Literature DB >> 17685745

Persistent neuropsychological deficit in euthymic bipolar patients: executive function as a core deficit.

Maria Mur1, Maria J Portella, Anabel Martínez-Arán, Josep Pifarré, Eduard Vieta.   

Abstract

OBJECTIVE: To characterize neuropsychological deficits during the euthymic phase in a sample of bipolar outpatients treated with lithium as the principal mood-stabilizer medication. We sought to determine cognitive functioning of typical bipolar outpatients treated in clinical settings.
METHOD: Forty-four stable outpatients, fulfilling criteria of bipolar disorder (DSM-IV), were consecutively recruited from a defined catchment area and compared with 46 healthy matched controls in 2003. Patients were remitted for at least 3 months and euthymic (Hamilton Rating Scale for Depression score < 8 and Young Mania Rating Scale score < 6 for at least 3 months). They were receiving lithium as monotherapy (45.5%) or combined with other psychotropic medication (54.5%). Neuropsychological assessment was performed by means of a neuropsychological test battery tapping into the main cognitive domains (executive function, attention, processing speed, verbal memory, and visual memory).
RESULTS: Multivariate analysis of variance showed that euthymic bipolar patients performed significantly worse than controls in measures of executive function (F = 2.57, df = 4,82; p = .04) and inhibition (F = 3.83, df = 2,84; p = .03), after controlling for subclinical symptomatology, years of education, and premorbid intelligence quotient. Processing speed also differed significantly between groups (F = 3.73, df = 2,84; p = .03). The subgroup of patients on lithium monotherapy (45.5%) differed significantly from healthy matched controls on tasks of lack of inhibition (F = 5.8, df = 2,36; p = .007). Executive tasks showed between-subject effects.
CONCLUSIONS: These results suggest that impaired executive function and loss of inhibition might be an important feature of bipolar disorder regardless of the severity of the disease or the effects of medication. Also, these executive-type cognitive traits may constitute an endophenotype for further studies on the etiology of bipolar disorder.

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Year:  2007        PMID: 17685745     DOI: 10.4088/jcp.v68n0715

Source DB:  PubMed          Journal:  J Clin Psychiatry        ISSN: 0160-6689            Impact factor:   4.384


  39 in total

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Review 3.  Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry.

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6.  The emerging modern face of mood disorders: a didactic editorial with a detailed presentation of data and definitions.

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7.  Aging changes and medical complexity in late-life bipolar disorder: emerging research findings that may help advance care.

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Review 8.  Lithium and cognitive enhancement: leave it or take it?

Authors:  Eleftheria Tsaltas; Dimitris Kontis; Vasileios Boulougouris; George N Papadimitriou
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Review 9.  Cognitive functioning in bipolar and co-occurring substance use disorders: a missing piece of the puzzle.

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10.  Clinical usefulness of the screen for cognitive impairment in psychiatry (SCIP-S) scale in patients with type I bipolar disorder.

Authors:  Georgina Guilera; Oscar Pino; Juana Gómez-Benito; J Emilio Rojo; Eduard Vieta; Rafael Tabarés-Seisdedos; Nuria Segarra; Anabel Martínez-Arán; Manuel Franco; Manuel J Cuesta; Benedicto Crespo-Facorro; Miguel Bernardo; Scot E Purdon; Teresa Díez; Javier Rejas
Journal:  Health Qual Life Outcomes       Date:  2009-04-01       Impact factor: 3.186

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