scholarly journals Cognitive functions in a mixed episode of bipolar affective disorder

Summary. According to various meta-analyzes, most patients with bipolar affective disorder have neurocognitive dysfunction even in remission. In recent studies, moderate to severe impairments have been found in attention, verbal learning and memory, and executive function. Whereas premorbid intelligence remains unchanged. The main body of research is devoted to the study of cognitive impairment in the first episode of bipolar affective disorder, in manic, depressive episodes, and euthymia. At the same time, the features of cognitive dysfunction in mixed forms of bipolar affective disorder remain poorly understood. The aim of the study was to study the characteristics of cognitive functions in patients with a mixed episode of bipolar affective disorder. Materials and methods. With the help of a battery of tests (a test for remembering ten unrelated words; a Ray-Osterritz test; a verbal speed test; a digital character substitution test; a symbol linking test), the cognitive features of 25 patients with a mixed episode, 16 patients with a manic episode, and 15 patients with a depressive episode of bipolar affective disorder. Results and conclusions. Deviations in cognitive function were found in all patients regardless of the type of affective symptomatology. In the form of a wide range of psychopathological phenomena which manifested themselves to a greater extent in patients with a mixed episode of bipolar affective disorder. The peculiarities of the phenomenological structure of cognitive impairment in patients with mixed phase of bipolar affective disorder are manifested in the form of a more pronounced deterioration of verbal memory, information processing speed; more pronounced violations of spatial representations, deterioration of visual memory, verbal associative performance and executive functions; a decrease in attention and a violation of its distribution. The findings suggest that the leading role in the formation of these disorders is played by the presence of depressive symptoms in the clinical structure of affective disorders.

2019 ◽  
Vol 25 (3) ◽  
pp. 124-129
Author(s):  
V. S. Pidkorytov ◽  
O. I. Syerikova ◽  
S. O. Ukrainskyi ◽  
O. V. Skrynnyk ◽  
O. S. Serikova

Background. Data of various meta-analyzes confirm that the majority of patients with bipolar affective disorder (BAD) have neurocognitive dysfunction, even during remission. According to the latest research, disturbed domains with moderate to pronounced changes are attention, verbal learning and memory, as well as executive functions, whereas premorbid intelligence may remain unchanged. The main body of research is devoted to the study of cognitive impairment in the first episode of BAD, in manic, depressive episodes and euthymia. At the same time, the features of cognitive dysfunction in mixed forms of biologically active substances remain insufficiently studied. Objective – to study the characteristics of the cognitive sphere in patients with a mixed episode of BAD. Materials and methods. With the help of battery tests (a test to memorize ten unrelated words; Rey-Osterreith Complex Figure Test; Verbal Fluency Test Digit Symbol Substitution Test; Trail making test), the cognitive functions of 25 patients with mixed episodes, 16 patients with manic episodes, and 15 patients with depressive episode of BAD. Results. Cognitive impairments were identified in all patients, regardless of the type of affective symptoms, in the form of a wide range of psychopathological phenomena, which are more pronounced in patients with a mixed episode BAD. The peculiarities of the phenomenological structure of cognitive impairment in patients with mixed phase BAD manifest themselves in the form of: a more pronounced deterioration of verbal memory, speed of information processing; more pronounced violations of spatial representations, impairment of visual memory, verbal associative performance and executive functions; reduction of attention and violations of its distribution. Conclusions. The findings suggest that the presence of depressive symptoms in the structure of mixed affect plays a dominant role in the formation of these disorders.


Introduction Historical perspective Mania/manic episode Hypomania/hypomanic episode Bipolar spectrum disorder Bipolar (affective) disorder 1: classification Bipolar (affective) disorder 2: clinical notes Bipolar (affective) disorder 3: aetiology Bipolar (affective) disorder 4: management principles Other issues affecting management decisions Treatment of acute manic episodes Treatment of depressive episodes...


2020 ◽  
Vol 66 (3) ◽  
pp. 240-248 ◽  
Author(s):  
Afaf Hamed Khalil ◽  
Marwa Abd el-Meguid ◽  
Mostafa Bastawy ◽  
Samah Rabei ◽  
Ramy Ali ◽  
...  

