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Yıl:2021; Cilt: 58; Sayı: 2>> Özet
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Nöropsikiyatri Arşivi; 2021;58(2):87-93
Bipolar Bozuklukta DEHB Ek Tanısı Varlığında Nörobilişsel İşlevler
H E Arat Çelik , D Ceylan , C Hıdıroğlu Ongun , A Erdoğan , D Tan ,P Gümüşkesen , B Bağcı , A Özerdem
Maltepe Üniversitesi, İstanbul
(DEHB) yetişkinlerde sıklıkla bir arada görülmektedir. Her iki durumda da nörobilişsel ve davranışsal problemler bulunmaktadır. Bu çalışmada DEHB ek tanısı olan erişkin BB (BB+DEHB) tanılı bireylerin nörobilişsel işlevlerinin yalnız BB tanılı bireyler, yalnız DEHB tanılı bireyler ve sağlıklı kontrollerle (SK) karşılaştırılması amaçlanmıştır. Yöntem: Nörobilişsel işlevlerin değerlendirilmesi amacıyla erişkin (18–65 yaş arası) BB tanılı bireylere (s=37), DEHB tanılı bireylere (s=43), BB+DEHB (s=20) tanılı bireylere ve sağlıklı kontrollere (s=51) sözel öğrenme ve bellek, görsel bellek, işlem hızı, dikkat, yürütücü işlevler, işleyen bellek ve sözel akıcılık işlevlerinin ölçüldüğü geniş bir nörobilişsel batarya uygulanmıştır. Nörobilişsel testler gruplar arasında, yaş, eğitim seviyesi ve toplam BIS puanları eş değişken olarak alınarak, çok faktörlü kovaryans analizi modeli kullanılarak değerlendirilmiştir. Bulgular: BB ve BB+DEHB grupları işlem hızı, dikkat, yürütücü işlev ve sözel akıcılık alanlarında, sağlıklı kontrollere göre anlamlı olarak düşük performans göstermiştir. BB grubu ek olarak yürütücü işlev, sözel öğrenme ve bellek alanlarında bozukluklar göstermiştir. BB ve BB+DEHB grupları arasında sözel öğrenme ve bellek, görsel bellek, işlem hızı, dikkat, yürütücü işlevler, işleyen bellek ve sözel akıcılık alanlarında anlamlı farklılık saptanmamıştır. DEHB grubu sözel akıcılık alanında sağlıklı kontrollere göre anlamlı olarak kötü performans sergilemiştir. Sonuç: Bulgularımız erişkin BB ve BB+DEHB tanılı bireylerin nörobilişsel işlevler açısından büyük oranda benzerlikler gösterdiğini ortaya koymaktadır. Bulgular BB ve DEHB’nin nörogelişimsel açıdan benzer ve farklı yönlerinin ortaya konması için daha çok çalışmaya ihtiyaç olduğunu göstermektedir
Neurocognitive Functions in Bipolar Disorder in Relation to Comorbid ADHD
Introduction: Bipolar disorder (BD) and attention deficit hyperactivity disorder (ADHD) often co-occur in adult population. Both conditions present various neurocognitive and behavioral problems. We aimed to examine neurocognitive functions in adult patients with comorbid BD and ADHD (BD+ADHD) in comparison to patients with only BD, only ADHD and healthy controls (HCs). Method: An extensive cognitive battery which evaluates verbal learning and memory, visual memory, processing speed, attention, executive functions, working memory and verbal fluency, was used to assess neurocognitive functions respectively in adult (age 18–65 years) patients with BD (n=37), ADHD (n=43), BD+ADHD (n=20) in comparison to HCs (n=51). The Multivariate Analysis of Covariance models, where age, level of education and total BIS-11 scores were included as covariates, were used for comparing neurocognitive scores among groups. Results: Both BD and BD+ADHD groups showed significantly poorer performance than HCs in processing speed, attention, executive functions, and verbal fluency domains. The BD group had additional significant deficits in executive functions, verbal learning and memory domains. There were no significant differences between BD and BD+ADHD groups with regards to verbal learning and memory, visual memory, processing speed, attention, executive functions, working memory and verbal fluency domains. Patients with only ADHD showed significantly poorer performance than HCs in verbal fluency domain. Conclusions: Our results show similarities in the neurocognitive functions of adults with BD and BD+ADHD across a wide range of cognitive domains. The findings point to the need for further exploration of diverging and converging neurodevelopmental trajectories of BD and ADHD.

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