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

Background Cross-sectional studies have found impaired cognitive functioning in patients with bipolar disorder, but long-term longitudinal studies are scarce. Aims The aims of this study were to examine the 6-year longitudinal course of cognitive functioning in patients with bipolar disorder and healthy controls. Subsets of patients were examined to investigate possible differences in cognitive trajectories. Method Patients with bipolar I disorder (n = 44) or bipolar II disorder (n = 28) and healthy controls (n = 59) were tested with a comprehensive cognitive test battery at baseline and retested after 6 years. We conducted repeated measures ANCOVAs with group as a between-subject factor and tested the significance of group and time interaction. Results By and large, the change in cognitive functioning between baseline and follow-up did not differ significantly between participants with bipolar disorder and healthy controls. Comparing subsets of patients, for example those with bipolar I and II disorder and those with and without manic episodes during follow-up, did not reveal subgroups more vulnerable to cognitive decline. Conclusions Cognitive performance remained stable in patients with bipolar disorder over a 6-year period and evolved similarly to healthy controls. These findings argue against the notion of a general progressive decline in cognitive functioning in bipolar disorder.

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Cognitive Performance and Cerebrospinal Fluid Biomarkers of Neurodegeneration: A Study of Patients with Bipolar Disorder and Healthy Controls

PLoS ONE ◽

10.1371/journal.pone.0127100 ◽

2015 ◽

Vol 10 (5) ◽

pp. e0127100 ◽

Cited By ~ 16

Author(s):

Sindre Rolstad ◽

Joel Jakobsson ◽

Carl Sellgren ◽

Carl-Johan Ekman ◽

Kaj Blennow ◽

...

Keyword(s):

Bipolar Disorder ◽

Cerebrospinal Fluid ◽

Cognitive Performance ◽

Healthy Controls ◽

Cerebrospinal Fluid Biomarkers

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Impact of subthreshold symptoms on cognitive performance and psychosocial functioning in patients with bipolar disorder

Frontiers in Psychiatry ◽

10.3389/conf.fpsyt.2017.48.00001 ◽

2017 ◽

Vol 8 ◽

Author(s):

Dimosthenis Tsapekos ◽

Tim Mantingh ◽

Rebecca Strawbridge ◽

Rafaela-Iro Schiza ◽

John Hodsoll ◽

...

Keyword(s):

Bipolar Disorder ◽

Cognitive Performance ◽

Psychosocial Functioning

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Comparison of cognitive performance in bipolar disorder, major depressive disorder, unaffected first‐degree relatives, and healthy controls

Psychiatry and Clinical Neurosciences ◽

10.1111/pcn.12797 ◽

2018 ◽

Vol 73 (2) ◽

pp. 70-76 ◽

Cited By ~ 6

Author(s):

Qijing Bo ◽

Fang Dong ◽

Xianbin Li ◽

Feng Li ◽

Peng Li ◽

...

Keyword(s):

Bipolar Disorder ◽

Major Depressive Disorder ◽

Depressive Disorder ◽

Cognitive Performance ◽

Healthy Controls ◽

Major Depressive ◽

First Degree Relatives

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Cognitive impairment in bipolar II disorder

The British Journal of Psychiatry ◽

10.1192/bjp.bp.105.017269 ◽

2006 ◽

Vol 189 (3) ◽

pp. 254-259 ◽

Cited By ~ 160

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.

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

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.246 ◽

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.

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Cognitive Performance in Euthymic Patients with Bipolar Disorder vs Healthy Controls: A Neuropsychological Investigation

Clinical Practice and Epidemiology in Mental Health ◽

10.2174/1745017901713010071 ◽

2017 ◽

Vol 13 (1) ◽

pp. 71-81 ◽

Cited By ~ 2

Author(s):

M. Carlotta Palazzo ◽

Chiara Arici ◽

Laura Cremaschi ◽

Marta Cristoffanini ◽

Cristina Dobrea ◽

...

Keyword(s):

Bipolar Disorder ◽

Cognitive Impairment ◽

Cognitive Performance ◽

Verbal Fluency ◽

Cognitive Task ◽

Healthy Controls ◽

Verbal Fluency Test ◽

Age Related ◽

Bipolar Patients ◽

Fluency Test

Objectives: Cognitive impairment may affect patients with Bipolar Disorder (BD) beyond the acute episodes, qualifying as a potential endophenotype. However, which cognitive domains are specifically affected in euthymic patients with BD and the potential influence of confounding factors (e.g., age and concomitant pharmacological treatment) are still a matter of debate. The present study was, therefore, conducted to assess cognitive performance across specific domains in euthymic bipolar patients, not older than 50 years (to avoid potential age-related bias) versus healthy controls (HCs). Methods: A cognitive task battery, including the Wisconsin Card Test, Span Attention Test, Tower of London, Trail Making Test, Verbal Fluency Test, Matrices Scores and N-Back, was administered to 62 subjects (30 bipolar patients and 32 matched HCs) and differences between the groups analyzed. Results: Bipolar patients performed significantly worse than HCs in the Span Forward task, in the expression of Verbal Fluency Test (Category) and in the N-Back task (all p<.05), with marginal differences between BD I and BD II patients. Conclusion: The present study pointed out significant differences in terms of cognitive performance between euthymic bipolar patients and HCs, supporting the notion that specific cognitive functions may remain impaired even after the resolution of the acute episodes in subjects suffering from BD. Future studies on larger samples are warranted to confirm the present results and further explore potential differences in cognitive impairment across specific bipolar subtypes.

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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

The British Journal of Psychiatry ◽

10.1192/bjp.2019.180 ◽

2019 ◽

pp. 1-8 ◽

Cited By ~ 7

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.

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Neuroserpin in Bipolar Disorder

Current Topics in Medicinal Chemistry ◽

10.2174/1568026620666200131125526 ◽

2020 ◽

Vol 20 (7) ◽

pp. 518-523

Author(s):

Rugül Köse Çinar

Keyword(s):

Gene Expression ◽

Bipolar Disorder ◽

Polymerase Chain Reaction Method ◽

Type I ◽

Healthy Controls ◽

Neuroprotective Effects ◽

Expression Levels ◽

Disease States ◽

Cord Injury ◽

System Functioning

Objective: Neuroserpin is a serine protease inhibitor predominantly expressed in the nervous system functioning mainly in neuronal migration and axonal growth. Neuroprotective effects of neuroserpin were shown in animal models of stroke, brain, and spinal cord injury. Postmortem studies confirmed the involvement of neuroserpin in Alzheimer’s disease. Since altered adult neurogenesis was postulated as an aetiological mechanism for bipolar disorder, the possible effect of neuroserpin gene expression in the disorder was evaluated. Methods: Neuroserpin mRNA expression levels were examined in the peripheral blood of bipolar disorder type I manic and euthymic patients and healthy controls using the polymerase chain reaction method. The sample comprised of 60 physically healthy, middle-aged men as participants who had no substance use disorder. Results: The gene expression levels of neuroserpin were found lower in the bipolar disorder patients than the healthy controls (p=0.000). The neuroserpin levels did not differ between mania and euthymia (both 96% down-regulated compared to the controls). Conclusion: Since we detected differences between the patients and the controls, not the disease states, the dysregulation in the neuroserpin gene could be interpreted as a result of the disease itself.

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