A five-year follow-up study of neurocognitive functioning in bipolar disorder

Objectives Cognitive dysfunction in bipolar disorder has been well‐established in cross‐sectional studies; however, there are few data regarding the longitudinal course of cognitive performance in bipolar disorder. The aim of this study was to examine the course of cognitive function in a sample of...

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Published inBipolar disorders Vol. 16; no. 7; pp. 722 - 731
Main Authors Santos, José Luis, Aparicio, Ana, Bagney, Alexandra, Sánchez-Morla, Eva María, Rodríguez-Jiménez, Roberto, Mateo, Jorge, Jiménez-Arriero, Miguel Ángel
Format Journal Article
LanguageEnglish
Published Denmark Blackwell Publishing Ltd 01.11.2014
Subjects
Adult
Analysis of Variance
Anticonvulsants - therapeutic use
Antimanic Agents - therapeutic use
bipolar disorder
Bipolar Disorder - complications
Bipolar Disorder - drug therapy
Bipolar Disorder - pathology
cognition
Cognition Disorders - etiology
Cross-Sectional Studies
Female
follow-up
Humans
Lithium Chloride - therapeutic use
Longitudinal Studies
Male
Middle Aged
Neuropsychological Tests
Psychiatric Status Rating Scales
Statistics as Topic
cognition
follow-up
bipolar disorder
Online AccessGet full text
ISSN1398-5647
1399-5618
1399-5618
DOI10.1111/bdi.12215

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Abstract Objectives Cognitive dysfunction in bipolar disorder has been well‐established in cross‐sectional studies; however, there are few data regarding the longitudinal course of cognitive performance in bipolar disorder. The aim of this study was to examine the course of cognitive function in a sample of euthymic patients with bipolar disorder during a five‐year follow‐up period. Methods Eighty euthymic outpatients with a DSM‐IV diagnosis of bipolar disorder and 40 healthy control comparison subjects were neuropsychologically assessed at baseline (T1) and then at follow‐up of five years (T2). A neurocognitive battery including the main cognitive domains of speed of processing, working memory, attention, verbal memory, visual memory, and executive function was used to evaluate cognitive performance. Results Repeated‐measures multivariate analyses showed that progression of cognitive dysfunction in patients was not different to that of control subjects in any of the six cognitive domains examined. Only a measure from the verbal memory domain, delayed free recall, worsened more in patients with bipolar disorder. Additionally, it was found that clinical course during the follow‐up period did not influence the course of cognitive dysfunction. Conclusions Cognitive dysfunction that is characteristic of bipolar disorder is persistent and stable over time. Only dysfunction in verbal recall was found to show a progressive course that cannot be explained by clinical or treatment variables.
AbstractList Cognitive dysfunction in bipolar disorder has been well-established in cross-sectional studies; however, there are few data regarding the longitudinal course of cognitive performance in bipolar disorder. The aim of this study was to examine the course of cognitive function in a sample of euthymic patients with bipolar disorder during a five-year follow-up period.OBJECTIVESCognitive dysfunction in bipolar disorder has been well-established in cross-sectional studies; however, there are few data regarding the longitudinal course of cognitive performance in bipolar disorder. The aim of this study was to examine the course of cognitive function in a sample of euthymic patients with bipolar disorder during a five-year follow-up period.Eighty euthymic outpatients with a DSM-IV diagnosis of bipolar disorder and 40 healthy control comparison subjects were neuropsychologically assessed at baseline (T1) and then at follow-up of five years (T2). A neurocognitive battery including the main cognitive domains of speed of processing, working memory, attention, verbal memory, visual memory, and executive function was used to evaluate cognitive performance.METHODSEighty euthymic outpatients with a DSM-IV diagnosis of bipolar disorder and 40 healthy control comparison subjects were neuropsychologically assessed at baseline (T1) and then at follow-up of five years (T2). A neurocognitive battery including the main cognitive domains of speed of processing, working memory, attention, verbal memory, visual memory, and executive function was used to evaluate cognitive performance.Repeated-measures multivariate analyses showed that progression of cognitive dysfunction in patients was not different to that of control subjects in any of the six cognitive domains examined. Only a measure from the verbal memory domain, delayed free recall, worsened more in patients with bipolar disorder. Additionally, it was found that clinical course during the follow-up period did not influence the course of cognitive dysfunction.RESULTSRepeated-measures multivariate analyses showed that progression of cognitive dysfunction in patients was not different to that of control subjects in any of the six cognitive domains examined. Only a measure from the verbal memory domain, delayed free recall, worsened more in patients with bipolar disorder. Additionally, it was found that clinical course during the follow-up period did not influence the course of cognitive dysfunction.Cognitive dysfunction that is characteristic of bipolar disorder is persistent and stable over time. Only dysfunction in verbal recall was found to show a progressive course that cannot be explained by clinical or treatment variables.CONCLUSIONSCognitive dysfunction that is characteristic of bipolar disorder is persistent and stable over time. Only dysfunction in verbal recall was found to show a progressive course that cannot be explained by clinical or treatment variables.
