Determinants of Functioning in Euthymic Patients with Bipolar Disorder: A Structural Equation Modelling Approach

2017 ◽  
Vol 41 (S1) ◽  
pp. S77-S77
Author(s):  
L. Samalin ◽  
L. Boyer ◽  
A. Murru ◽  
I. Pacchiarotti ◽  
M. Reinares ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Cognitive Performance ◽  
Psychosocial Functioning ◽  
Structural Equation ◽  
Sleep Disturbances ◽  
Path Coefficient ◽  
Residual Symptoms ◽  
Equation Modelling

BackgroundEuthymic patients with bipolar disorder (BD) experience residual symptoms. Interestingly, residual symptoms appear to impact the natural course of BD and represent potential predictors of recurrence and functional impairment.ObjectivesThe study aimed to analyse the relationship between residual depressive symptoms, sleep disturbances and cognitive impairment as determinants of psychosocial functioning in a large sample of euthymic BD patients.MethodsWe performed a cross-sectional study of 468 BD outpatients in clinical remission for at least 6 months. Bipolar Depression Rating Scale (BDRS), Pittsburgh Sleep Quality Index (PSQI) scale, Visual Analogic Scales (VAS) evaluated cognitive impairment and functioning assessment short test were used to assess residual symptomatology and functioning of patients. We evaluated functioning with. Structural equation modelling (SEM) was used to describe the relationships among the residual depressive symptoms, sleep disturbances, perceived cognitive performance and functioning.ResultsSEM showed good fit. This model revealed that residual depressive symptoms (path coefficient = 0.37) and perceived cognitive performance (path coefficient = 0.27) were the most important features significantly related to psychosocial functioning. Sleep disturbances were indirectly associated with functioning via residual depressive symptoms and perceived cognitive performance (path coefficient = 0.23).ConclusionsThis study contributes to a better understanding of the determinants of psychosocial functioning during the interepisodic periods of BD patients. These findings should have implications for the improvement of functioning of BD patients in a personalized approach to treatment.Disclosure of interestCOI: Dr. Samalin reports personal fees and nonfinancial support from Astra-Zeneca, Bristol Myers Squibb, Janssen, Lundbeck, and Otsuka.The authors L. Boyer, A. Murru, I. Pacchiarotti, M. Reinares, C.M. Bonnin, C. Torrent, V. Norma, P. Corinna, I. de Chazeron, M. Boucekine, P.A. Geoffroy, F. Bellivier, P.M. Llorca, E. Vieta have have not supplied their declaration of competing interest.

scholarly journals Cognitive impairment in bipolar II disorder

2006 ◽  
Vol 189 (3) ◽  
pp. 254-259 ◽  
Author(s):  
Carla Torrent ◽  
Anabel Martínez-Arán ◽  
Claire Daban ◽  
Jose Sánchez-Moreno ◽  
Mercè Comes ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Cognitive Performance ◽  
Psychosocial Functioning ◽  
Visual Memory ◽  
Digit Span ◽  
Control Group ◽  
Bipolar Ii Disorder ◽  
Bipolar Ii

BackgroundPersistent impairments in neurocognitive function have been described in bipolar disorder.AimsTo compare the cognitive performance of patients with bipolar II disorder with that of patients with bipolar I disorder and a healthy control group.MethodThe 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.ResultsCompared 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).ConclusionsCognitive 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.

Longitudinal relationships between cognition and functioning over 2 years in euthymic patients with bipolar disorder: a cross-lagged panel model approach with the FACE-BD cohort

2019 ◽  
pp. 1-8 ◽  
Author(s):  
Mickael Ehrminger ◽  
Eric Brunet-Gouet ◽  
Anne-Sophie Cannavo ◽  
Bruno Aouizerate ◽  
Irena Cussac ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Functional Outcome ◽  
Cognitive Performance ◽  
Psychosocial Functioning ◽  
Causal Effect ◽  
Causal Structure ◽  
Cognitive Remediation ◽  
Bipolar Disorders ◽  
Causal Link

Background Longitudinal studies of the relationship between cognition and functioning in bipolar disorder are scarce, although cognition is thought to be a key determinant of functioning. The causal structure between cognition and psychosocial functioning in bipolar disorder is unknown. Aims We sought to examine the direction of causality between cognitive performance and functional outcome over 2 years in a large cohort of euthymic patients with bipolar disorder. Method The sample consisted of 272 adults diagnosed with bipolar disorder who were euthymic at baseline, 12 and 24 months. All participants were recruited via the FondaMental Advanced Centers of Expertise in Bipolar Disorders. We used a battery of tests, assessing six domains of cognition at baseline and 24 months. Residual depressive symptoms and psychosocial functioning were measured at baseline and 12 and 24 months. The possible causal structure between cognition and psychosocial functioning was investigated with cross-lagged panel models with residual depressive symptoms as a covariate. Results The analyses support a causal model in which cognition moderately predicts and is causally primary to functional outcome 1 year later, whereas psychosocial functioning does not predict later cognitive performance. Subthreshold depressive symptoms concurrently affected functioning at each time of measure. Conclusions Our results are compatible with an upward causal effect of cognition on functional outcome in euthymic patients with bipolar disorder. Neuropsychological assessment may help specify individual prognoses. Further studies are warranted to confirm this causal link and evaluate cognitive remediation, before or simultaneously with functional remediation, as an intervention to improve functional outcome. Declaration of interest None.

