Executive Function in Patients with Remitted Bipolar Disorder and Schizophrenia and Its Relationship with Functional Outcome

Martínez‐Arán, Anabel; Penadés, Rafael; Vieta, Eduard; Colom, Francesc; Reinares, María; Benabarre, Antoni; Salamero, Manel; Gastó, Cristòbal

doi:10.1159/000049342

Cited by 167 publications

(138 citation statements)

References 36 publications

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“…It is also important to underline that BD II subjects in the latter study were depressed, so this finding may be related to findings reported by Martínez-Arán et al (2002, 2004b where the only significant difference between euthymic patients and depressed patients was observed in verbal fluency, suggesting that performance in the phonemic fluency task may be state-dependent.…”

Section: Verbal Fluencysupporting

confidence: 74%

Are bipolar II patients cognitively impaired? A systematic review

et al. 2011

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Background. There is evidence that bipolar disorder (BD) is associated with significant neurocognitive deficits and this occurs in individuals with BD type I (BD I) and with BD type II (BD II). Only a few studies have focused on cognitive impairment in BD II. The aim of this study was to describe the pattern of cognitive impairment in patients with BD II, in order to identify specific cognitive deficits that distinguish BD II from BD I patients as well as from healthy subjects.Method. We performed a systematic review of the literature of neuropsychological studies of BD II published between 1980 and July 2009. Fourteen articles fulfilled the inclusion criteria and were included in this review.Results. Main cognitive deficits found in BD II include working memory and some measures of executive functions (inhibitory control) and approximately half of the studies also detected verbal memory impairment.Conclusions. There are subtle differences between the two subtypes regarding cognition. This may suggest neurobiological differences between the two subgroups which will be helpful in order to determine cognitive endophenotypes in BD subtypes.

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Section: Verbal Fluencysupporting

confidence: 74%

Are bipolar II patients cognitively impaired? A systematic review

et al. 2011

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“…Of the 13 remaining reports, one was excluded for not exploring correlations between cognitive and functional domains, yielding 12 studies suitable for further analysis (1,3,4,23,(28)(29)(30)(31)(32)(33)(34)(35). These 12 studies provided 13 sets of correlations between cognitive and functional status, including eight studies involving euthymic BPD patients (3,4,(29)(30)(31)(32)(33)(34) and five involving BPD patients in non-euthymic or uncertain mood states (1,3,23,28,35). The latter five studies included BPD patients either recently hospitalized (23,28) or still in major depression, mania, or hypomania (1, 3), or in unspecified mood states (35).…”

Section: Resultsmentioning

confidence: 99%

“…Specifically, in studies of euthymic BPD patients (Table 2A), estimated premorbid IQ was assessed in 6 ⁄ 8 studies (3,4,(29)(30)(31)(32), executive function in six (3,4,30,(32)(33)(34), verbal learning and memory in six (3,4,29,(32)(33)(34), attention, concentration, mental tracking, information processing speed, and immediate memory in five (3,4,30,31,33), verbal fluency or language in four (4,30,31,33), visuospatial performance in three (29,31,33), and psychomotor speed in two studies (3,31). Euthymic BPD patients performed less well than matched healthy controls in these cognitive measures in 7 ⁄ 8 studies.…”

Section: Neurocognitive Performancementioning

confidence: 99%

“…c Participants had cognitive testing when Ôsufficiently stableÕ after hospitalization; at one-year follow-up they were rated for functional status [Multidimensional Scale for Independent Living To assess functional status in euthymic BPD patients, 5 ⁄ 8 studies (3,4,30,32,34) used the Global Assessment of Functioning (GAF) Scale (38); three of these (4, 32, 34) reported explicitly that only social and occupational functioning, and not mood symptoms, were considered, two relied on patient self-assessment on psychosocial functioning rating scales (29,31), and only one used performance-based measures to assess the instrumental activities of daily living [IADL (33)]. Functional domains considered were vocational and educational activities, household maintenance, level of independent living, and quality of family and social relationships.…”

Section: Neurocognitive Performancementioning

confidence: 99%

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Neurocognitive impairment in bipolar disorder patients: functional implications

