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Assessing cognitive deficits in bipolar disorder: are self-reports valid?
Katherine E Burdick1, Carrie J Endick, Joseph F Goldberg
1Department of Psychiatry Research, Zucker Hillside Hospital, North Shore Long Island Jewish Health System, 75-59 263rd Street, Glen Oaks, NY 11004, USA. Kburdick@lij.edu
Psychiatry Research
|July 19, 2005
Summary
Bipolar patients often have cognitive deficits in memory and learning. However, their self-assessments do not accurately reflect these objective impairments, suggesting issues with insight.
Area of Science:
- Neuroscience
- Psychiatry
- Cognitive Psychology
Background:
- Affective disorders, such as bipolar disorder, are frequently associated with self-reported cognitive difficulties.
- However, the relationship between subjective cognitive complaints and objective neuropsychological deficits in these patients is not well understood.
Purpose of the Study:
- To compare subjective (self-rated) cognition with objective (clinician-rated) neuropsychological functioning in outpatients with bipolar disorder.
- To investigate the correlation between mood states and cognitive self-reports or objective performance.
Main Methods:
- Thirty-seven outpatients diagnosed with DSM-IV bipolar disorder participated.
- Cognitive functioning was assessed using standardized self-report inventories (CDS, CFQ, PAOF) and a systematic neuropsychological test battery.
- Mood ratings for mania and depression were also collected.
Main Results:
- Over 75% of bipolar patients exhibited objective cognitive deficits, particularly in verbal learning and memory.
- Patients' self-reported cognitive difficulties did not reliably predict objective neuropsychological deficits.
- No significant correlations were found between mood ratings and self-reported or objectively measured cognitive variables.
Conclusions:
- Most bipolar patients show objective cognitive impairments that are not accurately reflected in their self-assessments.
- This discrepancy may be due to impaired insight, attempts to conceal deficits, or subthreshold affective symptoms.
- Further research is needed to understand the reasons behind the disconnect between subjective and objective cognitive functioning in bipolar disorder.