Memory performance predicts recurrence of mania in bipolar disorder following psychotherapy: A preliminary study

Cognitive complaints are common features of bipolar disorder (BD). Not much is, however, known about the potential moderator effects of these factors on the outcome of talking therapies. The goal of our study was to explore whether learning and memory abilities predict risk of recurrence of mood episodes or interact with a psychological intervention.

We analyzed data collected as part of a clinical trial evaluating relapse rates following Cognitive Behavioral Therapy (CBT) and Supportive Therapy (ST) (Meyer and Hautzinger, 2012). We included cognitive (Auditive Verbal Learning Test, general intelligence - Leistungsprüfsystem) and clinical measures from 76 euthymic patients with BD randomly assigned to either 9 months of CBT or ST and followed up for 2 years.

Survival analyses including treatment condition, AVLT measures, and general intelligence revealed that recurrence of mania was predicted by verbal free recall. The significant interaction between therapy condition and free recall indicated that while in CBT recurrence of mania was unrelated to free recall performance, in ST patients with a better free recall were more likely to remain euthymic, and those with a poorer free recall were less likely to remain mania-free.

These findings constitute first evidence that, when considering treatment outcome in BD, differences in verbal free recall might interact with the kind of psychotherapy provided. More research is needed to determine what other areas of cognitive functioning are related to outcome in psychological interventions.