Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2011, 155(1):19-26 | DOI: 10.5507/bp.155.2011.003

COGNITIVE IMPAIRMENT IN BIPOLAR DISORDER

Klara Latalovaa, Jan Praskoa,b,c, Tomas Divekya, Hana Velartovaa
a Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Czech Republic
b Prague Psychiatric Centre, Ustavni 91, 181 03 Praha
c Centre of Neuropsychiatric Studies, Ustavni 91, 181 03 Praha

Aim: Provide an overview of how bipolar disorder affects cognitive function in patients.

Methods: MEDLINE and PsycInfo data bases were searched for articles indexed by the combinations of MESH term or key word "bipolar disorder" with the following terms: "cognition", "memory", "neuropsychology", "neuropsychological tests", "lithium", "anticonvulsants", "antipsychotics", and "schizophrenia". Constraints limiting time period of publications or their language were not applied. Reference lists of publications identified by these procedures were hand-searched for additional relevant citations.

Results: There is evidence of stable and lasting cognitive impairment in all phases of bipolar disorder, including the remission phase, particularly in the following domains: sustained attention, memory and executive functions. But research on the cognitive functions has yielded inconsistent results over recent years. There is a growing need for clarification regarding the magnitude, clinical relevance and confounding variables of cognitive impairment in bipolar patients. The impact of bipolar illness on cognition can be influenced by age of onset, pharmacological treatments, individual response, familial risk factors, and clinical features. In addition to the mood state, cognitive performance in bipolar patients is influenced by seasonality.

Conclusion: Previous optimistic assumptions about the prognosis of bipolar disorder were based on the success of the control of mood symptoms by pharmacotherapy. However, it is now clear that the "remitted" euthymic bipolar patients have distinct impairments of executive function, verbal memory, psychomotor speed, and sustained attention. Mood stabilizers and atypical antipsychotics may reduce cognitive deficits in certain domains and may have a positive effect on quality of life and social functioning.

Keywords: Bipolar disorder, Cognitive impairment, Genetics, Mood stabilizers, Cognitive tests, Quality of life

Received: June 17, 2010; Accepted: November 16, 2010; Published: March 1, 2011  Show citation

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Latalova, K., Prasko, J., Diveky, T., & Velartova, H. (2011). COGNITIVE IMPAIRMENT IN BIPOLAR DISORDER. Biomedical papers, 155(1), 19-26. doi: 10.5507/bp.155.2011.003
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    References