Introduction: Cognitive impairment is one of the fundamental features among patients with schizophrenia. The relationship between schizophrenia symptoms, insight and cognitive domains remains controversial. We aimed to study these relations in a sample of Egyptian patients with schizophrenia. Methods: A total of 109 patients with schizophrenia were assessed using Structured Clinical Interview for DSM-IV ( Diagnostic and Statistical Manual of Mental Disorders (4th ed.)) Axis I diagnosis (SCID-I), Positive and Negative Syndrome Scale (PANSS) and Scale to Assess Unawareness of Medical Disorder (SUMD). Cognitive functions were assessed using the Wechsler Adult Intelligence Scale (WAIS), the Wisconsin Card Sorting Test (WCST) and the Wechsler Memory Scale (WMS). The cognitive functions would be distributed to cover six cognitive domains: attention/vigilance speed of processing, verbal learning, visual learning, working memory and reasoning/problem solving. Results: There was a significant correlation between all cognitive domains (except attention) and PANSS subscales. PANSS negative and general psychopathology subscales were significantly correlated with five cognitive domains: speed of processing, verbal learning, visual learning, working memory and reasoning/problem solving. PANSS negative subscale was significantly correlated with verbal learning (verbal paired association 1) and visual learning (visual paired association 1). There was a significant correlation between all cognitive domains and SUMD, except verbal and visual learning domains assessed by verbal and visual paired association 1 subtests, as well as attention assessed by failure to maintain set subtest. Only visual learning (trials administered), working memory (percentage error), and processing speed (perseverative responses, and trials to complete first category) were significantly negatively correlated to SUMD. Conclusion: Cognitive impairment in patients with schizophrenia is most likely to underlie negative symptoms, general psychopathology symptoms and poor insight, suggesting that treatment strategies minimizing these symptoms would improve cognitive impairment.


2008 ◽  
Vol 62 (5) ◽  
pp. 515-525 ◽  
Author(s):  
Basant K. Pradhan ◽  
Subho Chakrabarti ◽  
Ritu Nehra ◽  
Anupama Mankotia

2017 ◽  
Vol 41 (S1) ◽  
pp. S143-S144
Author(s):  
S. Fedorová ◽  
M. Blažková ◽  
P. Humpolíček ◽  
R. Barteček

IntroductionCognitive impairment in patients with depressive disorder is a subject of intensive research.ObjectivesThis study deals with the cognitive impairment in patients with severe depressive episode with psychotic symptoms and patients with major depressive disorder during the acute state of illness.AimsThe aim was to define domains and the level of cognitive impairment in both groups of patients.The next aim was to compare profiles of cognitive impairment in both groups of patients.The last aim was to find out a relationship between cognitive performance and severity of depressive episode during the acute state of illness.MethodsWe have used neuropsychological test battery (Auditory–Verbal Learning Test, Rey-Osterrieth Complex Figure Test, Logical Memory, Digit span test, Trail making test, Verbal Fluency Test, Block Design and Benton Visual Retention Test) for the evaluation of the cognitive functions in patients with severe depressive episode with psychotic symptoms (n = 5) and patients with major depressive disorder (n = 8).ResultsWe found cognitive impairment in all examined domains in both groups of patients.More profound cognitive impairment was found in patients with severe depressive episode with psychotic symptoms, particularly in visual memory, visuo-constructive abilities, speed of cognitive processing and executive functions. We found no correlation between cognitive performance and severity of depressive episodes.ConclusionsOur findings suggest a strong correlation between psychotic symptoms in depression and cognitive performance.


1980 ◽  
Vol 136 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Kenneth Shulman ◽  
Felix Post

SummaryIn a retrospective study of 67 elderly bipolar patients the first manic attack occurred at about age 60, often after a long period from the time of the first affective episode, after which further depressive episodes occurred. This calls into question Perris’ criteria for unipolar diagnosis. Among the men, a preponderance of cerebral-organic disorders was found. The evidence for sub-classification of bipolar disorders into secondary or symptomatic manias is discussed. The recurrent nature of the illness in old age stresses the need for further evaluation of lithium prophylaxis.


2019 ◽  
Vol 23 (3) ◽  
pp. 393-396
Author(s):  
Yu.I. Mysula ◽  
O.P. Wenger

Bipolar affective disorder (BAD) is one of the actual problems in modern psychiatry. The aim of the study is to investigate dyssomnia in patients with primary episode of BAD, taking into account, the sex and clinical features of the diseases debut. We have clinically examined 65 men and 88 women diagnosed with bipolar affective disorder in the period 2015–2019. It was found that dyssomnia is present in 98.3% of all patients, in 97.7% of men and in 98.7% of women with depressive variant of the primary episode of BAD, accordingly in 30.4%, 26.7% and 37.5% of patients with manic variant and at 100,0% of patients with mixed variant. The structure of sleep disorders varies significantly depending on the variant of the primary episode: with depressive, prevail night and early awakenings (100.0%), sleep disturbance (75.6%, 70.5%, and 78.7%), unstable sleep (47.9%, 59.1% and 41.3%, p<0.05), nightmares (12.6%, 13.6% and 12.0%); at manic — unstable sleep (73.9%, 73.3% and 75.0%), sleep disturbance (17.4%, 13.3% and 25.0%) and frequent night awakenings (13.0%, 13.3% and 12.0%), in the mixed variant — falling asleep (72.7%, 66.7% and 80.0%), unstable sleep (72.7%, 83.3% and 60.0%), frequent night awakenings (54.5%, 66.7%, and 40.0%), early awakening (36.4%, 50.0%, and 20.0%) and nightmares (27.3%, 16.7% and 40.0%). Thus, the primary episode of bipolar affective disorder is accompanied by a wide range of dyssomnias, among which the leading are disorders of depth and stability of sleep. Manifestations of dyssomnia vary depending on the clinical type of the primary episode of BAD: with the depressive variant, prevail night awakenings, early awakenings and sleep disturbances, with unstable sleep, and with mixed sleep disturbance and unstable sleep. Dyssomnia prevalence is highest for mixed and lowest for manic variants. In depressive men, unstable sleep was more common, and the other disorders of sleep in men and women were not significantly different.


