scholarly journals Neuropsychological dysfunction, soft neurological signs and social disability in euthymic patients with bipolar disorder

2006 ◽  
Vol 188 (4) ◽  
pp. 366-373 ◽  
Author(s):  
Utpal Goswami ◽  
Aditya Sharma ◽  
Udayan Khastigir ◽  
Ian Nicol Ferrier ◽  
Allan H. Young ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Executive Function ◽  
Verbal Memory ◽  
Psychosocial Functioning ◽  
Executive Dysfunction ◽  
Neurocognitive Deficits ◽  
Social Disability ◽  
Neuropsychological Dysfunction ◽  
Neurological Signs ◽  
Mood Symptoms

BackgroundNeurocognitive deficits exist in euthymic patients with bipolar disorder, but relationships between symptoms, psychosocial and neurological factors remain uncertain.AimsTo measure neurocognitive function in bipolar disorder and explore links to sub-syndromal mood symptoms, soft neurological signs and psychosocial impairment.MethodAttention, memory and executive function were tested in 37 euthymic patients with bipolar disorder and 37 controls. Psychosocial functioning, soft neurological signs and residual mood symptoms were assessed.ResultsPerformances on tests reflecting executive function and verbal memory (but not attention) were significantly poorer in the bipolar disorder group. Sub-syndromal mood symptoms produced small cognitive effects, predominantly on verbal memory. Soft neurological signs, especially frontal signs, were marked; some patients showed marked social disability which correlated strongly with soft neurological signs but weakly with executive dysfunction, which was linked to illness episodes.ConclusionsCognitive dysfunction, social dysfunction and soft signs occur in euthymic patients with bipolar disorder and may represent trait deficits.

scholarly journals Sleep impairment, mood symptoms, and psychosocial functioning in adolescent bipolar disorder

2012 ◽  
Vol 200 (2-3) ◽  
pp. 265-271 ◽  
Author(s):  
Jessica R. Lunsford-Avery ◽  
Charles M. Judd ◽  
David A. Axelson ◽  
David J. Miklowitz
Keyword(s):  
Bipolar Disorder ◽  
Psychosocial Functioning ◽  
Sleep Impairment ◽  
Mood Symptoms

scholarly journals ASSESSMENT OF COGNITIVE FUNCTION, SOCIAL DISABILITY AND BASIC LIFE SKILLS IN EUTHYMIC PATIENTS WITH BIPOLAR DISORDER

2021 ◽  
Author(s):  
Borjanka Batinic ◽  
Vanja Djokic ◽  
Maja Ivkovic
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Function ◽  
Psychosocial Functioning ◽  
Life Skills ◽  
Normal Population ◽  
Verbal Learning ◽  
Motor Speed ◽  
Social Disability ◽  
Brief Assessment ◽  
Basic Life Skills

Background: Data from the literature suggests the presence of cognitive impairments which persist in the euthymic phase of bipolar disorder (BD) and have significant consequences in regards to psychosocial functioning. The aims of our study were: 1) to ascertain the cognitive function (CF), social disability (SD) and basic life skills (BLS) of euthymic patients diagnosed with BD, 2) their relationship and 3) to compare CF, SD and BLS in euthymic patients diagnosed with BD to euthymic patients with recurrent major depressive disorder (rMDD).Subjects and methods: Ninety eight euthymic patients diagnosed either with BD (N=48, mean age 48.79 years, SD = 8.587) or rMDD (N=50, mean age 50.02 years, SD = 9.826) underwent testing using the Brief Assessment of Cognition in Affective Disorders (BAC-A) test, the Sheehan Disability Scale (SDS) and the UCSD performance-based skills assessment (UPSA-brief). Results: Euthymic patients with BD demonstrated significantly lower scores as compared to normal population values in verbal, learning and working memory, verbal fluency, attention and processing speed, affective memory for negative and positive words (p?0.01 each) and motor speed (p<0.05), but not for reasoning/problem solving (p=0.05). Furthermore, their mean total SDS score of 17.60 (SD = 6.450, Sk = -0.833) and its subscale scores were higher, while their UPSA-B total scores were lower (M = 76.01, SD = 17.148, Sk = -0.412). There was a correlation between CF, SD and BLS scores (p<0.01), as well as between BLS and SD scores (p<0.05). The analysis of variance did not however show significant differences between subgroups of patients. Conclusion: Patients with euthymic BD had lower cognitive function, greater social disability and lower basic life skills. There were similar decreases in cognitive and psychosocial function between patients in the euthymic phase of either BD or MDD.