    1. Harvey PD, Wingo AP, Burdick KE, Baldessarini RJ. Cognition and disability in bipolar disorder: lessons from schizophrenia research. Bipolar Disord 2010;12(4):364-375. Go to original source... Go to PubMed...
    2. Kendler KS, Neale MC. Endophenotype: a conceptual analysis. Mol Psychiatry 2010 February 9. Go to original source... Go to PubMed...
    3. Gottesman II, Gould TD. The endophenotype concept in psychiatry: etymology and strategic intentions. Am J Psychiatry 2003;160(4):636-645. Go to original source... Go to PubMed...
    4. 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- 2):1-20. Go to original source... Go to PubMed...
    5. Hill SK, Harris MS, Herbener ES, Pavuluri M, Sweeney JA. Neurocognitive allied phenotypes for schizophrenia and bipolar disorder. Schizophr Bull 2008;34(4):743-759. Go to original source... Go to PubMed...
    6. Reitan RM. Validity of the Trail Making Test as an indicator of organic brain damage. Percept Mot Skills 1958;8:271-276. Go to original source...
    7. Stroop JR. Studies of interference in serial verbal reactions. J Exp Psychol 1935;18:643-662. Go to original source...
    8. Heaton RK. A manual for the Wisconsin Card Sorting Test. Odessa, FL: Psychological Assessment Resources; 1981.
    9. Benton AL, Hamsher K. Multilingual Aphasia Examination Manual revised. Iowa City: University of Iowa; 1978.
    10. Delis DC, Kramer JH, Kaplan E, Ober BA. California Verbal Learning Test: Adult version. San Antonio, Texas: The Psychological Corporation; 1987. Go to original source...
    11. Brand N, Jolles J. Learning and retrieval rate of words presented auditorily and visually. J Gen Psychol 1985;112(2):201-210. Go to original source... Go to PubMed...
    12. Wechsler D. Wechsler Adult Intelligence Scale (Manual). New York: Psychological Corporation; 1955.
    13. Kurtz MM, Ragland JD, Bilker W, Gur RC, Gur RE. Comparison of the continuous performance test with and without working memory demands in healthy controls and patients with schizophrenia. Schizophr Res 2001;48(2-3):307-316. Go to original source... Go to PubMed...
    14. Wechsler D. Wechsler Adult Intelligence Scale-Revised. New York: Psychological Corporation; 1981.
    15. Grober E, Sliwinski M. Development and validation of a model for estimating premorbid verbal intelligence in the elderly. J Clin Exp Neuropsychol 1991;13(6):933-949. Go to original source... Go to PubMed...
    16. Malhi GS, Lagopoulos J, Das P, Moss K, Berk M, Coulston CM. A functional MRI study of Theory of Mind in euthymic bipolar disorder patients. Bipolar Disord 2008;10(8):943-956. Go to original source... Go to PubMed...
    17. Lahera G, Montes JM, Benito, Valdivia M, Medina E, Mirapeix I, Sáiz-Ruiz J. Theory of mind deficit in bipolar disorder: is it related to a previous history of psychotic symptoms? Psychiatry Res 2008;161(3):309-317. Go to original source... Go to PubMed...
    18. Montag C, Ehrlich A, Neuhaus K, Dziobek I, Heekeren HR, Heinz A, Gallinat J. Theory of mind impairments in euthymic bipolar patients. J Affect Disord 2010;123(1-3):264-269. Go to original source... Go to PubMed...
    19. Keck PE, Jr., McElroy SL, Havens JR, Altshuler LL, Nolen WA, Frye MA, Suppes T, Denikoff D, Kupka R, Lverish GS, Rush AJ, Post RM. Psychosis in bipolar disorder: phenomenology and impact on morbidity and course of illness. Compr Psychiatry 2003;44(4):263-269. Go to original source... Go to PubMed...
    20. Glahn DC, Bearden CE, Barguil, Barrett J, Reichenberg A, Bowden CL, Soares JC, Velligan DI. The neurocognitive signature of psychotic bipolar disorder. Biol Psychiatry 2007; 62(8):910-916. Go to original source... Go to PubMed...
    21. Bora E, Vahip S, Akdeniz F, Gonul AS, Eryavuz A, Ogut M, Alkan M. The effect of previous psychotic mood episodes on cognitive impairment in euthymic bipolar patients. Bipolar Disord 2007;9(5):468-477. Go to original source... Go to PubMed...
    22. Martinez-Aran A, Torrent C, Tabares-Seisdedos R, Salamero M, Dabon C, BalanzaMartinez V, Sanchez-Moreno J, Manuel Goikolea J, Benabarre A, Colom F, Vieta E. Neurocognitive impairment in bipolar patients with and without history of psychosis. J Clin Psychiatry 2008;69(2):233-239. Go to original source... Go to PubMed...
    23. Levy B, Weiss RD. Neurocognitive impairment and psychosis in bipolar I disorder during early remission from an acute episode of mood disturbance. J Clin Psychiatry 2010;71(2):201-206. Go to original source... Go to PubMed...
    24. Martinez-Aran A, Vieta E, Reinares M, Colom F, Torrent C, Sánchez-Moreno J, Benabarre A, Goikolea JM, Comes M, Salamero M. Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. Am J Psychiatry 2004;161(2):262-270. Go to original source... Go to PubMed...
