Comorbidity. Bipolar Disord, 1, 101.

Penadés, R., Pujol, N., Catalán, R., Masana, G., García-Rizo, C., Bargalló, N., & et al. (2016). Cortical thickness in regions of frontal and temporal lobes is associated with responsiveness to cognitive remediation therapy in schizophrenia. Schizophr. Res, 171(1-3), 110–116.

Poletti, S., SferrazzaPapa, G., Locatelli, C., Colombo, C., & Benedetti, F. (2014). Neuropsychological deficits in bipolar depression persist after successful antidepressant treatment. J. Affect. Disord, 156, 144–149.

Popov, T., Jordanov, T., Rockstroh, B., Elbert, T., Merzenich, M.M., & Miller, G.A. (2011). Specific cognitive training normalizes auditory sensory gating in schizophrenia: a randomized trial. Biol. Psychiatry, 69(5), 465–471.

Mann-Wrobel, M.C., Carreno, C.J., & Dickinson, J.T.D. (2011). Meta-analysis of neuropsychological functioning in euthymic bipolar disorder: an update and investigation of moderator variables. Bipolar Disord, 13(4), 334–42.

Martino, D.J., Strejilevich, S.A., Marengo, E., Ibañez, A., Scápola, M., & Igoa, A. (2014). Toward the identification of neurocognitive subtypes in euthymic patients with bipolar disorder. Journal of Affective Disorders, 167, 118–124.

 Martino, D.J., Strejilevich, S.A., Scápola, M., Igoa, A., Marengo, E., Ais, E., & et al. (2008). Heterogeneity in cognitive functioning among patients with bipolar disorder. J. Affect. Disord, 109(1–2), 149–156.

Maruta, N.A., Verbenko, V.A., & Verbenko, G.N. (2013). The neurocognitive dysfunction in adult patients with bipolar I disorder type. Crimean Journal of Experimental and Clinical edicine, 3, 1-2.

Merikangas, K.R., Jin, R., He, J.P., Kessler, R.C., Lee, S., Sampson, N.A., & et al. (2011). Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch. Gen. Psychiatry, 68(3), 241–251.

Miyake, A., & Friedman, N.P. (2012). The nature and organization of individual differences in executive functions: Four general conclusions. Current Directions in Psychological Science, 21(1), 8-14.

Mur, M., Portella, M.J., Martınez-Aran, A., Pifarre, J., & Vieta, E. (2008). Neuropsychological profile in bipolar disorder: a preliminary study of monotherapy lithiumtreated euthymic bipolar patients evaluated at a 2-year interval. Acta Psychiatr. Scand, 118(5), 373–381.

Murphy, F.C., & Sahakian, B.J. (2001). Neuropsychology of bipolar disorder. The British Journal of Psychiatry, 178(41), 120-127.

Subramaniam, K., Luks, T.L., Fisher, M., Simpson, G.V., Nagarajan, S., & Vinogradov, S. (2012). Computerized cognitive training restores neural activity within the reality monitoring network in schizophrenia. Neuron,73(4), 842–853.
Rubinsztein, J.S., Michael, A., Underwood, B.R., Tempest, M., & Sahakian, B.J. (2006). Impaired cognition and decision-making in bipolar depression but no _affective bias_ evident. Psychol Med, 36, 629–639.

Ryan, K.A., Vederman, A.C., McFadden, E.M., Weldon, A.L., Kamali, M., Langenecker. S.A., & et al. (2012). Differential executive functioning performance by phase of bipolar disorder. Bipolar Disord, 14(5), 527–536.

Sepede, G., De Berardis, D., Campanella, D., Perrucci, M.G., Ferretti, A., Serroni, N., & et al. (2012). Impaired sustained attention in euthymic bipolar disorder patients and nonaffected relatives: an fMRI study. Bipolar Disord, 14(7), 764–79.

Sole, B., Martınez-Aran, A., Torrent, C., Bonnin, C.M., Reinares, M., Popovic, D., & et al. (2011). Are bipolar II patients cognitively impaired? A systematic review. Psychol. Med, 41(9), 1791–1803.

Spreen, O., & Strauss, E.A. compendium of neuropsychological tests: administration, norms, and commentary. Oxford University Press; 1991.

Van Rheenen, T.E., & Rossell, S.L. (2014). An investigation of the component processes involved in verbal declarative memory function in bipolar disorder; utility of the Hopkins Verbal Learning Test-Revised. J Int Neuropsychol Soc, 20,1–9.

Wykes, T., Reeder, C., Huddy, V., Taylor, R., Wood, H., Ghirasim, N., & et al. (2012). Developing models of how cognitive improvements change functioning: mediation, moderation and moderated mediation. Schizophr Res, 138, 88–93.

Zihl, J., Reppermund, S., Thum, S., & Unger, K. (2010). Neuropsychological profiles in MCI and in depression: differential cognitive dysfunction patterns or similar final common pathway disorder? J Psychiatr Res, 44(10), 647–54.