scholarly journals Executive dysfunction and memory impairment in schizoaffective disorder: a comparison with bipolar disorder, schizophrenia and healthy controls

2012 ◽  
Vol 42 (10) ◽  
pp. 2127-2135 ◽  
Author(s):  
B. Amann ◽  
J. J. Gomar ◽  
J. Ortiz-Gil ◽  
P. McKenna ◽  
B. Sans-Sansa ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Executive Function ◽  
Schizoaffective Disorder ◽  
Executive Dysfunction ◽  
Psychotic Symptoms ◽  
Similar Degree ◽  
Healthy Controls ◽  
Patient Groups ◽  
Bipolar Patients ◽  
Manic Patients

BackgroundDeficits in memory and executive performance are well-established features of bipolar disorder and schizophrenia. By contrast, data on cognitive impairment in schizoaffective disorder are scarce and the findings are conflicting.MethodWe used the Wechsler Memory Scale (WMS-III) and the Behavioural Assessment of the Dysexecutive Syndrome (BADS) to test memory and executive function in 45 schizophrenic patients, 26 schizomanic patients and 51 manic bipolar patients in comparison to 65 healthy controls. The patients were tested when acutely ill.ResultsAll three patient groups performed significantly more poorly than the controls on global measures of memory and executive functioning, but there were no differences among the patient groups. There were few differences in memory and executive function subtest scores within the patient groups. There were no differences in any test scores between manic patients with and without psychotic symptoms.ConclusionsSchizophrenic, schizomanic and manic patients show a broadly similar degree of executive and memory deficits in the acute phase of illness. Our results do not support a categorical differentiation across different psychotic categories with regard to neuropsychological deficits.

scholarly journals Cognition as a treatment target in depression

2016 ◽  
Vol 47 (6) ◽  
pp. 987-989 ◽  
Author(s):  
M. Kaser ◽  
R. Zaman ◽  
B. J. Sahakian
Keyword(s):  
Clinical Outcomes ◽  
Cognitive Dysfunction ◽  
Psychosocial Functioning ◽  
Comprehensive Approach ◽  
Neurocognitive Deficits ◽  
Treatment Target ◽  
Mood Symptoms

Cognitive dysfunction in depression is associated with poorer clinical outcomes and impaired psychosocial functioning. However, most treatments for depression do not specifically target cognition. Neurocognitive deficits such as memory and concentration problems tend to persist after mood symptoms recover. Improving cognition in depression requires a better understanding of brain systems implicated in depression. A comprehensive approach is warranted for refined methods of assessing and treating cognitive dysfunction in depression.

scholarly journals Failure of activation of striatum during the performance of executive function tasks in adult patients with bipolar disorder

2019 ◽  
Vol 50 (4) ◽  
pp. 653-665 ◽  
Author(s):  
Fangfang Tian ◽  
Wei Diao ◽  
Xun Yang ◽  
Xiuli Wang ◽  
Neil Roberts ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Executive Function ◽  
Functional Neuroimaging ◽  
Meta Analysis ◽  
Executive Dysfunction ◽  
Brain Regions ◽  
Middle Temporal Gyrus ◽  
Precentral Gyrus ◽  
Web Based ◽  
Reliable Marker

