Cognitive functions in euthymic Egyptian patients with bipolar disorder: Are they different from healthy controls?

Jul 12, 2014Journal of affective disorders

Thinking skills in stable Egyptian bipolar patients compared to healthy people

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Abstract

Bipolar patients demonstrated statistically significant lower mean IQ scores across all WAIS subscales compared to healthy controls.

Cognitive functions in euthymic bipolar patients were found to be impaired, particularly in memory, attention, and executive performance.
Memory abilities, especially digit span and visual memory, were significantly lower in bipolar patients.
Higher impulsivity and inattention were observed in bipolar patients, though response times were not significantly different.
A positive correlation was noted between years of education and IQ scores in bipolar patients.
Clinical factors, such as the number and type of episodes as well as previous hospitalizations, were associated with cognitive deficits.

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BACKGROUND: There is marked interest to research neurocognitive functions in bipolar disorder during euthymia. Consequently we aimed to study cognitive functions in euthymic bipolar patients and factors affecting them.

METHODS: It is a cross sectional case-control study of 60 euthymic bipolar patients and 30 matched healthy controls. They were subjected to: Structured Clinical Interview for DSM-IV disorders, (SCID-I) to ascertain clinical diagnosis, Young Mania Rating Scale (YMRS), Hamilton Rating Scale for Depression (HRSD) to validate euthymia. Wechsler Adult Intelligence Scale (WAIS) for general intellectual abilities, Wechsler Memory Scale-Revised (WMS-R) for memory, Wisconsin Card Sorting Test (WCST) for executive functions, Continuous Performance Test (CPT) for attention and impulsivity, and an information sheet gathering patient data.

RESULTS: Bipolar patients had statistically significant lower mean IQ scores in all WAIS subscales (p=0.000), significantly lower memory abilities especially digit span and visual memory, higher impulsivity and inattention (p=0.000) but no significant difference in response time by CPT. They displayed significantly lower executive performance on WCST. Patients' years of education correlated positively with IQ. Hospital admission, number, type of episodes and total number of episodes affected memory functions. Hospital admission and number of hypomanic episodes correlated with attention and impulsivity. Previous hospitalization correlated with executive functions.

CONCLUSIONS: Euthymic bipolar patients exhibit cognitive deficits, which correlated with clinical variables as number, type of episodes and previous hospitalization, this knowledge could help minimize cognitive impairments for future patients.

LIMITATIONS: The small sample size, cross sectional design and lack of premorbid cognitive assessment limit generalization of findings.

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Cognitive functions in euthymic Egyptian patients with bipolar disorder: Are they different from healthy controls?

Abstract

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