    25. Malhi GS, Ivanovski B, Szekeres V, Olley A. Bipolar disorder: it's all in your mind? The neuropsychological profile of a biological disorder. Can J Psychiatry 2004;49(12):813-819. Go to original source... Go to PubMed...
    26. Malhi GS, Ivanovski B, Hadzi-Pavlovic D, Mitchell PB, Vieta E, Sachdev P. Neuropsychological deficits and functional impairment in bipolar depression, hypomania and euthymia. Bipolar Disord 2007;9(1-2):114-125. Go to original source... Go to PubMed...
    27. Jones SH, Thornicroft G, Coffey M, Dunn G. A brief mental health outcome scale-reliability and validity of the Global Assessment of Functioning (GAF). Br J Psychiatry 1995; 66(5):654-659. Go to original source... Go to PubMed...
    28. Rajajarvi E, Antila M, Kieseppa T, Lonnqvist J, Tuulio-Henriksson A, Partonen T. The effect of seasons and seasonal variation on neuropsychological test performance in patients with bipolar I disorder and their first-degree relatives. J Affect Disord 2010;127(1-3):58-65. Go to original source... Go to PubMed...
    29. Taylor Tavares JV, Clark L, Cannon DM, Erickson K, Drevets WC, Sahakian BJ. Distinct profiles of neurocognitive function in unmedicated unipolar depression and bipolar II depression. Biol Psychiatry 2007;62(8):917-924. Go to original source... Go to PubMed...
    30. Roiser JP, Cannon DM, Gandhi SK, Taylor Tavares J, Erickson K, Wood S, Klaver JM, Clark L, Zarate CA Jr, Sahakian BJ, Drevets WC. Hot and cold cognition in unmedicated depressed subjects with bipolar disorder. Bipolar Disord 2009;11(2):178-189. Go to original source... Go to PubMed...
    31. Holmes MK, Erickson K, Luckenbaugh DA, Drevets WC, Bain EE, Cannon DM, Snow J, Sahakian BJ, Manji HK Zarate CA Jr. A comparison of cognitive functioning in medicated and unmedicated subjects with bipolar depression. Bipolar Disord 2008;10(7):806- 815. Go to original source... Go to PubMed...
    32. Lopez-Jaramillo C, Lopera-Vasquez J, Ospina-Duque, García J, Gallo A, Cortez V, Palacio C, Torrent C, Martínez-Arán A, Vieta E. Lithium treatment effects on the neuropsychological functioning of patients with bipolar I disorder. J Clin Psychiatry 2010;71(8):1055- 1060. Go to original source... Go to PubMed...
    33. Rybakowski JK, Permoda-Osip A, Borkowska A. Response to prophylactic lithium in bipolar disorder may be associated with a preservation of executive cognitive functions. Eur Neuropsychopharmacol 2009;19(11):791-795. Go to original source... Go to PubMed...
    34. Wingo AP, Wingo TS, Harvey PD, Baldessarini RJ. Effects of lithium on cognitive performance: a meta-analysis. J Clin Psychiatry 2009;70(11):1588-1597. Go to original source... Go to PubMed...
    35. Ghaemi SN, Gilmer WS, Dunn RT, Hanlon RE, Kemp DE, Bauer AD, Chriki L, Filkowski MM, Harvey PD. A double-blind, placebo- controlled pilot study of galantamine to improve cognitive dysfunction in minimally symptomatic bipolar disorder. J Clin Psychopharmacol 2009;29(3):291-295. Go to original source... Go to PubMed...
    36. Iosifescu DV, Moore CM, Deckersbach T, Tilley CA, Ostacher MJ, Sachs GS, Nierenberg AA. Galantamine-ER for cognitive dysfunction in bipolar disorder and correlation with hippocampal neuronal viability: a proof-of-concept study. CNS Neurosci Ther 2009;15(4):309-319. Go to original source... Go to PubMed...
    37. Miklowitz DJ, Otto MW, Frank E, Reilly-Harrington NA, Kogan JN, Sachs GS, Thase ME, Calabrese JR, Marangell LB, Ostacher MJ, Patel J, Thomas MR, Araga M, Gonzales LM, Wisniewski SR. Intensive psychosocial intervention enhances functioning in patients with bipolar depression: results from a 9-month randomized controlled trial. Am J Psychiatry 2007;164(9):1340-1347. Go to original source... Go to PubMed...
    38. Deckersbach T, Nierenberg AA, Kessler R, Lund HG, Ametrano RM, Sachs G, Rauch SL, Dougherty D. Cognitive Rehabilitation for Bipolar Disorder: An Open Trial for Employed Patients with Residual Depressive Symptoms. CNS Neurosci Ther 2010;16:298- 307. Go to original source... Go to PubMed...
    39. Tsuang MT, Woolson RF, Fleming JA. Long-term outcome of major psychoses. I. Schizophrenia and affective disorders compared with psychiatrically symptom-free surgical conditions. Arch Gen Psychiatry 1979;36(12):1295-1301. Go to original source... Go to PubMed...
    40. Coryell W, Scheftner W, Keller M, Endicott J, Maser J, Klerman GL. The enduring psychosocial consequences of mania and depression. Am J Psychiatry 1993;150(5):720-727. Go to original source... Go to PubMed...
    41. Goetz I, Tohen M, Reed C, Lorenzo M, Vieta E. Functional impairment in patients with mania: baseline results of the EMBLEM study. Bipolar Disord 2007; 9(1-2):45-52. Go to original source... Go to PubMed...
