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Assessment of Executive Functions in a Brazilian Sample of Bipolar Subjects

  • Silvana Oliveira (a1), Flávio Kapczinski (a1), Suzi Camey (a1) and Clarissa Trentini (a1)
Abstract

Research has demonstrated impairments in executive functions in Bipolar Mood Disorder patients. Evidence shows that this impairment is present in both periods of active symptoms of the disorder, as well as euthymic stages, and is compounded by mood episodes, especially manic phases. The purpose of this study was to compare the executive performance of a sample of Brazilian bipolar patients in depressive episodes, (44 participants), euthymia (37 participants), and in controls (43 participants). The main instrument for evaluation was the Wisconsin Card Sorting Test. Significant differences were found in performance on the Wisconsin Card Sorting Test between Bipolar subjects (Type I) (both in depression and euthymia) and the controls. No significant correlations were found between the number of manic episodes and the performance on execute measurement variables. The findings suggest that the executive dysfunctions in Bipolar Disorder may be related to both transitory and permanent deficits.

La investigación ha demostrado deterioros en las funciones ejecutivas de pacientes con desorden bipolar del estado de ánimo. Los resultados sugieren que el deterioro está presente en los periodos de los síntomas activos del trastorno, los estados de eutimia que pueden ser agravados por variaciones del ánimo, especialmente por fases maníacas. El objetivo de este estudio fue comparar el desempeño ejecutivo en una muestra de pacientes bipolares brasileños con diferentes diagnósticos. Participaron 44 depresivos, 37 eutímicos, y 43 controles. El principal instrumento de evaluación fue el test de clasificación de cartas de Wisconsin. Se observaron diferencias significativas en la ejecución de esta prueba entre participantes bipolares-depresivos y eutímicos (Tipo I)- y controles. No se observaron correlaciones significativas entre el número de episodios maníacos y el desempeño en la ejecución de medidas variables. Los resultados sugieren que las disfunciones ejecutivas en el desorden bipolar pueden estar relacionadas tanto con déficits transitorios como permanentes.

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Corresponding author
Correspondence concerning this article should be addressed to Silvana Oliveira. Institute of Psychology, Universidade Federal do Rio Grande do Sul (UFRGS). Rua Ramiro Barcelos 2600 room 120. Bairro Rio Branco. 90035-003 - Porto Alegre, RS (Brazil). Phone: + 51-3308-5475. E-mail: silvana.oliveira@live.com
References
Hide All
Ardila A., Pineda D., & Rosseli M. (2000). Correlation between intelligence test scores and executive function measures. Archives of Clinical Neuropsychology, 15, 3136. doi:10.1016/S0887-6177(98)00159-0
Borkowska A., Leszczynska-Rodziewicz A., Kapelski P., Hauser J., & Janusz R. (2005). Eye movement disturbances and working memory deficit in bipolar affective disorder. Psychiatria Polska, 39, 481495.
Clark L., Kempton M., Scarna A., Grasby P., & Goodwin G. (2005). Sustained attention-deficit confirmed in euthymic bipolar disorder but not in first-degree relatives of bipolar patients or euthymic unipolar depression. Biological Psychiatry, 57, 183187. doi:10.1016/j.biopsych.2004.11.007
Cunha J. A. (2000). Psicodiagnóstico V [Psychodiagnostic V]. Porto Alegre, Brazil: Artes Médicas.
Cunha J. A., Trentini C. M., Argimon I. L., Oliveira M. S., Werlang B. G., & Prieb R. G. (2005). Teste Wisconsin de Classificação de Cartas – Adaptação e Padronização Brasileira [Wisconsin Card Sorting Test – Brazilian adaptation and standardization]. São Paulo, Brazil: Casa do Psicólogo.
Deckersbach T., Dougherty D., Savage C., McMurrich S., Fischman A., Nierenberg A.,… Rauch S. (2006). Impaired recruitment of the dorsolateral prefrontal cortex and hippocampus during encoding in bipolar disorder. Biological Psychiatry, 59, 138146. doi:10.1016/j.biopsych.2005.06.030
Delaloye C., de Bilbao F., Moy G., Baudois S., Weber K., Campos L., … Gold G. (2009). Neuroanatomical and neuropsychological features of euthymic patients with bipolar disorder. The American Journal of Geriatric Psychiatry, 12, 10121021. doi:10.1097/JGP.0b013e3181b7f0e2
Doyle A., Wilens T., Kwon A., Seidman L., Faraone S., Fried R.,… Biederman J. (2005). Neuropsychological functioning in youth with bipolar disorder. Biological Psychiatry, 58, 540548. doi:10.1016/j.biopsych.2005.07.019
Duncan J., Burgess P., & Emslie H. (1995). Fluid intelligence after frontal lobe lesions. Neuropsychologia, 33, 261268. doi:10.1016/0028-3932(94)00124-8
El-Mallakh R., & Ghaemi (2008). Depressão Bipolar: um guia abrangente [Bipolar depression: a comprehensive guide]. Porto Alegre, Brazil: Artmed.
