台大心理系

Bipolar disorder (BD) is recognized as a severe and chronic mental disorder; bipolar I disorder (BDI) and bipolar II disorder (BDII) are the most known subtypes of BD. However, the criteria for two subtypes are somewhat similar and difficult to distinguish. A series of studies have been conducted, and interaction between different genotypes related to dopamine neuro-circuit have been found between BDI and BDII. The aldehyde dehydrogenase 2 polymorphisms (ALDH2) and DRD2, DRD3 play different role between BDI and BDII, indicating the possible neuropsychological impairment would be affected by different BD subtypes. Subsequently, we also found an interaction between genotype differences and neuropsychological impairment in BD. That the brain-derived neurotrophic polymorphism is more likely to impact on memory impairment in BDII while brain-derived neurotrophic factor level is correlated to clinical characteristics in BD patients. The BDNF and memory impairment may play as distinguishable factors in BD. In addition, BD patients often comorbid with other disorders, alcoholism and anxiety disorders have been reported as the most commonly seen comorbidity in BD previously. Having comorbidities would worsen their functioning and prolong patients’ remission period. Firstly, we found a relatively lower prevalent rate of both alcoholism dependence and anxiety disorders in BD comparing to previous reports conducted in western countries, indicating a possible role of ethnic and genotypes. The ALDH2 has been indicated as an important genotype to explain the significantly lower prevalent rate of alcoholism dependence among Han Chinese in Taiwan comparing to the western people. We found an interaction between ALDH2 and cognitive functioning in BD with/without anxiety comorbidity. Furthermore, an interaction between anxiety disorder comorbidity and some domains of neuropsychological performance in BD across different mood episodes was found. The memory and executive impairment may play as state-like cognitive phenotypes while sustained attention deficit plays as trait-like for BD. So far, the etiology between BDI and BDII is different; and the comorbidity plays another impact on different domains of neuropsychological impairment would help us to develop further evaluation and therapy.