The effects of cognitive reserve and depressive symptoms on cognitive performance in major depression and bipolar disorder

2020 ◽  
Vol 274 ◽  
pp. 813-818
Author(s):  
André Ponsoni ◽  
Laura Damiani Branco ◽  
Charles Cotrena ◽  
Flávio Milman Shansis ◽  
Rochele Paz Fonseca
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Cognitive Performance ◽  
Cognitive Reserve

An Exploratory Study of Pathways from White Matter Hyperintensities to Cognitive Impairment through Depressive Symptoms Using Structural Equation Modeling: A Cross Sectional Study in Patients with Dementia

2020 ◽  
Vol 26 (7) ◽  
pp. 679-689
Author(s):  
Chang Hyun Lee ◽  
Do Hoon Kim
Keyword(s):  
Cognitive Impairment ◽  
Structural Equation Modeling ◽  
Depressive Symptoms ◽  
Cognitive Function ◽  
White Matter ◽  
Structural Equation ◽  
White Matter Hyperintensities ◽  
Mediating Effect ◽  
Equation Modeling ◽  
Cross Sectional

AbstractObjective:The aim of this study was to model the relationships among white matter hyperintensities (WMHs), depressive symptoms, and cognitive function and to examine the mediating effect of depressive symptoms on the relationship between WMHs and cognitive impairment.Methods:We performed structural equation modeling using cross-sectional data from 1158 patients from the Clinical Research for Dementia of South Korea (CREDOS) registry who were diagnosed with mild-to-moderate dementia. Periventricular white matter hyperintensities (PWMHs) and deep white matter hyperintensities (DWMHs) were obtained separately on the protocol of magnetic resonance imaging (MRI). Depression and cognitive function were assessed using the Korean Form of the Geriatric Depression Scale (KGDS) and the Seoul Neuropsychological Screening Battery (SNSB), respectively.Results:The model that best reflected the relationships among the variables was the model in which DWMHs affected cognitive function directly and indirectly through the depressive symptoms; on the other hand, PWMHs only directly affected cognitive function.Conclusions:This study presents the mediation model including the developmental pathway from DWMHs to cognitive impairment through depressive symptoms and suggests that the two types of WMHs may affect cognitive impairment through different pathways.

scholarly journals Cigarette smoking and depression: tests of causal linkages using a longitudinal birth cohort

2010 ◽  
Vol 196 (6) ◽  
pp. 440-446 ◽  
Author(s):  
Joseph M. Boden ◽  
David M. Fergusson ◽  
L. John Horwood
Keyword(s):  
Depressive Symptoms ◽  
Cigarette Smoking ◽  
Birth Cohort ◽  
Nicotine Dependence ◽  
Structural Equation Modelling ◽  
Fixed Effects ◽  
Structural Equation ◽  
Early Adulthood ◽  
Equation Modelling ◽  
Increased Risk

BackgroundResearch on the comorbidity between cigarette smoking and major depression has not elucidated the pathways by which smoking is associated with depression.AimsTo examine the causal relationships between smoking and depression via fixed-effects regression and structural equation modelling.MethodData were gathered on nicotine-dependence symptoms and depressive symptoms in early adulthood using a birth cohort of over 1000 individuals.ResultsAdjustment for confounding factors revealed persistent significant (P<0.05) associations between nicotine-dependence symptoms and depressive symptoms. Structural equation modelling suggested that the best-fitting causal model was one in which nicotine dependence led to increased risk of depression. The findings suggest that the comorbidity between smoking and depression arises from two routes; the first involving common or correlated risk factors and the second a direct path in which smoking increases the risk of depression.ConclusionsThis evidence is consistent with the conclusion that there is a cause and effect relationship between smoking and depression in which cigarette smoking increases the risk of symptoms of depression.