AbstractBackgroundAlthough numerous studies have used functional neuroimaging to identify executive dysfunction in patients with bipolar disorder (BD), the findings are not consistent. The aim of this meta-analysis is to identify the most reliable functional anomalies in BD patients during performance of Executive Function (EF) tasks.MethodsA web-based search was performed on publication databases to identify functional magnetic resonance imaging studies of BD patients performing EF tasks and a voxel-based meta-analytic method known as anisotropic Effect Size Signed Differential Mapping (ES-SDM) was used to identify brain regions which showed anomalous activity in BD patients compared with healthy controls (HC).ResultsTwenty datasets consisting of 463 BD patients and 484 HC were included. Compared with HC, BD patients showed significant hypo-activation or failure of activation in the left striatum (p = 0.00007), supplementary motor area (BA 6, p = 0.00037), precentral gyrus (BA 6, p = 0.0014) and cerebellum (BA 37, p = 0.0019), and hyper-activation in the left gyrus rectus (BA 11, p ≈ 0) and right middle temporal gyrus (BA 22, p = 0.00031) during performance of EF tasks. Sensitivity and subgroup analyses showed that the anomaly of left striatum is consistent across studies and present in both euthymic and BD I patients.ConclusionsPatients with BD consistently showed abnormal activation in the cortico-striatal system during performance of EF tasks compared with HC. Failure of activation of the striatum may be a reliable marker for impairment in performance of especially inhibition tasks by patients with BD.

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.

Interepisode Functioning of Bipolar Disorder

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
O. Aydemir
Keyword(s):  
Bipolar Disorder ◽  
Verbal Memory ◽  
Psychosocial Functioning ◽  
Subjective Assessment ◽  
Substantial Effect ◽  
Cognitive Domain ◽  
Residual Symptoms ◽  
Psychosocial Impairment ◽  
Objective Tests ◽  
Bipolar Patients

Even though bipolar disorder is suggested to have a benign course with episodes and remissions, it has been shown that interepisode functioning of bipolar disorder is not so good. Subclinical residual mood symptoms are found to be in 24% of bipolar patients during remission. Furthermore, it appears that 30-60% of individuals with bipolar disorder fail to regain full functioning in occupational and social domains. In cognitive domain, euthymic bipolar patients demonstrate relatively marked impairment in aspects of executive function such as processing speed and verbal fluency, sustained attention, and verbal memory.It is estimated that 30-50% of largely remitted patients fail to attain premorbid levels of psychosocial functioning due to their cognitive impairment. It is also suggested that the subsyndromal residual depressive symptoms have substantial effect on the persistence of cognitive and psychosocial impairment after remission. Thus, residual symptoms play an important role in the inter-episode functioning of the bipolar patients.In the assessment of interepisode functioning, subjective QOL in bipolar patients may not accurately reflect objective functional outcome status. Especially, in the subjective assessment of cognitive functions, bipolar patients tend to over-estimate themselves. There is only weak to moderate correlation between subjective cognitive complains and objective cognitive tests. Therefore, it would be more accurate to assess the inter-episode functioning of the bipolar patients via objective tests and ratings.

Neuropsychological function in euthymic patients with bipolar disorder

1999 ◽  
Vol 175 (3) ◽  
pp. 246-251 ◽  
Author(s):  
I. N. Ferrier ◽  
Biba R. Stanton ◽  
T. P. Kelly ◽  
Jan Scott
Keyword(s):  
Bipolar Disorder ◽  
Executive Function ◽  
Depressive Symptoms ◽  
Neuropsychological Tests ◽  
Good Evidence ◽  
Neuropsychological Impairment ◽  
Neuropsychological Function ◽  
Limited Evidence ◽  
Neuropsychological Dysfunction ◽  
Low Levels

BackgroundThe assumption that patients with bipolar disorder make a full inter-episode recovery has been challenged by limited evidence that suggests that neuropsychological dysfunction in bipolar disorder may persist beyond episodes of illness.AimsTo test the hypothesis that patients with euthymic bipolar disorder show neuropsychological impairment.MethodA battery of neuropsychological tests (assessed attention, working memory, learning and executive function) was administered to three matched groups of subjects: good-outcome patients with bipolar disorder (n=21); poor-outcome patients with bipolar disorder (n=20); controls (n=20). All patients were clinically euthymic, although some had low levels of depressive symptoms.ResultsPatients performed worse than controls on a number of neuropsychological tests. When age, premorbid IQ and depressive symptoms were controlled for, the results indicated impairment of executive function.ConclusionsThese findings provide good evidence for the existence of neuropsychological impairment in patients with euthymic bipolar disorder, although the possible effect of medication should not be overlooked. This may be of clinical relevance and raises questions about the course and outcome of the illness.

