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Cognitive impairment in bipolar II disorder

  • Carla Torrent (a1), Anabel Martínez-Arán (a1), Claire Daban (a1), Jose Sánchez-Moreno (a2), Mercè Comes (a3), José Manuel Goikolea (a3), Manel Salamero (a3) and Eduard Vieta (a3)...
Abstract
Background

Persistent impairments in neurocognitive function have been described in bipolar disorder.

Aims

To compare the cognitive performance of patients with bipolar II disorder with that of patients with bipolar I disorder and a healthy control group.

Method

The study included 71 euthymic patients with bipolar disorder (38 bipolar I, 33 bipolar II), who were compared on clinical and neuropsychological variables (e.g. executive function, attention, verbal and visual memory) and contrasted with 35 healthy controls on cognitive performance.

Results

Compared with controls, both bipolar groups showed significant deficits in most cognitive tasks including working memory (Digit Span Backwards, P=0.002) and attention (Digit Span Forwards, P=0.005; Trail Making Test, P=0.001). Those with type II disorders had an intermediate level of performance between the bipolar I group and the control group in verbal memory (P < 0.005) and executive functions (Stroop interference task, P=0.020).

Conclusions

Cognitive impairment exists in both subtypes of bipolar disorder, although more so in the bipolar I group. The best predictors of poor psychosocial functioning in bipolar II disorder were subclinical depressive symptoms, early onset of illness and poor performance on a measure related to executive function.

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Copyright
Corresponding author
Dr Eduard Vieta, Clinical Institute of Neuroscience, University Hospital Clinic of Barcelona, Villarroel 170, 08036 Barcelona, Spain. Tel: +34 93 2275401; fax: +34932275477; email: evieta@clinic.ub.es
Footnotes
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Declaration of interest

None.

Funding detailed in Acknowledgements.

