양극성 조증 환자에서 로샤 주요 변인과 실행 인지기능의 관계 = Relations of Executive Cognitive Functions with Rorschach Variables in Patients with Bipolar Mania

다국어 초록 (Multilingual Abstract)

Objectives : The Rorschach is the commonly used personality and symptom assessment in clinical practices including schizophrenia or bipolar disorder. We investigated the association between the executive functions probably required to respond to the Rorschach task and mania-related Rorschach variables in patients with bipolar mania. Methods : The Rorschach task as well as some subtests of Korean-Wechsler Adult Intelligence Scale (K-WAIS), Trail making test (TMT), Stroop test, and Controlled Oral Word Association Test (COWAT) were performed in 58 inpatients with bipolar mania. Results : There were significant correlations between organizational activities (Zf) and TMT-A and between thought disorder (Wsum6, Sum6) and TMT-B. Semantic fluency of COWAT and ‘block design’ of K-WAIS showed a significant correlation with affective cluster variables (FC, Afr) probably related to emotional regulation. However, Stroop test and the ‘reasoning’ subtest of K-WAIS did not show any significant correlation with the Rorschach variables. Conclusion : Despite some limitations, these findings suggest that cognitive flexibility, verbal fluency and visuoperceptual organization among executive functions may be differentially associated with cognitive processing- or affective regulation-related Rorschach variables in bipolar mania. So this result may support the potential use of the Rorschach in the study of emotion-cognition characteristics in bipolar disorder.

참고문헌 (Reference)

1 Weiss LG, "WAIS-IV clinical use and interpretation" Academic Press 2010

2 Minassian A, "Visual scanning deficits in schizophrenia and their relationship to executive functioning impairment" 74 : 69-79, 2005

3 Erol A, "Ventral prefrontal executive fun-ction impairment as a potential endophenotypic marker for bipolar disorder" 2013

4 Tohen M, "Two-year syndromal and functional recovery in 219 cases of first-episode major affective disorder with psychotic featu-res" 157 : 220-228, 2000

5 Mahurin RK, "Trail making test errors and executive function in schizophrenia and depression" 20 : 271-288, 2006

6 Singer HK, "The use of the Rorschach to differentiate unipolar and bipolar disorders" 60 : 333-345, 1993

7 Kortte KB, "The trail making test, part B: cognitive flexibility or ability maintain set?" 9 : 106-109, 2002

8 Jorgensen K, "The diagnostic efficiency of the rorschach depression index and the schizophrenia index : a review" 7 : 259-280, 2000

9 Stuss DT, "The Trail Making Test : A study in focal lesion patients" 13 : 230-239, 2001

10 Stuss DT, "Stroop performance in focal lesion patients : dissociation of processes and frontal lobe lesion location" 39 : 771-786, 2001

11 Heim S, "Specialisation in Broca’s region for semantic, phonological, and syntactic fluency?" 40 : 1362-1368, 2008

12 McGrath J, "Performance on tests sensitive to impaired executive ability in schizophrenia, mania and well controls: acute and subacute phases" 26 : 127-137, 1997

13 Smith SR, "Perceptual-organizational characteristics of the Rorschach task" 21 : 789-799, 2007

14 Goldberg E, "Neuropsychologic assessment of frontal lobe dysfunction" 28 : 567-580, 2005

15 Khadivi A, "Manic indices on the Rorschach" 69 : 365-375, 1997

16 Depp CA, "Health-related quality of life and functioning of middle-aged and elderly adults with bipolar disorder" 67 : 215-221, 2006

17 Chayer C, "Frontal lobe Functions" 2 : 547-552, 2001

18 Elliott R, "Executive functions and their disorders" 65 : 49-59, 2003

19 Stuss DT, "Executive functions and the frontal lobes: A conceptual view" 63 : 289-298, 2000

20 Alvarez JA, "Executive function and the frontal lobes : a meta-analytic review" 16 : 17-42, 2006

21 Viglione DJ, "Empirical support for interrater reliability of Rorschach Comprehensive System coding" 59 : 111-121, 2003

22 El-Badri SM, "Electrophysiological and cognitive function in young euthymic patients with bipolar affective disorder" 3 : 79-87, 2001

23 Ryan KA, "Differential executive functioning performance by phase of bipolar disorder" 14 : 527-536, 2012

24 Iloen T, "Diagnostic efficiency of the rorschach schizophrenia and depression indices in identifying first-episode schizophrenia and se-vere depression" 87 : 183-192, 1999

25 Yochim B, "D-KEFS Trail Making Test performance in patients with lateral prefrontal cortex lesions" 13 : 704-709, 2007

26 Morice R, "Cognitive inflexibility and pre-frontal dysfunction in schi-zophrenia and mania" 157 : 50-54, 1990

27 Martienz-Aran A, "Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder" 161 : 262-270, 2004

28 Troyer AK, "Clus-tering and switching on verbal fluency : The effects of focal frontal-and temporal-lobe lesions" 36 : 499-504, 1998

29 Chan RC, "Assessment of executive functions : review of instruments and identification of critical issues" 23 : 201-216, 2008

30 Dickstein LJ, "American psychiatric press review of psychiatry volume 15" American psychiatric press 1996

31 Chen CH, "A quantitative meta-analysis of fMRI studies in bipolar disorder" 13 : 1-15, 2011

32 Blumberg HP, "A functional magnetic resonance imaging study of bipolar disorder. State and trait related dysfunction in ventral prefrontal cortices" 60 : 601-609, 2003

33 Exner JE Jr., "A Rorschach workbook for the comprehensive system. 5th korean edition" Hakjisa 2011