2009

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Growing evidence suggests that bipolar disorder (BPD) patients experience prominent neurocognitive impairment not only during acute mood episodes (1-3) but also during euthymia (1,(4)(5)(6)(7)(8)(9)(10)(11)(12). A recent meta-analytic review of 39 studies comparing neurocognitive functioning in 948 euthymic BPD patients and 1,128 normal controls, matched for age, sex, education, and estimated premorbid IQ, found medium-to-large effect sizes (ES, as group differences ⁄ variance) for impaired attention and processing speed (ES = 0.60-0.79), episodic memory (ES = 0.43-0.81), and executive functioning (ES = 0.47-0.71) in the BPD patients (11). Another meta-analytic review of 20 studies, also comparing neurocognitive performance in euthymic BPD patients to matched normal controls, found deficits of similar magnitude in measures of executive functions, verbal learning, immediate Background: Functional recovery among treated bipolar disorder (BPD) patients is far less likely than syndromal and even symptomatic recovery. We hypothesized that increasingly well-documented aspects of cognitive impairment may contribute to poor functional outcomes in BPD patients, and reviewed the available research on the topic.Methods: Computerized literature searching identified 12 studies with 13 comparisons that simultaneously evaluated cognitive and functional status in euthymic (n = 8) or non-euthymic (n = 5 comparisons) adult BPD patients versus otherwise similar healthy controls.Results: In 6 ⁄ 8 studies of euthymic BPD patients and 5 ⁄ 5 studies of non-euthymic BPD patients, neurocognitive impairment was significantly associated with impaired psychosocial functioning, even after adjusting for residual mood symptoms and relevant demographic and clinical variables. Cognitive status was consistently assessed with standardized, performance-based neuropsychological tests, but functional status usually was based on subjective self-appraisals. Approximately 55% of BPD patients were unemployed.Conclusions: Available studies are limited by subjective assessments of functional status rather than objective, performance-based measures. Nevertheless, they support the hypothesis that enduring aspects of cognitive impairment found even in euthymic BPD patients are associated with inferior functioning. These findings encourage further studies with better assessment methods and greater rehabilitative efforts in BPD patients.

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“…However, SCZ and BP show an overlap in clinical symptoms (including increased suicide risk) (Kravariti et al, 2005;Martinez-Aran et al, 2002;Seidman et al, 2002; Van et al, 1999) as well as in genetic etiology as discussed below.…”

Section: Introductionmentioning

confidence: 99%

Allelic association of G72/G30 with schizophrenia and bipolar disorder: A comprehensive meta-analysis

Shi

Badner

Gershon

et al. 2008

Schizophrenia Research

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The G72/G30 gene complex (G72 also known as D-amino acid oxidase activator, DAOA) and its chromosomal region 13q32-34 have been linked and associated with both schizophrenia (SCZ) and bipolar disorder (BP) in multiple studies, including our initial association report on BP. However, the inconsistency of associated variants across studies is obvious. Previous meta-analyses had small data sets. The present meta-analysis combined 18 association articles published before April of 2007. There were 19 independent studies of SCZ, with 4304 cases, 5423 controls, and 1384 families, and four independent studies of BP with 1145 cases, 1829 controls, and 174 families. Of 15 single nucleotide polymorphisms (SNPs) analyzed in the 95-kb G72/G30 gene region, M18/rs947267 and M22/rs778293 showed association with SCZ in Asians, and M24/rs1421292 with SCZ in Europeans. The associations of C allele at M18 and A allele at M22 with SCZ in Asians survived conservative Bonferroni correction for multiple testing for 15 markers and subgroup analysis (adjusted P = 0.0000253 for M18; adjusted P = 0.009 for M22). No single maker showed evidence of overall association with BP. These results suggest that G72/G30 may influence susceptibility to schizophrenia with weak effects.

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Executive Function in Patients with Remitted Bipolar Disorder and Schizophrenia and Its Relationship with Functional Outcome

Cited by 167 publications

References 36 publications

Are bipolar II patients cognitively impaired? A systematic review

Are bipolar II patients cognitively impaired? A systematic review

Neurocognitive impairment in bipolar disorder patients: functional implications

Allelic association of G72/G30 with schizophrenia and bipolar disorder: A comprehensive meta-analysis

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