Neurocognitive impairment in euthymic patients with bipolar affective disorder

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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mentioning

confidence: 99%

Neurocognitive impairment in bipolar disorder patients: functional implications

2009

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“…Tekrarlayan depresyon dönemlerinin sürdürülebilir dikkatte bozulma ile ilişkili olabileceği, ancak diğer bilişsel işlevlerin depresif semptomatolojiden bağımsız olduğu söylenebilir. Yazında depresif dönem sayısı ile nöropsikolojik işlevlerin çeşitli ölçümleri arasında anlamlı ilişki bildiren çalışmalar bulunmaktadır (11,41,42,47,48 …”

Section: Discussionunclassified

“…Yazında hastane yatış sayısı ile görsel bellek, yürütücü işlevler, sözel akıcılık arasında anlamlı ilişki bildiren çalışmalar bulunmaktadır (47,48).…”

Section: Sonuçunclassified

İki̇ Uçlu Duygudurum Bozukluğu Tanili Hastalarin Depresyon, Eşi̇kalti Depresyon Ve İyi̇li̇k Dönemleri̇ni̇n Nöropsi̇koloji̇k Açidan Karşilaştirilmasi

Temur¹,

Güleç²,

Akarsu³

et al. 2016

Osmangazi̇ Journal of Medicine

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“…Recent reports have suggested the presence of persistent cognitive impairments in patients diagnosed with BD even after prolonged euthymic phases [16,26,[40][41][42][43][44][45][46][47][48]. Review by Torres et al [4] revealed widespread cognitive deficits in tests assessing attention, speed of information processing, memory and executive dysfunctions in remitted bipolars versus controls.…”

Section: Cognitive Functions In Bipolar Patientsmentioning

confidence: 99%