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Zaburzenia ci g o ci uwagi u pacjentów z chorob afektywn dwubiegunow w remisji

Keywords: bipolar disorder , cognitive functions , sustained attention , Rapid Visual Information Processing , lithium

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Abstract:

Background: Sustained attention deficits are proposedto be both state and trait indicators of bipolar disorder.The results of studies evaluating attention of bipolarpatients are inconsistent. Most of them assessed patientsin acute episodes of affective illness. In euthymic bipolarpatients some authors reported attention deficits andregarded them as one of core features of bipolar disorder(BD), others have not reported attention disturbances.The aim of this study was to assess sustained attentionin patients with bipolar disorder in remission using RapidVisual Processing Test (RVIP) from CambridgeAutomated Neuropsychological Test Battery (CANTAB).Material and methods: Ninety-eight patients with bipolardisorder in remission lasting for at least 4 months diagnosedaccording to ICD-10 criteria and ninety healthy controlsentered the study. Duration of illness was at least 5 yearsand prophylactic treatment lasted for at least 2 years. Sixtypatients were treated with lithium and 38 with other moodstabilizers. Mental state of patients was assessed usingHamilton Depression Rating Scale (HAMD), and YoungMania Scale (YMS). All included bipolar patients metcriteria of remission – HAMD < 8 and YMS < 6.Results: Bipolar patients showed significantly worsesensitivity to the target (A’) and longer reaction time thanhealthy controls. Lithium treated patients and patientstaking other mood stabilizers showed worse differentiationbetween signals and noise and longer time of reactionthan controls. In the lithium group serum level of lithiumshowed positive correlation with time of reaction andnegative correlation with total hits number and totalcorrect rejections. A target sensitivity was negativelycorrelated with a duration of illness and mean latency waspositively correlated with the age of patients, a durationof illness as well as a number of reccurences.Conclusions: The results of the study point tothe persistence of sustained attention deficits in remissionof bipolar disorder. Bipolar patients treated with lithiumin combination with other drugs scored less in RVIPthan remaining patients.

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