Identifying cognitive subgroups in bipolar disorder: A cluster analysis

Lima, Francisco Esmaile de Sales; Rabelo‐da‐Ponte, Francisco Diego; Bücker, Joana; Czepielewski, Letícia Sanguinetti; Hasse-Sousa, Mathias; Telesca, Raissa; Solé, Brisa; Reinares, María; Rosa, Adriane Ribeiro

doi:10.1016/j.jad.2018.12.044

Cited by 52 publications

(32 citation statements)

References 51 publications

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“…However, the assessment of the relationship of these cognitive subgroups with number of episodes is incipient and the results inconclusive. While some cross-sectional studies show a tendency toward fewer previous affective episodes in the preserved cognitive functioning group (Burdick et al, 2014;Martino et al, 2018a), other studies do not show differences between subgroups (Lima et al, 2019;Roux et al, 2017;Volkert et al, 2015). Based on our results, we propose that episode density more than the number of episodes could be a more accurate measure of the clinical course to assess this relationship.…”

Section: Discussionsupporting

confidence: 46%

Neurocognitive predictors of long-term clinical course in bipolar disorder

Valerio

Lomastro²,

Martino

2020

Aust N Z J Psychiatry

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Objective: The aim of this study was to estimate whether neurocognitive deficits are predictors of the long-term clinical course of patients with bipolar disorder. Methods: A total of 76 outpatients with bipolar disorder performed a neurocognitive assessment at baseline and were followed for a period of at least 48 months. The clinical course during the follow-up period was documented by two measures: (1) number of affective episodes and (2) time spent ill. Results: Patients had lower performance than controls in the domains of verbal memory and executive functions, and they were followed-up for a mean period of 70.73 months. Global cognitive deficits (performance 1.5 standard deviations below the mean in two or more cognitive domain) were independent predictors of both hypo/manic episode density and time spent with hypo/manic symptoms during follow-up. On the contrary, no neurocognitive measure showed a relationship with depressive morbidity during follow-up. Conclusion: Our findings suggest that cognitive deficits could be useful for predicting hypo/manic morbidity in the long-term clinical course. Theoretical and clinical implications of these findings are discussed.

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Section: Discussionsupporting

confidence: 46%

Neurocognitive predictors of long-term clinical course in bipolar disorder

Valerio

Lomastro²,

Martino

2020

Aust N Z J Psychiatry

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“…Furthermore, cognition is said to play a marked role in the course and prognosis of BD illness, 72 but its expression varies when objective and subjective assessments are compared. Studies report a weak correlation between these two types of cognitive assessment 71,73,74 . Although subjectively reported cognitive complaints and objectively assessed neuropsychological tests are intertwined by certain discrepancies, it is important to highlight that FAST is a semi‐objective instrument; therefore, these data reinforce the cognitive impairment found in other studies and underscore the importance of this topic in patients’ lives and functioning 60 …”

Section: Discussionmentioning

confidence: 68%

“…In fact, cluster analysis studies have reported within‐group heterogeneity in the cognitive performance of individuals with BD, suggesting the existence of subgroups based on performance. While some authors divide them into similar to the HC range and selective cognitive impairment (representing almost one‐third of the sample), 66,67 others divide the impaired group into selective cognitive impairment (modest deficits on only a subset of domains) and global severe impairment (deficit across most of the cognitive domains) 68‐71 …”

Section: Discussionmentioning

confidence: 99%

Functioning in euthymic patients with bipolar disorder: A systematic review and meta‐analysis using the Functioning Assessment Short Test

2020

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Objectives Systematically review the prevalence of functional impairment (FI) in euthymic patients with bipolar disorder (BD), as assessed only with the Functioning Assessment Short Test (FAST), explore the prevalence of this impairment among all the domains, identify the most compromised of them and the clinical variables associated with low functioning in this population. Methods Meta‐analyses were performed, searching for relevant papers published from 2007 to 2019 in Medline, Embase, Cochrane, PsycINFO databases and via hand‐searching, without language restrictions. 1128 studies were initially identified, 13 of which were ultimately chosen based on the eligibility criteria. A two‐step meta‐analysis was performed using the mean difference with a 95% confidence interval for continuous variables and proportion estimation with a fixed‐effects model for categorical variables. Results In the first step, all FAST domains showed worse FI in patients than in healthy controls, with significant differences between groups. In the second step, the prevalence of FI domains were as follows: global, 58.6%; occupational, 65.6%; cognitive, 49.2%; autonomy, 42.6%; interpersonal relationships, 42.1%; leisure, 29.2%; and financial issues, 28.8%. Residual depressive symptoms were the most frequently cited variable associated with FI. Conclusions This study reinforces the relevant functional impact of BD in this population and suggests that the occupational domain may be the most impaired. Greater efforts should be directed toward targeting functioning in patient care, as it constitutes the most meaningful endpoint of response to treatment, especially with occupational and cognitive rehabilitation, thus allowing patients to overcome the course of illness and carry fulfilling lives.

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“…Both bipolar disorder and schizophrenia are considered heterogeneous disorders. Heterogeneity in bipolar disorder has been reported in genetic architecture 20,21 , cognitive profiles [22][23][24][25][26] , and clinical symptoms 27,28 . Likewise, heterogeneity in schizophrenia has been noted at the genetic 29 , cognitive 12,30 , and clinical level [31][32][33] .…”

Section: Discussionmentioning

confidence: 99%

Personalized estimates of morphometric similarity in bipolar disorder and schizophrenia

Doucet

Lin

et al. 2020

npj Schizophr

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Bipolar disorder and schizophrenia are associated with brain morphometry alterations. This study investigates inter-individual variability in brain structural profiles, both within diagnostic groups and between patients and healthy individuals. Brain morphometric measures from three independent samples of patients with schizophrenia (n = 168), bipolar disorder (n = 122), and healthy individuals (n = 180) were modeled as single vectors to generated individualized profiles of subcortical volumes and regional cortical thickness. These profiles were then used to compute a person-based similarity index (PBSI) for subcortical volumes and for regional cortical thickness, to quantify the within-group similarity of the morphometric profile of each individual to that of the other participants in the same diagnostic group. There was no effect of diagnosis on the PBSI for subcortical volumes. In contrast, compared to healthy individuals, the PBSI for cortical thickness was lower in patients with schizophrenia (effect size = 0.4, p ≤ 0.0002), but not in patients with bipolar disorder. The results were robust and reproducible across samples. We conclude that disease mechanisms for these disorders produce modest inter-individual variations in brain morphometry that should be considered in future studies attempting to cluster patients in subgroups.

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Identifying cognitive subgroups in bipolar disorder: A cluster analysis

Cited by 52 publications

References 51 publications

Neurocognitive predictors of long-term clinical course in bipolar disorder

Neurocognitive predictors of long-term clinical course in bipolar disorder

Functioning in euthymic patients with bipolar disorder: A systematic review and meta‐analysis using the Functioning Assessment Short Test

Personalized estimates of morphometric similarity in bipolar disorder and schizophrenia

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