Cognitive dysfunction in bipolar disorder has been well-established in cross-sectional studies; however, there are few data regarding the longitudinal course of cognitive performance in bipolar disorder. The aim of this study was to examine the course of cognitive function in a sample of euthymic patients with bipolar disorder during a five-year follow-up period. Eighty euthymic outpatients with a DSM-IV diagnosis of bipolar disorder and 40 healthy control comparison subjects were neuropsychologically assessed at baseline (T1) and then at follow-up of five years (T2). A neurocognitive battery including the main cognitive domains of speed of processing, working memory, attention, verbal memory, visual memory, and executive function was used to evaluate cognitive performance. Repeated-measures multivariate analyses showed that progression of cognitive dysfunction in patients was not different to that of control subjects in any of the six cognitive domains examined. Only a measure from the verbal memory domain, delayed free recall, worsened more in patients with bipolar disorder. Additionally, it was found that clinical course during the follow-up period did not influence the course of cognitive dysfunction. Cognitive dysfunction that is characteristic of bipolar disorder is persistent and stable over time. Only dysfunction in verbal recall was found to show a progressive course that cannot be explained by clinical or treatment variables.
Objectives Cognitive dysfunction in bipolar disorder has been well‐established in cross‐sectional studies; however, there are few data regarding the longitudinal course of cognitive performance in bipolar disorder. The aim of this study was to examine the course of cognitive function in a sample of euthymic patients with bipolar disorder during a five‐year follow‐up period. Methods Eighty euthymic outpatients with a DSM‐IV diagnosis of bipolar disorder and 40 healthy control comparison subjects were neuropsychologically assessed at baseline (T1) and then at follow‐up of five years (T2). A neurocognitive battery including the main cognitive domains of speed of processing, working memory, attention, verbal memory, visual memory, and executive function was used to evaluate cognitive performance. Results Repeated‐measures multivariate analyses showed that progression of cognitive dysfunction in patients was not different to that of control subjects in any of the six cognitive domains examined. Only a measure from the verbal memory domain, delayed free recall, worsened more in patients with bipolar disorder. Additionally, it was found that clinical course during the follow‐up period did not influence the course of cognitive dysfunction. Conclusions Cognitive dysfunction that is characteristic of bipolar disorder is persistent and stable over time. Only dysfunction in verbal recall was found to show a progressive course that cannot be explained by clinical or treatment variables.