    42. Wingo AP, Harvey PD, Baldessarini RJ. Neurocognitive impairment in bipolar disorder patients: functional implications. Bipolar Disord 2009;11(2):113-125. Go to original source... Go to PubMed...
    43. Pope M, Dudley R, Scott J. Determinants of social functioning in bipolar disorder. Bipolar Disord 2007; 9(1-2):38-44. Go to original source... Go to PubMed...
    44. Waghorn G, Chant D, Jaeger J. Employment functioning and disability among community residents with bipolar affective disorder: results from an Australian community survey. Bipolar Disord 2007;9(1-2):166-182. Go to original source... Go to PubMed...
    45. Martinez-Aran A, Vieta E, Torrent C, Sanchez-Moreno J, Goikolea JM, Salamero M, Malhi GS, Gonzales-Pinto A, Daban C, Alvarez- Grandi S, Fountoulakis K, Kaprinis G, Tabares-Seisdedos R, Ayuso- Mateos JL. Functional outcome in bipolar disorder: the role of clinical and cognitive factors. Bipolar Disord 2007;9(1-2):103-113. Go to original source... Go to PubMed...
    46. Jaeger J, Berns S, Loftus S, Gonzalez C, Czobor P. Neurocognitive test performance predicts functional recovery from acute exacerbation leading to hospitalization in bipolar disorder. Bipolar Disord 2007;9(1-2):93-102. Go to original source... Go to PubMed...
    47. Sanchez-Morla EM, Barabash A, Martinez-Vizcaino V, Tabares- Seisdedos R, Balanzá-Martínez V, Cabranes-Díaz JA, Baca- Baldomero E, Gómez JL. Comparative study of neurocognitive function in euthymic bipolar patients and stabilized schizophrenic patients. Psychiatry Res 2009;169(3):220-228. Go to original source... Go to PubMed...
    48. Huxley N, Baldessarini RJ. Disability and its treatment in bipolar disorder patients. Bipolar Disord 2007; 9(1-2):183-196. Go to original source... Go to PubMed...
    49. Hill SK, Reilly JL, Harris MS, Rosen C, Marvin RW, Deleon O, Sweney JA. A comparison of neuropsychological dysfunction in first-episode psychosis patients with unipolar depression, bipolar disorder, and schizophrenia. Schizophr Res 2009;113(2-3):167-175. Go to original source... Go to PubMed...
    50. Czobor P, Jaeger J, Berns SM, Gonzalez C, Loftus S. Neuropsychological symptom dimensions in bipolar disorder and schizophrenia. Bipolar Disord 2007;9(1-2):71-92. Go to original source... Go to PubMed...
    51. Antila M, Tuulio-Henriksson A, Kieseppa T, Soronen P, Palo OM, Paunio T, Haukka J, Partonen T, Lonnqvist J. Heritability of cognitive functions in families with bipolar disorder. Am J Med Genet B Neuropsychiatr Genet 2007;144B(6):802-808. Go to original source... Go to PubMed...
    52. Antila M, Tuulio-Henriksson A, Kieseppa T, Eerola M, Partonen T, Lonnqvist J. Cognitive functioning in patients with familial bipolar I disorder and their unaffected relatives. Psychol Med 2007;37(5):679-687. Go to original source... Go to PubMed...
    53. Antila M, Partonen T, Kieseppa T, Suvissaari J, Eerola M, Lönnqvist J, Tuulio-Henriksson A . Cognitive functioning of bipolar I patients and relatives from families with or without schizophrenia or schizoaffective disorder. J Affect Disord 2009; 116(1-2):70-79. Go to original source... Go to PubMed...
    54. Bora E, Vahip S, Akdeniz F, Ilerisoy H, Aldemir E, Alkan M. Executive and verbal working memory dysfunction in first-degree relatives of patients with bipolar disorder. Psychiatry Res 2008; 161(3):318-324. Go to original source... Go to PubMed...
    55. Arts B, Jabben N, Krabbendam L, van OJ. Meta-analyses of cognitive functioning in euthymic bipolar patients and their first-degree relatives. Psychol Med 2008;38(6):771-785. Go to original source... Go to PubMed...
    56. Van Snellenberg JX, de Candia T. Meta-analytic evidence for familial coaggregation of schizophrenia and bipolar disorder. Arch Gen Psychiatry 2009;66(7):748-755. Go to original source... Go to PubMed...
    57. Zalla T, Joyce C, Szoke A, Schürhoff F, Pillon B, Komano O, Perez-Diaz F, Bellivier F, Alter C, Dubois B, Rouillon F, Houde O, Leboyer M. Executive dysfunctions as potential markers of familial vulnerability to bipolar disorder and schizophrenia. Psychiatry Res 2004;121(3):207-217. Go to original source... Go to PubMed...
    58. Szoke A, Schürhoff F, Golmard JL, Alter C, Roy I, Méary A, Etain B, Bellivier F, Leboyer M. Familial resemblance for executive functions in families of schizophrenic and bipolar patients. Psychiatry Res 2006;144(2-3):131-138. Go to original source... Go to PubMed...
    59. Besnier N, Richard F, Zendjidjian X, Kaladjian A, Mazzola- Pomietto P, Adida M, Azorin JM. Stroop and emotional Stroop interference in unaffected relatives of patients with schizophrenic and bipolar disorders: distinct markers of vulnerability? World J Biol Psychiatry 2009;10(4 Pt 3):809-818. Go to original source... Go to PubMed...

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