Anger and Executive Function in Bipolar Disorder
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Bipolāri traucējumi ir garastāvokļa traucējumi, ko raksturo mānijas vai hipomānijas un depresijas vai jauktu stāvokļu epizodes. Traucējumi ietekmē ne tikai garastāvokli un uzvedību, bet arī domas, emocijas un izziņu. Iepriekš tika pieņemts, ka pacientu labāka funkcionalitāte starp garastāvokļa epizodēm nekā dažu citu nopietnu psihopatoloģiju gadījumā, piemēram, šizofrēnijas gadījumā, ir saistīta ar emocionālu un kognitīvu simptomu neesamību. Tomēr tagad ir atzīts, ka tiem, kuriem ir bipolāri traucējumi, ir gan emocionālās, gan kognitīvās funkcijas traucējumu pazīmes neatkarīgi no garastāvokļa epizodes simptomiem. Ir zināms, ka šie traucējumi ietekmē pacientu funkcionalitāti un dzīves kvalitāti.
Ir konstatētas izmaiņas bipolāru pacientu emocionālajā apstrādē, kā arī palielināts negatīvo emociju biežums un ar emocijām saistītā impulsivitāte. Šos atklājumus apstiprina kortiko-limbisko ceļu disfunkcija, kas novērota funkcionālās magnētiskās rezonanses attēlveidošanā, jo īpaši kā amigdalas, striatuma un talāma pārmērīga aktivizēšana. Kognitīvie traucējumi tagad tiek atpazīti arī eitimiskos stāvokļos un ka dažās izziņas jomās notiek ilgtermiņa lejupslīde. Tomēr kognitīvais profils ir ļoti mainīgs un neviendabīgs, un šķiet, ka noteiktu pacientu daļu tas neietekmē. Tie ir saistīti ar atšķirībām prefrontālās garozas aktivācijā funkcionālās magnētiskās rezonanses attēlveidošanā.
Izpildfunkcijai ir nozīme emociju regulēšanā, bet kognitīvie un emocionālie traucējumi nav plaši pētīti kopā ar tiem, kam ir bipolāri traucējumi. Šī literatūras apskata mērķis bija novērtēt pašreizējo literatūru par kognitīviem traucējumiem, īpaši izpildfunkciju, un emocionālo regulējumu, un īpaši par dusmu regulēšanu tiem, kam ir bipolāri traucējumi. Turklāt uzmanība tika pievērsta korelācijai starp emocionāliem un kognitīviem traucējumiem.
Bipolar disorder is a mood disorder characterized by episodes of mania or hypomania and depression or mixed states. The disorder not only affects the mood and behaviour, but also thoughts, emotions, and cognition. Previously it has been presumed that patients’ better functionality between mood episodes than in some other major psychopathologies, e.g., schizophrenia, has been due to the absence of emotional and cognitive symptoms. Now, however, it is recognized that those with bipolar disorder show signs of disturbances in both emotional and cognitive function, independent of mood episode symptoms. These impairments are known to affect patients’ functionality and quality of life. There have been found changes in bipolar patients’ emotional processing as well as increased frequency of negative emotions and emotion-related impulsivity. These findings are supported by dysfunction in cortico-limbic pathways seen in functional magnetic resonance imaging, most prominently as overactivation of the amygdala, striatum, and thalamus. Cognitive impairments are now also recognized in euthymic states as well and there’s a long-term decline in certain domains of cognition. However, there’s great variability and heterogeneity of cognitive profile and a certain portion of patients seem not to be affected by them. These are related to differences in prefrontal cortex activation in functional magnetic resonance imaging. Executive function plays a role in emotion regulation, but cognitive and emotional impairments have not been widely studied together with those with bipolar disorder. This literature review aimed to evaluate current literature in cognitive impairments, especially executive function, and emotional regulation, and specifically anger regulation in those with bipolar disorder. Additionally, there was a focus on the correlation between emotional and cognitive impairments.
Bipolar disorder is a mood disorder characterized by episodes of mania or hypomania and depression or mixed states. The disorder not only affects the mood and behaviour, but also thoughts, emotions, and cognition. Previously it has been presumed that patients’ better functionality between mood episodes than in some other major psychopathologies, e.g., schizophrenia, has been due to the absence of emotional and cognitive symptoms. Now, however, it is recognized that those with bipolar disorder show signs of disturbances in both emotional and cognitive function, independent of mood episode symptoms. These impairments are known to affect patients’ functionality and quality of life. There have been found changes in bipolar patients’ emotional processing as well as increased frequency of negative emotions and emotion-related impulsivity. These findings are supported by dysfunction in cortico-limbic pathways seen in functional magnetic resonance imaging, most prominently as overactivation of the amygdala, striatum, and thalamus. Cognitive impairments are now also recognized in euthymic states as well and there’s a long-term decline in certain domains of cognition. However, there’s great variability and heterogeneity of cognitive profile and a certain portion of patients seem not to be affected by them. These are related to differences in prefrontal cortex activation in functional magnetic resonance imaging. Executive function plays a role in emotion regulation, but cognitive and emotional impairments have not been widely studied together with those with bipolar disorder. This literature review aimed to evaluate current literature in cognitive impairments, especially executive function, and emotional regulation, and specifically anger regulation in those with bipolar disorder. Additionally, there was a focus on the correlation between emotional and cognitive impairments.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Bipolāri traucējumi, izpildfunkcija, emociju regulēšana, dusmas, Bipolar disorder, executive function, emotion regulation, anger