Identifying cognitive subgroups in bipolar disorder: A cluster analysis
Flávia Lima1, Francisco Diego Rabelo-da-Ponte1, Joana Bücker2
1Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Postgraduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
Journal of Affective Disorders
|December 28, 2018
Summary
Bipolar disorder (BD) patients exhibit cognitive heterogeneity, with distinct subgroups identified: intact, selectively impaired, and globally impaired cognition. These findings highlight the need for comprehensive assessments combining objective and subjective measures.
Area of Science:
- Neuroscience
- Psychiatry
- Cognitive Psychology
Background:
- Bipolar disorder (BD) is characterized by significant heterogeneity in cognitive function among patients.
- Previous research suggests the existence of distinct neurocognitive subgroups within the BD population.
Purpose of the Study:
- To replicate findings on cognitive subgroups in bipolar disorder.
- To assess subjective cognitive difficulties and functional impairment within each identified cognitive cluster.
Main Methods:
- Hierarchical cluster analysis was employed to identify neurocognitive subgroups based on a comprehensive neurocognitive battery.
- Subjective cognitive complaints were measured using the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA).
- Functional impairment was assessed using the Functioning Assessment Short Test (FAST).
Main Results:
- Three distinct cognitive subgroups were identified: intact cognition (43.5%), selective cognitive impairment (33.3%), and global cognitive impairment (23.3%).
- The intact cognition group demonstrated higher education and IQ, but also younger age at diagnosis and first hospitalization compared to the globally impaired group.
- Significant differences in cognitive reserve, education, IQ, age at diagnosis, and age at first hospitalization were observed across the subgroups.
Conclusions:
- The study supports a continuum of cognitive functioning in bipolar disorder, ranging from no impairment to severe impairment.
- Individuals in the intact cognition group appear to have higher cognitive reserve but still report cognitive complaints and functional difficulties.
- Comprehensive assessment of BD patients requires a combination of objective cognitive measures, subjective cognitive assessments, and functional outcome measures.
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