Neurocognitive profiles in treatment-resistant bipolar I and bipolar II disorder depression

BMC Psychiatry. 2013 Apr 4:13:105. doi: 10.1186/1471-244X-13-105.

Abstract

Background: The literature on the neuropsychological profiles in Bipolar disorder (BD) depression is sparse. The aims of the study were to assess the neurocognitive profiles in treatment-resistant, acutely admitted BD depression inpatients, to compare the neurocognitive functioning in patients with BD I and II, and to identify the demographic and clinical illness characteristics associated with cognitive functioning.

Methods: Acutely admitted BD I (n = 19) and BD II (n = 32) inpatients who fulfilled the DSM-IV-TR criteria for a major depressive episode were tested with the MATRICS Consensus Cognitive Battery (MCCB), the Wechsler Abbreviated Scale of Intelligence, the National Adult Reading Test, and a battery of clinical measures.

Results: Neurocognitive impairments were evident in the BD I and BD II depression inpatients within all MCCB domains. The numerical scores on all MCCB-measures were lower in the BD I group than in the BD II group, with a significant difference on one of the measures, category fluency. 68.4% of the BD I patients had clinically significant impairment (>1.5 SD below normal mean) in two or more domains compared to 37.5% of the BD II patients (p = 0.045). A significant reduction in IQ from the premorbid to the current level was seen in BD I but not BD II patients. Higher age was associated with greater neurocognitive deficits compared to age-adjusted published norms.

Conclusions: A high proportion of patients with therapy-resistant BD I or II depression exhibited global neurocognitive impairments with clinically significant severity. The cognitive impairments were more common in BD I compared to BD II patients, particularly processing speed. These findings suggest that clinicians should be aware of the severe neurocognitive dysfunction in treatment-resistant bipolar depression, particularly in BD I.

Trial registration: NCT00664976.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attention
  • Bipolar Disorder / complications
  • Bipolar Disorder / psychology*
  • Cognition Disorders / complications
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / psychology
  • Cognition*
  • Depression / complications
  • Depression / psychology*
  • Female
  • Humans
  • Intelligence
  • Learning
  • Male
  • Memory, Short-Term
  • Middle Aged
  • Neuropsychological Tests
  • Problem Solving

Associated data

  • ClinicalTrials.gov/NCT00664976