Author Rodríguez-Jiménez, Roberto
Aparicio, Ana
Bagney, Alexandra
Sánchez-Morla, Eva María
Mateo, Jorge
Santos, José Luis
Jiménez-Arriero, Miguel Ángel
Author_xml – sequence: 1
  givenname: José Luis
  surname: Santos
  fullname: Santos, José Luis
  organization: Department of Psychiatry, Hospital Virgen de la Luz, Cuenca, Spain
– sequence: 2
  givenname: Ana
  surname: Aparicio
  fullname: Aparicio, Ana
  organization: Department of Psychiatry, Hospital Virgen de la Luz, Cuenca, Spain
– sequence: 3
  givenname: Alexandra
  surname: Bagney
  fullname: Bagney, Alexandra
  organization: Department of Psychiatry, Instituto de Investigación Hospital 12 de Octubre, CIBERSAM, Madrid, Spain
– sequence: 4
  givenname: Eva María
  surname: Sánchez-Morla
  fullname: Sánchez-Morla, Eva María
  email: Corresponding author:Eva María Sánchez-MorlaDepartment of PsychiatryHospital Universitario de GuadalajaraC/Hermandad Donantes de SangreGuadalajara 19002SpainFax: +34 949 209218, emsanchez@sescam.jccm.es
  organization: Department of Psychiatry, Hospital Virgen de la Luz, Cuenca, Spain
– sequence: 5
  givenname: Roberto
  surname: Rodríguez-Jiménez
  fullname: Rodríguez-Jiménez, Roberto
  organization: Department of Psychiatry, Instituto de Investigación Hospital 12 de Octubre, CIBERSAM, Madrid, Spain
– sequence: 6
  givenname: Jorge
  surname: Mateo
  fullname: Mateo, Jorge
  organization: Innovation in Bioengineering Research Group, University of Castilla La Mancha, Cuenca, Spain
– sequence: 7
  givenname: Miguel Ángel
  surname: Jiménez-Arriero
  fullname: Jiménez-Arriero, Miguel Ángel
  organization: Department of Psychiatry, Instituto de Investigación Hospital 12 de Octubre, CIBERSAM, Madrid, Spain
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Keywords cognition
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bipolar disorder
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Nuechterlein KH, Green MF, Kern RS et al. The MATRICS Consensus Cognitive Battery, part 1: test selection, reliability, and validity. Am J Psychiatry 2008; 165: 203-213.
Peralta V, Cuesta MJ. Psychometric properties of the Positive and Negative Syndrome Scale (PANSS) in schizophrenia. Psychiatry Res 1994; 53: 31-40.
Lobo A, Chamorro L, Luque A et al. Validation of the Spanish versions of the Montgomery-Asberg depression and Hamilton anxiety rating scales. Med Clin (Barc) 2002; 118: 493-499.
Kurtz MM, Gerraty RT. A meta-analytic investigation of neurocognitive deficits in bipolar illness: profile and effects of clinical state. Neuropsychology 2009; 23: 551-562.
Bearden CE, Shih VH, Green MF et al. The impact of neurocognitive impairment on occupational recovery of clinically stable patients with bipolar disorder: a prospective study. Bipolar Disord 2011; 13: 323-333.
Sánchez-Morla EM, Barabash A, Martínez-Vizcaíno V et al. Comparative study of neurocognitive function in euthymic bipolar patients and stabilized schizophrenic patients. Psychiatry Res 2009; 169: 220-228.
Videira Dias V, Balanzá-Martinez V, Soeiro-de-Souza MG et al. Pharmacological approaches in bipolar disorders and the impact on cognition: a critical overview. Acta Psychiatr Scand 2012; 126: 315-331.
Krabbendam L, Arts B, van Os J, Aleman A. Cognitive functioning in patients with schizophrenia and bipolar disorder: a quantitative review. Schizophr Res 2005; 80: 137-149.
van Gorp WG, Altshuler L, Theberge DC, Wilkins J, Dixon W. Cognitive impairment in euthymic bipolar patients with and without prior alcohol dependence. A preliminary study. Arch Gen Psychiatry 1998; 55: 41-46.
Schretlen DJ, Cascella NG, Meyer SM et al. Neuropsychological functioning in bipolar disorder and schizophrenia. Biol Psychiatry 2007; 62: 179-186.
Nehra R, Chakrabarti S, Pradhan BK, Khehra N. Comparison of cognitive functions between first- and multi-episode bipolar affective disorders. J Affect Disord 2006; 93: 185-192.
El-Badri SM, Ashton CH, Moore PB, Marsh VR, Ferrier IN. Electrophysiological and cognitive function in young euthymic patients with bipolar affective disorder. Bipolar Disord 2001; 3: 79-87.
