Control study on executive function in adolescents with bipolar disorder before and after therapy

Abstract

Objective To study the executive function and the related factors before and after therapy.Methods Thirty adolescents with depressed bipolar patients and 30 adolescents with manic bipolar patients (study group),thirty health adolescents controls(control group)were assessed for executive function using the Wisconsin Card Sorting Test(WCST),the Stroop Color Word Test(SCW),the Tower of London Test,the Digital Sequence Test and Spatial Span Test.Neuropsychological assessment was performed respectively in the 1st week of entering the group and the end of the 8th week.Results Before and after the treatment the study group performed poorer on all of the neuropsyehological tests than control group(P＜0.01).Furthermore,follow-up assessment revealed that although study group demonstrated an overall improvement,the deficits in executive functions remain.Manic bipolar patients showed the worse performance than depressed bipolar patients on subtests reflecting inhibitory control before treatment(NRPE:27.30±5.19 vs 31.77±6.13;R F:30.60±7.41 vs 35.33±9.06;RTA:(53.40±8.97)s vs(63.63±8.85)s;RTB:(81.93±8.44)s vs(93.87±6.98)s;RTC:(127.27±12.52)s vs(160.27±13.70)s;SIE:(45.33±13.90)s vs(66.40±13.56)s,P＜0.01 or P＜0.05).After 8 weeks treatment,there were remarkable differences between depressed bipolar group and mania bipolar group on RF,TOL,RTA,RTB,RTC,SIE(P＜0.01 or P＜0.05).Self-comparison of the depressed bipolar on nenropsychological performance before and after treatment showed significant difference(P＜0.01),except RTA and RTB of the SCW (P＞0.05).Self-comparisen of the manic bipolar on neuropsychological performance before and after treatment showed significant difference(P＜0.01).The Tower of London test and the number of categories of WCST were negatively correlated to the course of disease(P＜0.05);Perseverative Errors score,Non-Perseverative Errors score and the Responses of Finishing the first Category of WCST and the Interference of Stroop were positive correlated to the course of disease(P＜0.05).Conclusion The impairment of executive function in young patients with bipolar disorder is observed in the period of disease,which could improve after treatment. Key words: Adolescents; Bipolar disorder; Executive function; Control study