Cognitive performance and psychosocial functioning in unaffected siblings of bipolar disorder patients in comparison with healthy controls

2020 ◽  
Vol 54 ◽  
pp. 102246
Author(s):  
Vigneshvar Chandrasekaran ◽  
Shivanand Kattimani ◽  
Karthick Subramanian ◽  
Venkatalakshmi Penchilaiya ◽  
Arivazhagan Karunanithi
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Performance ◽  
Psychosocial Functioning ◽  
Healthy Controls

scholarly journals Self-reported sleep disturbances are associated with poorer cognitive performance in older adults with hypertension: a multi-parameter risk factor investigation

2019 ◽  
Vol 32 (7) ◽  
pp. 815-825 ◽  
Author(s):  
Jordan N. Kohn ◽  
Emily Troyer ◽  
Robert N. Guay-Ross ◽  
Kathleen Wilson ◽  
Amanda Walker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Logistic Regression ◽  
Cognitive Impairment ◽  
Cognitive Performance ◽  
Sleep Disturbances ◽  
Depressive Symptomatology ◽  
Cognitive Outcomes ◽  
Cognitive Domain ◽  
Increased Risk

ABSTRACTObjectives:Given the evidence of multi-parameter risk factors in shaping cognitive outcomes in aging, including sleep, inflammation, cardiometabolism, and mood disorders, multidimensional investigations of their impact on cognition are warranted. We sought to determine the extent to which self-reported sleep disturbances, metabolic syndrome (MetS) factors, cellular inflammation, depressive symptomatology, and diminished physical mobility were associated with cognitive impairment and poorer cognitive performance.Design:This is a cross-sectional study.Setting:Participants with elevated, well-controlled blood pressure were recruited from the local community for a Tai Chi and healthy-aging intervention study.Participants:One hundred forty-five older adults (72.7 ± 7.9 years old; 66% female), 54 (37%) with evidence of cognitive impairment (CI) based on Montreal Cognitive Assessment (MoCA) score ≤24, underwent medical, psychological, and mood assessments.Measurements:CI and cognitive domain performance were assessed using the MoCA. Univariate correlations were computed to determine relationships between risk factors and cognitive outcomes. Bootstrapped logistic regression was used to determine significant predictors of CI risk and linear regression to explore cognitive domains affected by risk factors.Results:The CI group were slower on the mobility task, satisfied more MetS criteria, and reported poorer sleep than normocognitive individuals (all p < 0.05). Multivariate logistic regression indicated that sleep disturbances, but no other risk factors, predicted increased risk of evidence of CI (OR = 2.00, 95% CI: 1.26–4.87, 99% CI: 1.08–7.48). Further examination of MoCA cognitive subdomains revealed that sleep disturbances predicted poorer executive function (β = –0.26, 95% CI: –0.51 to –0.06, 99% CI: –0.61 to –0.02), with lesser effects on visuospatial performance (β = –0.20, 95% CI: –0.35 to –0.02, 99% CI: –0.39 to 0.03), and memory (β = –0.29, 95% CI: –0.66 to –0.01, 99% CI: –0.76 to 0.08).Conclusions:Our results indicate that the deleterious impact of self-reported sleep disturbances on cognitive performance was prominent over other risk factors and illustrate the importance of clinician evaluation of sleep in patients with or at risk of diminished cognitive performance. Future, longitudinal studies implementing a comprehensive neuropsychological battery and objective sleep measurement are warranted to further explore these associations.

scholarly journals Cognitive impairment in depression: a systematic review and meta-analysis

2013 ◽  
Vol 44 (10) ◽  
pp. 2029-2040 ◽  
Author(s):  
P. L. Rock ◽  
J. P. Roiser ◽  
W. J. Riedel ◽  
A. D. Blackwell
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Depressive Symptoms ◽  
Psychosocial Functioning ◽  
Meta Analysis ◽  
Neuropsychological Test ◽  
Low Mood ◽  
Memory And Attention ◽  
Core Feature

BackgroundThis review aimed to address the question of whether cognitive impairment should be considered a core feature of depression that may be a valuable target for treatment.MethodWe conducted a systematic review and meta-analysis of cognitive function, assessed with a single neuropsychological test battery, the Cambridge Neuropsychological Test Automated Battery (CANTAB), in patients with depression during symptomatic and remitted states. Inclusion of studies comparing patients remitted from depression and controls enabled us to investigate whether cognitive impairment persists beyond episodes of low mood in depression.ResultsOur meta-analysis revealed significant moderate cognitive deficits in executive function, memory and attention in patients with depression relative to controls (Cohen's d effect sizes ranging from −0.34 to −0.65). Significant moderate deficits in executive function and attention (Cohen's d ranging from −0.52 to −0.61) and non-significant small/moderate deficits in memory (Cohen's d ranging from −0.22 to −0.54) were found to persist in patients whose depressive symptoms had remitted, indicating that cognitive impairment occurs separately from episodes of low mood in depression.ConclusionsBoth low mood and cognitive impairment are associated with poor psychosocial functioning. Therefore, we argue that remediation of cognitive impairment and alleviation of depressive symptoms each play an important role in improving outcome for patients with depression. In conclusion, this systematic review and meta-analysis demonstrates that cognitive impairment represents a core feature of depression that cannot be considered an epiphenomenon that is entirely secondary to symptoms of low mood and that may be a valuable target for future interventions.

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