ABSTRACT

【Abstract】Objective Exploring Clinical Symptoms, Cognitive Functions, and Cognitive-Symptom Network Differences in Adolescents with Major Depressive Disorder (Depression), Depressive Phase of Bipolar Disorder (Bipolar Depression), and Manic Phase of Bipolar Disorder (Bipolar Mania).
Methods This study enrolled 175 healthy adolescent controls and 380 patients (including 146 with depression, 131 with bipolar depression, and 103 with bipolar mania). Differences among groups were compared in terms of clinical symptoms and cognitive impairment. Network structure invariance testing was used to analyze differences in network structures among the three groups.
Results In terms of hypomania (HCL-32) and manic symptoms (MDQ), the severity of symptoms showed a "gradient" difference across the three groups: depression group < bipolar depression group < bipolar mania group (Ps < 0.05). In cognitive function, the bipolar mania group exhibited more significant cognitive impairment compared to the other groups (Ps < 0.05). The network structure of the bipolar mania group significantly differed from that of the depression group (M = 0.562, P = 0.028) and the bipolar depression group (M = 0.584, P = 0.028).
Conclusion   The bipolar mania group exhibited more severe hypomanic and manic symptoms, as well as greater cognitive impairment. Their symptom-cognitive network structure also differed from the other diagnostic groups. The symptoms and cognitive impairments of the depression and bipolar depression groups overlapped significantly. Therefore, it is crucial to explore more reliable assessment tools to differentiate between depression and bipolar depression.

Key words: Adolescent; Major depressive disorder; Bipolar disorder; Cognitive function; Network structure