Estela Jiménez-López1, Eva María Sánchez-Morla2, Ana López-Villarreal3, Ana Isabel Aparicio4, Vicente Martínez-Vizcaíno5, Eduard Vieta6, Roberto Rodriguez-Jimenez2, José Luis Santos7. 1. Department of Psychiatry, Hospital Virgen de La Luz, Cuenca, Spain; CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain; Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain. 2. CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain; Instituto de Investigación Sanitaria Hospital, 12 de Octubre (imas12), Madrid, Spain; CogPsy-Group, Universidad Complutense de Madrid (UCM), Spain. 3. Department of Psychiatry, Hospital Virgen de La Luz, Cuenca, Spain. 4. Department of Psychiatry, Hospital Virgen de La Luz, Cuenca, Spain; CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain. 5. Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain; Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile. 6. CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain; Department of Psychiatry, Hospital Clínic of Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain. 7. Department of Psychiatry, Hospital Virgen de La Luz, Cuenca, Spain; CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain. Electronic address: jlsantosg@sescam.jccm.es.
Abstract
BACKGROUND: Bipolar disorder (BD) and schizophrenia (SZ) are characterized by neurocognitive and functional deficits with marked heterogeneity. It has been suggested that BD with a history of psychotic symptoms (BD-P) could constitute a phenotypically homogeneous subtype characterized by greater neurocognitive and functional impairments, or by a distinct trajectory of such deficits. The aim of this study was to compare the neurocognitive and functional course of euthymic BD-P, euthymic BD patients without a history of psychosis (BD-NP), stabilized patients with schizophrenia and healthy subjects, during a five-year follow-up. METHODS: Neurocognitive and psychosocial function was examined in 100 euthymic patients with BD (50 BD-P, 50 BD-NP), 50 stabilized patients with schizophrenia (SZ), and 51 healthy controls (HC) at baseline (T1), and after a 5-year follow-up (T2). RESULTS: The course of both neurocognitive performance and functional outcome of patients with SZ and BD (BD-P and BD-NP) is stable. The profile of neurocognitive impairment of patients with SZ or BD (BD-P and BD-NP), is similar, with only quantitative differences circumscribed to certain domains, such as working memory. The subgroup of patients with BD-NP does not show functional deterioration. CONCLUSIONS: We have not found evidence of progression in the neurocognitive or psychosocial impairment in any of the three groups of patients, although it cannot be dismissed the possibility of a subset of patients with a progressive course. Other longitudinal studies with larger samples and longer duration are necessary to confirm these findings.
BACKGROUND:Bipolar disorder (BD) and schizophrenia (SZ) are characterized by neurocognitive and functional deficits with marked heterogeneity. It has been suggested that BD with a history of psychotic symptoms (BD-P) could constitute a phenotypically homogeneous subtype characterized by greater neurocognitive and functional impairments, or by a distinct trajectory of such deficits. The aim of this study was to compare the neurocognitive and functional course of euthymic BD-P, euthymic BD patients without a history of psychosis (BD-NP), stabilized patients with schizophrenia and healthy subjects, during a five-year follow-up. METHODS: Neurocognitive and psychosocial function was examined in 100 euthymic patients with BD (50 BD-P, 50 BD-NP), 50 stabilized patients with schizophrenia (SZ), and 51 healthy controls (HC) at baseline (T1), and after a 5-year follow-up (T2). RESULTS: The course of both neurocognitive performance and functional outcome of patients with SZ and BD (BD-P and BD-NP) is stable. The profile of neurocognitive impairment of patients with SZ or BD (BD-P and BD-NP), is similar, with only quantitative differences circumscribed to certain domains, such as working memory. The subgroup of patients with BD-NP does not show functional deterioration. CONCLUSIONS: We have not found evidence of progression in the neurocognitive or psychosocial impairment in any of the three groups of patients, although it cannot be dismissed the possibility of a subset of patients with a progressive course. Other longitudinal studies with larger samples and longer duration are necessary to confirm these findings.