Relationship between emotional intelligence and neurocognition in severe mental disorders

2016 ◽  
Vol 33 (S1) ◽  
pp. S367-S367
Author(s):  
E. Chapela ◽  
I. Morales ◽  
J. Quintero ◽  
M. Félix-Alcántara ◽  
J. Correas ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Emotional Intelligence ◽  
Mental Disorders ◽  
Clinical Symptoms ◽  
Clinical Care ◽  
Executive Dysfunction ◽  
Type I ◽  
Neurocognitive Deficits ◽  
Severe Mental Disorders ◽  
Assessment Protocol

IntroductionThe severe mental disorders are the subject of growing research in the area of emotional intelligence because of his relationship with psychosocial functionality loss. Despite treatment advances, patients continue to experience high levels of social, professional and personal disabilities, related to the presence of deficits in cognition. These changes are manifested in two areas: the neurocognitive and social cognition.ObjectivesTo better understand the relationship between neuro- and sociocognition in schizophrenia and bipolar disorder.AimsThe aim of this research is to study the factors related to emotional intelligence, with particular interest in neurocognitive deficits.MethodsA total of 75 adult patients with schizophrenia and bipolar disorder type I were evaluated. The assessment protocol consisted of a questionnaire on socio-demographic and clinical-care data, and a battery of clinical and cognitive scales, including MSCEIT, WAIS-IV, TMT and Rey Figure.ResultsMSCEIT was negatively correlated with age, the severity of the clinical symptoms (BPRS, CGI-S), the TMT-A and the Test of Complex Figure, and positively with the intelligence quotient.ConclusionsThe deficits in emotional intelligence are part of a set of cognitive, social and non-social skills, which are altered in these severe mental disorders. Emotional intelligence worsens with the deterioration of cognitive functioning, executive dysfunction and severity of psychiatric disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Neurocognitive predictors of functional outcome in patients with bipolar disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 928-928
Author(s):  
S. Hauska ◽  
A. Erfurth ◽  
G. Lenz ◽  
G. Sachs
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Functional Outcome ◽  
Verbal Memory ◽  
Early Recurrence ◽  
Clinical Impression ◽  
Healthy Controls ◽  
Neurocognitive Deficits ◽  
Treatment Conditions ◽  
Global Clinical Impression

IntroductionNeurocognitive deficits are known as a core feature in bipolar disorder (BPD). Persisting neurocognitive impairment is associated with low self-reported quality of life and low psychosocial functioning. Current findings indicate the importance of adjunctive psychosocial interventions in the treatment of BPD patients to enhance symptomatic and functional outcome.ObjectivesTo assess whether functional outcome in patients with BPD is affected by cognitive psychoeducational therapy, clinical parameters and cognitive impairment.AimsTo identify potential predictors of functional outcome, global clinical impression and early recurrence in patients with BPD.MethodsUsing a neurocognitive test battery 43 patients with BPD in euthymic state were compared to 40 healthy controls. Patients were assigned to two treatment Conditions cognitive psychoeducational therapy over 14 weeks (n = 19, 12 female, age) and treatment-as-usual (n = 24, 14 female). Predictors for functional disability, global clinical impression and early recurrence including clinical and cognitive variables as well as treatment conditions were examined using logistic regression.ResultsCompared to healthy controls patients with BPD showed lower performance in executive function (p < 0.01) and sustained attention (p < 0.001). Cognitive psychoeducation (p < 0.05) and subthreshold depressive symptoms (p < 0.05) were predictors for occupational functioning. Age (p < 0.05), delayed verbal memory (p < 0.05) and word fluency (p < 0.05) predicted global clinical impression. Recurrence in the follow-up period of 12 months was predicted by delayed verbal memory (p < 0.05).ConclusionsPatients with BPD seem to benefit from cognitive psychoeducational training mainly in areas of working life. The extent of cognitive impairment appears to impact clinical outcome and recurrence rate.

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