Footnotes
References
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Altshuler, L. L., Ventura, J., van Gorp, W. G., et al (2004) Neurocognitive function in clinically stable men with bipolar I disorder or schizophrenia and normal control subjects. Biological Psychiatry, 56, 560569.
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.
Ayuso-Gutierrez, J. L. & Ramos-Brieva, J. A. (1982) The course of manic-depressive illness. A comparative study of bipolar I and bipolar II patients. Journal of Affective Disorders, 4, 914.
Balanza-Martinez, V., Tabares-Seisdedos, R., Selva-Vera, G., et al (2005) Persistent cognitive dysfunctions in bipolar I disorder and schizophrenic patients: a 3-year follow-up study. Psychotherapy and Psychosomatics, 74, 113119.
Benazzi, F. (2001) Prevalence and clinical correlates of residual depressive symptoms in bipolar II disorder. Psychotherapy and Psychosomatik, 70, 232238.
Cassano, G. B. & Savino, M. (1997) Chronic and residual major depressions. In Dysthymia and the Spectrum of Chronic Depressions (eds Akiskal, H. S. & Cassano, G. B.), pp. 5465. New York: Guilford.
Cavanagh, J. T., Van Beck, M., Muir, W., et al (2002) Case–control study of neurocognitive function in euthymic patients with bipolar disorder: an association with mania. British Journal of Psychiatry, 180, 320326.
Clark, L., Iversen, S. D. & Goodwin, G. M. (2002) Sustained attention deficit in bipolar disorder. British Journal of Psychiatry, 180, 313319.
Cohen, J. (1988) Statistical Power Analysis for the Behavioral Sciences Hillsdale, NJ: Erlbaum.
Colom, F., Vieta, E., Martinez-Aran, A., et al (2002) Spanish version of ascale for the assessment of mania: validity and reliability of the Young Mania Rating Scale (in Spanish). Medicina Clinica, 119, 366371.
Deckersbach, T., Savage, C. R., Dougherty, D. D., et al (2005) Spontaneous and directed application of verbal learning strategies in bipolar disorder and obsessive–compulsive disorder. Bipolar Disorders, 7, 166175.
Delis, D. C., Kramer, J. H., Kaplan, E., et al (1987) California Verbal Learning Test Manual. San Antonio, TX: Psychological Corp.
Dickerson, F. B., Boronow, J. J., Stallings, C. R., et al (2004) Association between cognitive functioning and employment status of persons with bipolar disorder. Psychiatric Services, 55, 5458.
Dixon, T., Kravariti, E., Frith, C., et al (2004) Effect of symptoms on executive function in bipolar illness. Psychological Medicine, 34, 811821.
Donaldson, S., Goldstein, L. H., Landau, S., et al (2003) The Maudsley Bipolar Disorder Project: the effect of medication, family history, and duration of illness on IQ and memory in bipolar I disorder. Journal of Clinical Psychiatry, 64, 8693.
Fava, G. A. (1999) Subclinical symptoms in mood disorders: pathophysiological and therapeutic implications. Psychological Medicine, 29, 4761.
Ferrier, I. N., Stanton, B. R., Kelly, T. P., et al (1999) Neuropsychological function in euthymic patients with bipolar disorder. British Journal of Psychiatry, 175, 246251.
First, M., Spitzer, R., Gibbon, M., et al (1997) Structured Clinical Interview for DSM–IV Axis I Disorder, Research Version. New York: Biometrics Research.
Fleck, D. E., Shear, P. K. & Strakowski, S. M. (2005) Processing efficiency and sustained attention in bipolar disorder. Journal of the International Neuropsychological Society, 11, 4957.
Glahn, D. C., Bearden, C. E., Niendam, T. A., et al (2004) The feasibility of neuropsychological endophenotypes in the search for genes associated with bipolar affective disorder. Bipolar Disorders, 6, 171182.
Goldberg, J. F. & Harrow, M. (1999) Poor-outcome bipolar disorders. In Bipolar Disorders: Clinical Course and Outcome (eds Goldberg, J. F. and Harrow, M.), pp. 119. Washington, DC: American Psychiatric Publishing.
Golden, C. J. (1978) Stroop Color and Word Test: A Manual for Clinical and Experimental Uses. Chicago, IL: Stoelting.
Hamilton, M. (1960) Arating scalefor depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 5662.
Heaton, R. K. (1981) Wisconsin Card Sorting Test Manual. Odessa, FL: Psychological Assessment Resources.
Judd, L. L., Akiskal, H. S., Schettler, P. J., et al (2003) The comparative clinical phenotype and long term longitudinal episode course of bipolar I and II: a clinical spectrum or distinct disorders? Journal of Affective Disorders, 73, 1932.
Kieseppa, T., Tuulio-Henriksson, A., Haukka, J., et al (2005) Memory and verbal learning functions in twins with bipolar-I disorder, and the role of information-processing speed. Psychological Medicine, 35, 205215.
Kravariti, E., Dixon, T., Frith, C., et al (2005) Association of symptoms and executive function in schizophrenia and bipolar disorder. Schizophrenia Research, 74, 221231.
Lezak, M. D. (1995) Neuropsychological Assessment. New York: Oxford University Press.
Martinez-Aran, A., Vieta, E., Colom, F., et al (2002) Neuropsychological performance in depressed and euthymic bipolar patients. Neuropsychobiology 46 (suppl. l): 1621.
Martinez-Aran, A., Vieta, E., Colom, F., et al (2004a) Cognitive impairment in euthymic bipolar patients: implications for clinical and functional outcome. Bipolar Disorders, 6, 224232.
Martinez-Aran, A., Vieta, E., Reinares, M., et al (2004b) Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. American Journal of Psychiatry, 161, 262270.
Martinez-Aran, A., Vieta, E., Torrent, C., et al (2006) Functional outcome in bipolar disorder: the role of clinical and cognitive factors. Bipolar Disorders, in press.
McKay, A. P., Tarbuck, A. F., Shapleske, J., et al (1995) Neuropsychological function in manic-depressive psychosis. Evidence for persistent deficits in patients with chronic, severe illness. British Journal of Psychiatry, 167, 5157.
Ramos-Brieva, J. A. & Cordero-Villafafila, A. (1988) A new validation of the Hamilton Rating Scale for Depression. Journal of Psychiatric Research, 22, 2128.
Reitan, R. M. (1958) Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual and Motor Skills, 8, 271276.
Selva, G., Salazar, J., Balanza-Martinez, V., et al (2006) Bipolar I patients with and without an history of psychotic symptoms: do they differ in their cognitive functioning? Journal of Psychiatric Research, in press.
Spreen, O. & Strauss, E. (1998) A Compendium of Neuropsychological Tests (2nd edn). New York: Oxford University Press.
Stip, E., Dufresne, J., Lussier, I., et al (2000) A ouble-blind, placebo-controlled study of the effects of lithium on cognition in healthy subjects: mild and selective effects on learning. Journal of Affective Disorders, 60, 147157.
Thompson, J. M., Gallagher, P., Hughes, J. H., et al (2005) Neurocognitive impairment in euthymic patients with bipolar affective disorder. British Journal of Psychiatry, 186, 3240.
Van Gorp, W. G., Altshuler, L., Theberge, D. C., et al (1998) Cognitive impairment in euthymic bipolar patients with and without prior alcohol dependence. A preliminary study. Archives of General Psychiatry, 55, 4146.
Vieta, E., Gasto, C., Otero, A., et al (1997) Differential features between bipolar I and bipolar II disorder. Comprehensive Psychiatry, 38, 98101.
Vieta, E., Colom, F., Martinez-Arán, A., et al (2000) Bipolar II and comorbidity. Comprehensive Psychiatry, 41, 339343.
Vieta, E., Colom, F. & Martinez-Aran, A. (2002) Chronicity, milder forms, and cognitive impairment in bipolar disorder. In Bipolar Disorders (eds Maj, M., Akiskal, H. S., Lopez-Ibor, J. J., et al), pp. 182184. Chichester: Wiley.
Wechsler, D. (1955) Wechsler Adult Intelligence Scale – Revised. Cleveland, OH: Psychological Corporation.
Young, R. C., Biggs, J. T., Ziegler, V. E., et al (1978) A rating scale for mania: reliability, validity and sensitivity. British Journal of Psychiatry, 133, 429435.
Zarate, C. A., Tohen, M., Land, M., et al (2000) Functional impairment and cognition in bipolar disorder. Psychiatric Quarterly, 71, 309329.
Zubieta, J. K., Huguelet, P., O'Neil, R. L., et al (2001) Cognitive function in euthymic bipolar I disorder. Psychiatry Research, 102, 920.
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  • EISSN: 1472-1465
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Cognitive impairment in bipolar II disorder

  • Carla Torrent (a1), Anabel Martínez-Arán (a1), Claire Daban (a1), Jose Sánchez-Moreno (a2), Mercè Comes (a3), José Manuel Goikolea (a3), Manel Salamero (a3) and Eduard Vieta (a3)...
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