Forlenza O. (2000). Neuropsiquiatria geriátrica [Geriatric neuropsychiatry]. São Paulo, Brazil: Editora Atheneu.
Frangou S., Dakhil N., Landau S., & Kumari V. (2006). Fronto-temporal function may distinguish bipolar disorder from schizophrenia. Bipolar Disorders, 8, 4755. doi:10.1111/j.1399-5618.2006.00274.x
Goldberg J., & Chengappa K. (2009). Identifying and treating cognitive impairment in bipolar disorder. Bipolar Disorders, 11(2), 123137. doi:10.1111/j.1399-5618.2009.00716.x
Haldane M., & Frangou S. (2005). Maudsley Bipolar Disorder Project: insights sobre o papel do córtex pré-frontal em pacientes com transtorno de humor bipolar tipo I [Maudsley Bipolar Disorder Project: insights into the role of the prefrontal cortex in patients with bipolar disorder type I]. Revista de Psiquiatria do Rio Grande do Sul, 27(3), 241250. doi:10.1590/S0101-81082005000300003
Jamrozinski K. (2010). Do euthymic bipolar patients have normal cognitive functioning? Current Opinion in Psychiatry, 23(3), 255260. doi:10.1097/yCO.0b013e328338620a
Joseph R., McGrath L., & Tager-Flusberg H. (2005). Executive Dysfunction and Its Relation to Language Ability in Verbal School-Age Children With Autism. Developmental Neuropsychology, 27(3), 361378. doi:10.1207/s15326942dn2703_4
Kessler R., Coccaro E., Fava M., Jaeger S., Jin R., & Walters E. (2006). The prevalence and correlates of DSM-IV intermittent explosive disorder in the national comorbidity survey replication. Archives of General Psychiatry, 63, 669678. doi:10.1001/archpsyc.63.6.669
Kobak K., Greist J., Jefferson J., Katzelnick D., & Mundt J. (2001). New Technologies to Improve Clinical Trials. Guest Editorial, Journal of Clinical Psychopharmacology, 21, 255256. doi:10.1097/00004714-200106000-00001
Lebowitz B., Shear P., Steed M., & Strakowski S. (2001). Verbal fluency in mania: relationship to number of manic episodes. Neuropsychiatry, Neurpshycology, & Behavioral Neurology, 14(3), 177182.
Lezak M. (2004). Neuropsychological Assessment. New york, Ny: Oxford University Press.
Lima M., Tassi J., Novo I., & Mari J. (2005). Epidemiologia do transtorno bipolar [Epidemiology of bipolar disorders]. Revista de Psiquiatria Clínica, 32, 1520. doi:10.1590/S0101-60832005000700003
Maalouf F., Klein C., Clark L., Sahakian B., Labarbara E., Versace A.,… Phillips M. (2010). Impaired sustained attention and executive dysfunction: bipolar disorder versus depression-specific markers of affective disorders. Neuropsychologia, 48, 18621868. doi:10.1016/j.neuropsychologia.2010.02.015
Martínez-Arán A., Goodwin G., & Vieta E. (2001). El mito de la ausencia de disfunciones en el transtorno bipolar [The myth of the absence of dysfunction in bipolar disorder]. In Vieta E. (org.). Transtornos bipolares: avances clínicos y terapéuticos. (1st ed.) Madrid, Spain: Médica Panamericana.
Martínez-Arán A., Penades R., Vieta E., Colom F., Reinares M., Benabarre A.,… Gasto C. (2002). Executive function in patients with remitted bipolar disorder and schizophrenia in its relationship with functional outcome. Psychotherapy and Psychosomatics, 71, 3946.
Martínez-Arán A., Vieta E., Colom F., Torrent C., Sanchez-Moreno J., Reinares M.,… Salamero M. (2004a). Cognitive impairment in euthymic bipolar patients: implications for clinical and functional outcome. Bipolar Disorders, 6, 224232.
Martínez-Arán A., Vieta E., Reinares M., Colom F., Torrent C., Sanchez-Moreno J.,… Salamero M. (2004b). Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. The American Journal of Psychiatry, 161, 262270.
