Relationship between prior course of illness and neuropsychological functioning in patients with bipolar disorder
K D Denicoff1, S O Ali, A F Mirsky
1Section on Psychobiology, Biological Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892, USA. kirk.denicoff@nih.gov
Background:
This study investigated the relationship between prior course of illness and neuropsychological deficits in relatively high functioning outpatients with bipolar disorder.
Method:
Forty-nine bipolar I or II patients, in a relatively euthymic state during treatment with mood stabilizers, were administered neuropsychological tests that assessed a variety of functions, including verbal memory, sustained attention and vigilance, and intelligence. A detailed retrospective life chart was completed for each patient using the NIMH Life Chart Method" to define variables reflecting duration and severity of illness, and frequency of episodes.
Results:
Stepwise multiple regression analyses show that several different measures of a more severe course of prior illness related to greater duration and a larger number of affective episodes and hospitalizations were associated with poorer performance on tests of abstraction, attention and memory.
Conclusion:
The results indicate that bipolar patients with a more severe prior course of illness and a greater number of affective episodes have more impaired neuropsychological functioning. The direction of causality and the pathophysiological mechanisms remain to be explored.
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