Original Research Article
Year: 2017 | Month: September | Volume: 4 | Issue: 9 | Pages: 23-33
Evaluation of Executive Functions in Patients of Unipolar and Bipolar Depression
Vinay Kumar Srivastava1, Himani2
1Associate Professor, Department of Psychiatry, Major SD Singh Medical College, Farrukhabad
2Assistant Professor, Department of Microbiology, Major SD Singh Medical College, Farrukhabad
Corresponding Author: Himani
ABSTRACT
Background: Depression, bipolar and unipolar both have disturbances in executive functioning with loss of spontaneous and reactive cognitive flexibility. The cognitive rigidity associated with dorsolateral prefrontal dysfunction in depression may prevent patients to cope with life events and lead to a perpetuation of depressed mood by continuation of stress exposure. Though this is an area which has not been widely explored, yet it has great potential as an aid to clinical diagnosis in distinction of bipolar from unipolar depression.
Methods: The study was carried out in the Department of Psychiatry, Major S D Singh Medical College and Hospital, Farrukhabad, between the periods, June 2014 to Sep 2015.The present study was conducted to evaluate the executive function ability in patients of unipolar and bipolar depression. Patients of both groups were compared during their active phase of illness and after recovery for severity of depression by using Hamilton rating scale of depression (HAM-D) and for executive function abilities by WCST at regular intervals.
Results: Out of 60 patients, 7 patients dropped out due to no apparent reason. Out of remaining 53 patients, 27 patients were in unipolar group & 26 patients were in bipolar depression group. On comparison of mean HAM-D score at the beginning, unipolar and bipolar depression patients were found to differ significantly in severity. It was found that bipolar depression patients were more depressed in severity. But on reassessment at 6 weeks and 6 months after appropriate treatment, both groups were not different significantly on HAM-D scores. On comparison, the number of categories completed and perseverative errors committed by bipolar depression patients were significantly different in comparison to unipolar depression patients at the beginning of study, also after 6 weeks and 6 months of treatment. This also shows that patients of bipolar depression completed lesser number of categories and committed more perseverative errors than patients of unipolar depression. In comparison to unipolar, patients of bipolar depression showed poorer performance of executive functioning on WCST.
Conclusion: The study indicates that patients of unipolar and bipolar depression demonstrate significant deficits in the executive functioning as assessed by WCST. The patients of bipolar depression showed more significant deficit in executive functions compared to patients of unipolar depression. This finding is consistent with the observation that there is more definitive cognitive deterioration in bipolar depression compared to unipolar depression. Also patients with more severe depression were having greater impairment in executive functioning than those suffering with lesser degree of depression.
Key words: Depression, unipolar, bipolar, executive function.
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