研究背景
過去研究發現，雙極症患者即使在緩解之後仍然有持續的神經心理功能缺損，且大多研究認為雙極症患者的心理社會及職業失能與神經心理功能損傷有關。第一型雙極症與第二型雙極症為雙極症中較常見且嚴重的兩種亞型，由於兩者具許多不同病理特性，實務上應針對兩種亞型的神經心理障礙之差異分別設計治療或復健計劃才能達到較佳療效。然而由於第二型雙極症在臨床上不易偵測且易被誤診，因此過去研究大多針對第一型雙極症，目前對於第二型雙極症的瞭解仍較為不足。本研究目的在比較第一型雙極症與第二型雙極症患者及健康控制組之神經心理功能差異，以作為往後臨床實務之參考。

研究方法
共收集67名症狀穩定之雙極症患者（第一型雙極症 30人，第二型雙極症 37人），另有22名健康受試者。進行記憶力、心理運動速度、執行功能等一系列的神經心理學功能測驗。

研究結果
第一型雙極症相較於第二型雙極症與健康控制組有較差的語文記憶、心理運動速度、執行功能。兩組亞型皆比健康控制組有較差的工作記憶與心理運動速度，在心理速度方面第二型雙極症表現優於第一型雙極症。兩組亞型的視覺記憶表現未顯著發現低於健康控制組。

研究結論
第一型雙極症有較差的語文記憶、工作記憶、心理運動速度、執行功能；第二型雙極症僅發現有工作記憶與心理運動速度的缺損。顯示認知功能缺損皆存在於不同的雙極症亞型，且第一型雙極症較為嚴重。因此復健計畫應考慮這些差異針對不同的亞型設計不同的治療與認知復健計畫。

Background
The literature reports persistent cognitive impairments in patients with bipolar disorder even after prolonged remission. However, a majority of studies have focused only on bipolar I disorder (BP-I), primarily because bipolar II disorder (BP-II) is often underdiagnosed or misdiagnosed. More attention should be paid to the differences between BP-I and BP-II, especially the aspects of neuropsychological functioning. We examined the different neuropsychological functions in BP-I and BP-II patients and compared them with those of healthy controls.

Methods
The study included 67 patients with inter-episode bipolar disorder (BP-I: n = 30, BP-II: n = 37), and 22 healthy controls compared using a battery of neuropsychological tests that assessed memory, psychomotor speed and certain aspects of frontal executive function.

Results
The BP-I group performed poorly on verbal memory, psychomotor speed, and executive function compared to the BP-II and control groups. Both bipolar groups performed significantly less well than the control group on measures of working memory and psychomotor speed, while the BP-II group showed an intermediate level of performance in psychomotor speed compared to the BP-I and control groups. There was no difference between the groups on visual memory.

Conclusions
BP-I was characterized by reduced performance in verbal memory, working memory, psychomotor speed, and executive function, while BP-II showed a reduction only in working memory and psychomotor speed. Cognitive impairment existed in both subtypes of bipolar disorder, and was greater in BP-I patients. Rehabilitation interventions should take into account potential cognitive differences between these bipolar subtypes.

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