Merikangas K., Akiskal H., Angst J., Greenberg P., Hirschfeld R., Petukhova M., & Kessler R. (2007). Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Archives of General Psychiatry, 64, 543552. doi:10.1001/archpsyc.64.5.543
Meyer T., & Deckersbach T. (2005). No evidence for verbal memory impairment in individuals putatively at risk for bipolar disorder. Comprehensive Psychiatry, 46, 472476. doi:10.1016/j.comppsych.2005.02.003
Miller E., & Cohen J. (2001) Integrative theory of prefrontal cortex function. Annual Reviews in the Neurosciences, 24, 167202.
Morice R. (1990). Cognitive inflexibility and pre-frontal dysfunction in schizophrenia and mania. British Journal of Psychiatry, 157, 5054. doi:10.1192/bjp.157.1.50
Mur M., Portella M., Martínez-Arán A., Pifarré J., & Vieta E. (2007). Persistent neuropsychological deficit in euthymic bipolar patients: executive function as a core deficit. Journal of Clinical Psychiatry, 68, 10781086. doi:10.4088/JCP.v68n0715
Nascimento E., & Figueiredo V. (2002). WISC-III e WAIS-III: alterações nas versões originais americanas decorrentes das adaptações para o uso no Brasil [WISC-III and WAIS-III: changes arising in the original American version of adaptations for use in Brazil]. Psicologia: Reflexão e Crítica, 15, 603612. doi:10.1590/S0102-79722002000300014
Obonsawin M., Crawford J., Page J., Chalmers P., Cochrane R., & Low G. (2002). Performance on tests of frontal lobe function reflects general intellectual ability. Neuropsychologia, 40, 970977. doi:10.1016/S0028-3932(01)00171-3
Rocca C., & Lafer B. (2006). Alterações neuropsicológicas no transtorno bipolar [Neuropsychological impairments in bipolar disorder]. Revista Brasileira de Psiquiatria, 28(3), 226237. doi:10.1590/S1516-44462006000300016
Rzezak P., Fuentes D., Guimarães C., Thomé-Souza S., Kuczynski E., Guerreiro M., & Valente K. (2009). Executive dysfunction in children and adolescents with temporal lobe epilepsy: Is the Wisconsin Card Sorting Test enough? Epilepsy and Behavior, 15, 376381. doi:10.1016/j.yebeh.2009.04.014
Smith D., Muir W., & Blackwood D. (2006). Neurocognitive impairment in euthymic young adults with bipolar spectrum disorder and recurrent major depressive disorder. Bipolar Disorders, 8, 4046. doi:10.1111/j.1399-5618.2006.00275.x
Spitzer R., Williams J., Gibbon M., & First M. (1992). Structured Clinical Interview for the DSM-III-R (SCID). Archives of General Psychiatry, 49, 624629.
Souza F. (2005). Tratamento do transtorno bipolar: Eutimia [treatment of bipolar disorder: Eutimia]. Revista de Psiquiatria Clínica, 32, 6370. doi:10.1590/S0101-60832005000700010
Tabares-Seisdedos R., Balanza-Martinez V., Salazar-Fraile J., Selva-Vera G., Leal-Cercos C., & Gómez-Beneyto M. (2003). Specific executive/attentional deficits in patients with schizophrenia or bipolar disorder who have a positive family history of phychosis. Journal of Psychiatric Research, 37, 479486.
Tavares M. (2000). Entrevista Clínica Estruturada para o DSM-IV [structured clinical interview for DSM-IV]. In Cunha J. et al. , Psicodiagnóstico V. Porto Alegre, Brazil: Artes Médicas.
Totic-Poznanovic S., Marinkovic D., Pavlovic D., & Paunovic V.R. (2005). Neuropsychological profile of patients with bipolar depression in remission. Vojnosanitetski Pregled, 62, 543550. doi:10.2298/VSP0508543T
Toulopoulou T., Quraishi S., Mc Donald C., & Murray R.M. (2006). The Maudsley Family Study: premorbid and current general intellectual function levels in familial bipolar I disorder and schizophrenia. Journal of Clinical and Experimental Neuropsychology, 28, 243259. doi:10.1080/13803390500360513
Van Gorp W., Altshuler L., Theberge D., Wilkins J., & Dixon W. (1998). Cognitive impairment in euthymic bipolar patients with and without prior alcohol dependence: A preliminary study. Archives of General Psychiatry, 55, 4146. doi:10.1001/archpsyc.55.1.41
Wechsler D. (1997). WAIS – III – administration and scoring manual. San Antonio, TX: Psychological Corporation.
Young R., Biggs J., Ziegler V., & Meyer D.(1978). A rating scale for mania: reliability, validity and sensitivity. British Journal of Psychiatry, 133, 429435. doi:10.1192/bjp.133.5.429
Zubieta J., Huguelet P., O'Neil R., & Giordani B. (2001). Cognitive function in euthymic bipolar I disorder. Psychiatry Research, 102, 920. doi:10.1016/S0165-1781(01)00242-6
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