Author(s):  
S. A. Yaroslavtsev

362 patients with cognitive impairment in depressive disorders were examined: 123 patients with recurrent depressive disorder (RDD), 141 patients with bipolar affective disorder (BAD) and 98 people with prolonged depressive reaction (PDR). It was found that cognitive dysfunctions were less pronounced in patients with PDR, than in patients with RDD and BAR (p<0,035). Cognitive dysfunctions in depressive disorders was underlined by the presence of disorders in the mental sphere, in the sphere of attention, executive, visual-spatial and linguistic functions. The differential features of cognitive impairment in patients with RDD, BAR and PDR are highlighted and it should be taken during conducting differential diagnosis of cognitive impairment in depressive disorders. Keywords: patients with cognitive impairment, depressive disorders, cognitive dysfunctions, recurrent depressive disorder, bipolar depressive disorder, prolonged depressive reaction.


2015 ◽  
Vol 41 (4-5) ◽  
pp. 305-312 ◽  
Author(s):  
Stephen L. Seliger ◽  
Carrington R. Wendell ◽  
Shari R. Waldstein ◽  
Luigi Ferrucci ◽  
Alan B. Zonderman

Background: Renal disease has been associated with greater risk of dementia and greater cognitive impairment. However, the relationship of lower renal function with long-term decline in specific domains of cognitive function remains unclear among community-dwelling, non-demented individuals. Methods: Stroke- and dementia-free participants (n = 2,116) were enrolled in the Baltimore Longitudinal Study of Aging, a community-based, prospective, longitudinal study. Renal function was estimated by the inverse of serum creatinine adjusted for age, sex and race and (in sensitivity analyses) estimated glomerular filtration rate (eGFR) using the MDRD formula. Outcome measures were changes in scores on 6 cognitive tests encompassing a range of cognitive functions, measured at 2-year intervals. Mixed-effects regression models examined the longitudinal relations of renal function with cognitive functions after adjusting for demographics, comorbidity and other potential confounders. Results: Mean age at initial testing was 53.9 years (SD 17.1), and 94 participants (4.4%) had an eGFR <60 ml/min/1.73 m2 and 18.5% had at least one comorbidity. With increasing age, longitudinal increases in creatinine concentrations were associated with more rapid decline in performance on several cognitive measures, including the learning slope of the California Verbal Learning Test, a test of verbal learning (p < 0.01), and the Benton Visual Retention Test, a test of visual memory (p < 0.01). Associations were similar for changes in eGFRMDRD, which was also associated with the rate of decline in verbal memory. Conclusion: In a community-based adult population, declines in renal function independently associated with greater long-term declines in visual memory and verbal memory and learning.


1998 ◽  
Vol 28 (5) ◽  
pp. 1027-1038 ◽  
Author(s):  
LARS VEDEL KESSING

Background. A review of studies of cognition in the euthymic phase of unipolar and bipolar affective disorder reveals diverging results.Methods. The study was designed as a controlled cohort study, with the Danish psychiatric case register of admissions used to identify patients and the Danish civil register to identify controls. Patients who were hospitalized between 19 and 25 years ago with an affective diagnosis and who at interviews fulfilled criteria for a primary affective unipolar or bipolar disorder, according to ICD-10, were compared with age- and gender-matched controls. Interviews and assessment of the cognitive function were made in the euthymic phase of the disorder. In all, 118 unipolar patients, 28 bipolar patients and 58 controls were included. Analyses were adjusted for differences in the level of education and for subclinical depressive and anxiety symptoms.Results. Patients with recurrent episodes were significantly more impaired than patients with a single episode and more impaired than controls. Also, within patients the number of prior episodes seemed to be associated with cognitive outcome. There was no difference in the severity of the dysfunction between unipolar and bipolar patients.Conclusions. Cognitive impairment in out-patients with unipolar and bipolar disorder appears to be associated with the number of affective episodes.


Sign in / Sign up

Export Citation Format

Share Document