Cognitive flexibility and problem-solving in patients with bipolar disorder

Abstract

Introduction: This study focuses on the cognitive impairment in patients with bipolar disorder and also the distribution of cognitive flexibility and problem-solving by degree of education, chronicity, and episode of patient is in at the time of evaluation.Methods: This was a cross sectional descriptive study with purposive sampling method. The population was the Harmony in Diversity Group in Surabaya, Indonesia. Twenty-two patients agreed to be subjects and each of them finished the Wisconsin Card Sorting Test (WCST) to measure cognitive flexibility and the Tower of London (TOL) to measure problem-solving. Results: The WCST score are below normal for 90.9% of the patients. Higher cognitive flexibility is found in patients with bachelor’s degree and euthymic patients, while lower cognitive flexibility is found in patients in depression episode, manic episode, and mixed episode. No patients could finish the TOL within the minimum required steps. Better problem-solving is found in patients in manic episode and euthymic patients while lower problem-solving is found in mixed episode and depressive episode.Conclusion: The cognitive flexibility and problem-solving in patients with bipolar disorder are lower than the normal cut off. The type of episode and chronicity are contributing factors. Euthymic patients tend to have better cognitive flexibility and manic patients tend to have better problem-solving ability.

A Randomized Clinical Trial to Assess the Effect of Medication Therapy Plus tDCS on Problem-solving and Emotion Regulation of Patients with Bipolar Disorder Type I

“…In patients with BD, extreme mood changes can impair their ability to solve problems [ 10 ]. They also tend to use more maladaptive emotion regulation strategies and engage in maladaptive emotion-related impulsivity [ 19 , 20 ].…”

“…BD is associated with other mental and physical problems and an increased risk of suicide [ 9 ]. At least 25−50% of people with BD attempt suicide at least once and it reduces about 9.2 years of the life expectancy [ 10 ]. With each additional mood episode, BD patients tend to experience an increased severity of symptoms and an increased risk for recurrence [ 11 ].…”

“…Patients could have trouble adapting as a result of having less cognitive flexibility and having trouble solving their everyday problems. This cognitive disability can affect social function, resulting in psychosocial disability, because cognitive function is also related to functional and emotional domain [ 10 ]. Cognitive impairment in BD is significantly associated with impaired psychosocial function and poor quality of life [ 12 ].…”

Effects of Playing Angklung and Practicing Silence on Emotion, Cognition and Oxytocin Levels in Children: A Preliminary Study

“…The validity of the WCST to measure cognitive flexibility has been tested internationally. The test has also been used in an Indonesian population ( 37 , 38 ). The subjects were scored based on the number of mistakes they made (0%–100%) with scores ≤ 13% considered to indicate normal condition.…”