PDF(Pubmed)
Abstract：
Even though pseudodementia has been historically linked to depression, other psychiatric conditions may cause reversible cognitive alterations. The purpose of this study is to improve our understanding of pseudodementia occurring throughout the entire bipolar spectrum. A systematic review was conducted according to PRISMA guidelines. PubMed, Scopus, and Web of Science databases were searched up to March 2023. Fifteen articles on patients with pseudodementia and bipolar disorder (BD), mania, hypomania, or mixed depression have been included. Moreover, seven female patients with mood disorders diagnosed with pseudodementia have been described. According to our research, pseudodementia in patients with BD mostly occurs during a depressive episode. However, pseudodementia has also been observed in the context of manic and mixed states. Psychomotor and psychotic symptoms were commonly associated. The most typical cognitive impairments were disorientation, inattention, and short-term memory deficits. Alterations in neuroimaging were frequently observed. Electroconvulsive therapy and lithium, either alone or in combination with antipsychotics, resulted in the most widely used therapies. Cognitive decline may occur in a substantial proportion of patients. Since pseudodementia can manifest along the entire mood spectrum, it should be taken into consideration as a possible diagnosis in BD patients showing cognitive deficits during manic, mixed, and depressive states.
摘要：
尽管从历史上看，假性痴呆与抑郁症有关，其他精神疾病可能导致可逆性认知改变。这项研究的目的是提高我们对整个双极频谱中发生的假性痴呆的理解。根据PRISMA指南进行了系统审查。PubMed,Scopus,和WebofScience数据库被搜索到2023年3月。15篇关于假性痴呆和双相情感障碍（BD）患者的文章，躁狂症,轻躁狂,或混合抑郁症已包括在内。此外，已经描述了七名被诊断为假性痴呆的情绪障碍的女性患者。根据我们的研究,BD患者的假性痴呆主要发生在抑郁发作期间。然而,在躁狂和混合状态的情况下也观察到假性痴呆。精神运动和精神病症状通常相关。最典型的认知障碍是定向障碍，注意力不集中,和短期记忆缺陷。经常观察到神经影像学的改变。电惊厥疗法和锂，单独或与抗精神病药联合使用，导致最广泛使用的疗法。认知能力下降可能发生在相当大比例的患者中。由于假性痴呆可以在整个情绪谱中表现出来，在狂躁期间表现出认知缺陷的BD患者中，应考虑将其作为可能的诊断，混合,和抑郁状态。