Mora E, Portella MJ, Forcada I, Vieta E, Mur M. Persistence of cognitive impairment and its negative impact on psychosocial functioning in lithium-treated, euthymic bipolar patients: a 6-year follow-up study. Psychol Med 2013; 43: 1187-1196.
Bonnín CM, Martínez-Arán A, Torrent C et al. Clinical and neurocognitive predictors of functional outcome in bipolar euthymic patients: a long-term, follow-up study. J Affect Disord 2010; 121: 156-160.
Robinson LJ, Ferrier IN. Evolution of cognitive impairment in bipolar disorder: a systematic review of cross-sectional evidence. Bipolar Disord 2006; 8: 103-116.
Schouws SN, Stek ML, Comijs HC, Dols A, Beekman AT. Cognitive decline in elderly bipolar disorder patients: a follow-up study. Bipolar Disord 2012; 14: 749-755.
Mur M, Portella MJ, Martínez-Arán A, Pifarré J, Vieta E. Long-term stability of cognitive impairment in bipolar disorder: a 2-year follow-up study of lithium-treated euthymic bipolar patients. J Clin Psychiatry 2008; 69: 712-719.
Colom F, Vieta E, Martínez-Arán A et al. Spanish version of a scale for the assessment of mania: validity and reliability of the Young Mania Rating Scale. Med Clin (Barc) 2002; 119: 366-371.
Balanzá-Martínez V, Tabarés-Seisdedos R, Selva-Vera G et al. Persistent cognitive dysfunctions in bipolar I disorder and schizophrenic patients: a 3-year follow-up study. Psychother Psychosom 2005; 74: 113-119.
Burdick KE, Goldberg JF, Harrow M. Neurocognitive dysfunction and psychosocial outcome in patients with bipolar I disorder at 15-year follow-up. Acta Psychiatr Scand 2010; 122: 499-506.
Braw Y, Erez G, Sela T et al. A longitudinal study of cognition in asymptomatic and mildly symptomatic bipolar disorder patients. Psychiatry Res 2013; 210: 842-849.
Goswami U, Sharma A, Khastigir U et al. Neuropsychological dysfunction, soft neurological signs and social disability in euthymic patients with bipolar disorder. Br J Psychiatry 2006; 188: 366-373.
Savitz J, Solms M, Ramesar R. Neuropsychological dysfunction in bipolar affective disorder: a critical opinion. Bipolar Disord 2005; 7: 216-235.
Ramos-Brieva JA, Cordero-Villafafila A. A new validation of the Hamilton Rating Scale for Depression. J Psychiatr Res 1988; 22: 21-28.
Cavanagh JT, Van Beck M, Muir W, Blackwood DH. Case-control study of neurocognitive function in euthymic patients with bipolar disorder: an association with mania. Br J Psychiatry 2002; 180: 320-326.
Krabbendam L, Honig A, Wiersma J et al. Cognitive dysfunctions and white matter lesions in patients with bipolar disorder in remission. Acta Psychiatr Scand 2000; 101: 274-280.
Dhingra U, Rabins PV. Mania in the elderly: a 5-7 year follow-up. J Am Geriatr Soc 1991; 39: 581-583.
Deckersbach T, Savage CR, Reilly-Harrington N, Clark L, Sachs G, Rauch SL. Episodic memory impairment in bipolar disorder and obsessive-compulsive disorder: the role of memory strategies. Bipolar Disord 2004; 6: 233-244.
Clark L, Iversen SD, Goodwin GM. Sustained attention deficit in bipolar disorder. Br J Psychiatry 2002; 180: 313-319.
Robinson LJ, Thompson JM, Gallagher P et al. A meta-analysis of cognitive deficits in euthymic patients with bipolar disorder. J Affect Disord 2006; 93: 105-115.
Depp CA, Savla GN, Moore DJ et al. Short-term course of neuropsychological abilities in middle-aged and older adults with bipolar disorder. Bipolar Disord 2008; 10: 684-690.
