A meta-analysis of data-driven cognitive subgroups in bipolar disorder

IF 6.1 2区 医学 Q1 CLINICAL NEUROLOGY European Neuropsychopharmacology Pub Date : 2024-11-06 DOI:10.1016/j.euroneuro.2024.10.008
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Abstract

The delineation of cognitive subgroups of bipolar disorder (BD) might be helpful for identifying biologically valid subtypes of this disorder. This meta-analysis identified peer-reviewed literature on studies investigating cognitive subgroups of BD with data-driven clustering methods. Relevant studies were searched in PubMed, Scopus, and Web of Science. Random-effects meta-analysis was performed using R software. A total of 14 cross-sectional studies including euthymic or mildly symptomatic patients with BD were included in the current meta-analysis. The available studies have consistently supported a 3-cluster solution. The pooled prevalence of the severe-impairment, moderate-impairment, and major good-functioning groups were 23.1 % (95%CI, 18.5 %–27.7 %), 42.5 % (95%CI, 36.3 %–48.8 %), and 33.5 % (95%CI, 25.9 %–41.1 %) respectively. Compared to healthy controls, both the severe-impairment (g=−1.40 to −1.73) and moderate-impairment groups (g=−0.59 to −0.96) had significant deficits in all six cognitive domains (verbal memory, visual memory, executive functions, working memory, attention and processing speed). The good-performance subgroup had a small increase in the performance of executive functions (g=0.23) and normal functioning in all other domains. Compared to the good-performance subgroup, the severe-impairment subgroup was characterized by more severe functional impairment, more hospital admissions, a higher percentage of type I BD and antipsychotic use. The characteristics of the moderate-impairment subgroup were lying between the other two subgroups for most of the measures. The current findings support the existence of 3 cognitive subgroups in BD including severe-impairment and moderate-impairment groups which are associated with a more severe course of illness.
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双相情感障碍认知分组数据荟萃分析
双相情感障碍(BD)认知亚组的划分可能有助于确定该障碍在生物学上有效的亚型。这项荟萃分析采用数据驱动的聚类方法,对调查双相情感障碍认知亚组的研究进行了同行评议,并确定了相关文献。相关研究在 PubMed、Scopus 和 Web of Science 中进行了检索。使用 R 软件进行随机效应荟萃分析。目前的荟萃分析共纳入了 14 项横断面研究,其中包括无症状或症状轻微的 BD 患者。现有研究一致支持 3 簇解决方案。重度受损组、中度受损组和主要功能良好组的汇总患病率分别为 23.1%(95%CI,18.5%-27.7%)、42.5%(95%CI,36.3%-48.8%)和 33.5%(95%CI,25.9%-41.1%)。与健康对照组相比,重度受损组(g=-1.40 至-1.73)和中度受损组(g=-0.59 至-0.96)在所有六个认知领域(言语记忆、视觉记忆、执行功能、工作记忆、注意力和处理速度)均存在显著缺陷。表现良好的亚组在执行功能方面的表现略有提高(g=0.23),而在所有其他领域的表现正常。与表现良好亚组相比,重度受损亚组的特点是功能受损更严重、入院次数更多,I 型 BD 的比例更高,并使用抗精神病药物。中度受损亚组在大多数测量指标上的特征介于其他两个亚组之间。目前的研究结果支持在 BD 中存在 3 个认知亚组,包括重度损伤组和中度损伤组,它们与更严重的病程有关。
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来源期刊
European Neuropsychopharmacology
European Neuropsychopharmacology 医学-精神病学
CiteScore
10.30
自引率
5.40%
发文量
730
审稿时长
41 days
期刊介绍: European Neuropsychopharmacology is the official publication of the European College of Neuropsychopharmacology (ECNP). In accordance with the mission of the College, the journal focuses on clinical and basic science contributions that advance our understanding of brain function and human behaviour and enable translation into improved treatments and enhanced public health impact in psychiatry. Recent years have been characterized by exciting advances in basic knowledge and available experimental techniques in neuroscience and genomics. However, clinical translation of these findings has not been as rapid. The journal aims to narrow this gap by promoting findings that are expected to have a major impact on both our understanding of the biological bases of mental disorders and the development and improvement of treatments, ideally paving the way for prevention and recovery.
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