Attention impairment in bipolar disorder: A systematic review.

Bipolar disorder (BD) is associated with important cognitive deficits that persist during the periods of remission. Although these deficits seem to play an important role in the functional impairment experienced by bipolar patients, evidence regarding their clinical management is scant. We revised the databases PubMed, MEDLINE, and clinicaltrials.gov, searching for studies focusing on the pharmacological and nonpharmacological treatment of cognitive deficits among bipolar patients. In addition, a manual search of bibliographical cross-references was performed. Currently, there is no Food and Drug Administration–approved pharmacological agent for the management of cognitive deficits in BD. A number of agents have been tested in the treatment of cognitive deficits in BD, with mixed results. Nonpharmacological interventions, such as cognitive remediation and noninvasive brain stimulation techniques, seem promising, but their role has not yet been properly explored among bipolar patients. Additional studies, aiming at evaluating the efficacy of interventions combining cognitive rehabilitation and biological treatments, are highly desirable.

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“…12,13,24 Moreover, a high number of mood episodes has been linked to poor performance across cognitive domains. 25–27 …”

Section: Cognitive Impairment In Bp: General Aspectsmentioning

confidence: 99%

The Management of Cognitive Impairment in Bipolar Disorder

Sanches

Bauer

Gálvez

et al. 2015

American Journal of Therapeutics

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“…Moreover, there is evidence suggesting that illness duration and symptom severity have a negative impact on memory performance and executive functioning [13-15]. In particular, a high number of mood episodes has been shown to be a predictor of poor performance in higher order cognitive domains [16, 17]. …”

Section: Introductionmentioning

confidence: 99%

Evaluation of cognitive function in bipolar disorder using the Brief Assessment of Cognition in Affective Disorders (BAC-A)

Bauer

Keefe

Sanches

et al. 2015

Journal of Psychiatric Research

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Background Although cognitive impairment is a core feature of bipolar disorder (BD) there is no instrument of choice for the assessment of bipolar patients. The aim of this study is to assess cognitive performance using the Brief Assessment of Cognition in Affective Disorders (BAC-A), a comprehensive test battery developed specifically for BD, and determine its suitability to estimate global functioning. Methods The BAC-A was administered to 93 BD patients (M±S. E: 35.18±1.39 years) and 56 healthy controls (HC - M±S.E.: 36.17±1.91 years). The scores of the BAC-A were combined in eight summary scores: visuomotor, immediate affective and non-affective memory, verbal fluency, delayed affective and non-affective memory, inhibition, and problem solving. Post hoc analyses were performed on subtests of the summary scores found to be significantly different between BD patients and HC. Correlational analyses explored the association between the Global Assessment of Functioning (GAF) score and cognitive functioning. Results Compared to HC, BD patients showed a significant impairment in short-term non-affective memory and verbal fluency. Poorer performance in verbal memory and verbal fluency summary scores correlated positively with reduced GAF. Conclusions Our results are consistent with previous reports of verbal memory and verbal fluency impairment in BD. The deficits in short-term memory and semantic fluency may indicate inefficient learning strategies and/or difficulties in retrieving information. The BAC-A could be used to estimate global functioning in BD patients.

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“…This suggests that there are other factors besides the affective state that may influence psychiatric morbidity awareness in patients with BD. In this case, cognitive deficits may be related to high levels of insight impairment 26. Low levels of insight were associated with poor performance in tests of executive function, 12,27 divided attention, cognitive flexibility, working memory, response inhibition, and interference resolution, all of which are mediated by the frontal lobes.…”

mentioning

confidence: 97%