Delaloye C, Moy G, de Bilbao F et al. Longitudinal analysis of cognitive performances and structural brain changes in late-life bipolar disorder. Int J Geriatr Psychiatry 2011; 26: 1309-1318.
Lezak MD, Howieson DB, Bigler ED, Tranel D. Neuropsychological Assessment. New York, NY: Oxford University Press, 2012.
Zubieta JK, Huguelet P, O'Neil RL, Giordani BJ. Cognitive function in euthymic bipolar I disorder. Psychiatry Res 2001; 102: 9-20.
Bora E, Yucel M, Pantelis C. Cognitive endophenotypes of bipolar disorder: a meta-analysis of neuropsychological deficits in euthymic patients and their first-degree relatives. J Affect Disord 2009; 113: 1-20.
Gildengers AG, Chisholm D, Butters MA et al. Two-year course of cognitive function and instrumental activities of daily living in older adults with bipolar disorder: evidence for neuroprogression? Psychol Med 2013; 43: 801-811.
Quraishi S, Frangou S. Neuropsychology of bipolar disorder: a review. J Affect Disord 2002; 72: 209-226.
Mann-Wrobel MC, Carreno JT, Dickinson D. Meta-analysis of neuropsychological functioning in euthymic bipolar disorder: an update and investigation of moderator variables. Bipolar Disord 2011; 13: 334-342.
Gildengers AG, Butters MA, Seligman K et al. Cognitive functioning in late-life bipolar disorder. Am J Psychiatry 2004; 161: 736-738.
Hellvin T, Sundet K, Simonsen C et al. Neurocognitive functioning in patients recently diagnosed with bipolar disorder. Bipolar Disord 2012; 14: 227-238.
Levy B, Manove E. Functional outcome in bipolar disorder: the big picture. Depress Res Treat 2012: 949248. doi: 10.1155/2012/949248.
Nuechterlein KH, Barch DM, Gold JM, Goldberg TE, Green MF, Heaton RK. Identification of separable cognitive factors in schizophrenia. Schizophr Res 2004; 72: 29-39.
Saeedi H, Remington G, Christensen BK. Impact of haloperidol, a dopamine D2 antagonist, on cognition and mood. Schizophr Res 2006; 85: 222-231.
Soeiro-de-Souza MG, Dias VV, Figueira ML et al. Translating neurotrophic and cellular plasticity: from pathophysiology to improved therapeutics for bipolar disorder. Acta Psychiatr Scand 2012; 126: 332-341.
Torrent C, Martinez-Arán A, Bonnin CM et al. Long-term outcome of cognitive impairment in bipolar disorder. J Clin Psychiatry 2012; 73: e899-e905.
Martínez-Arán A, Vieta E, Colom F et al. Cognitive impairment in euthymic bipolar patients: implications for clinical and functional outcome. Bipolar Disord 2004; 6: 224-232.
Rubinsztein JS, Michael A, Paykel ES, Sahakian BJ. Cognitive impairment in remission in bipolar affective disorder. Psychol Med 2000; 30: 1025-1036.
Heinrichs RW, Zakzanis KK. Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 1998; 12: 426-445.
Engelsmann F, Katz J, Ghadirian
2008; 192
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Snippet Objectives Cognitive dysfunction in bipolar disorder has been well‐established in cross‐sectional studies; however, there are few data regarding the...
Cognitive dysfunction in bipolar disorder has been well-established in cross-sectional studies; however, there are few data regarding the longitudinal course...
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SubjectTerms Adult
Analysis of Variance
Anticonvulsants - therapeutic use
Antimanic Agents - therapeutic use
bipolar disorder
Bipolar Disorder - complications
Bipolar Disorder - drug therapy
Bipolar Disorder - pathology
cognition
Cognition Disorders - etiology
Cross-Sectional Studies
Female
follow-up
Humans
Lithium Chloride - therapeutic use
Longitudinal Studies
Male
Middle Aged
Neuropsychological Tests
Psychiatric Status Rating Scales
Statistics as Topic
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Title A five-year follow-up study of neurocognitive functioning in bipolar disorder
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