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Three-year longitudinal cognitive functioning in patients recently diagnosed with bipolar disorder
I J Torres1,2, H Qian3, J Basivireddy1
1Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
Acta Psychiatrica Scandinavica
|December 17, 2019
Summary
Cognitive functioning in bipolar disorder (BD) patients shows initial deficits but stabilizes over three years post-manic episode. Treatment and substance use impact cognitive trajectories, suggesting potential for recovery.
Area of Science:
- Neuroscience
- Psychiatry
- Cognitive Psychology
Background:
- The long-term effects of a first manic episode on cognitive abilities in bipolar disorder (BD) remain unclear.
- Understanding cognitive changes is crucial for managing BD and improving patient outcomes.
Purpose of the Study:
- To investigate the longitudinal changes in neuropsychological functioning over three years following a first manic episode in individuals with BD.
- To compare cognitive trajectories in BD patients with those of healthy controls.
Main Methods:
- A cohort of 91 newly diagnosed BD patients and 61 healthy controls underwent neuropsychological assessments at baseline, 1 year, and 3 years.
- Cognitive domains evaluated included processing speed, executive functioning, and verbal memory.
- Clinical assessments, including mood ratings, were conducted at all time points.
Main Results:
- BD patients exhibited baseline cognitive deficits across all domains compared to controls.
- Most cognitive domains showed similar longitudinal trajectories between BD patients and controls.
- Processing speed improved in BD patients from baseline to 1 year, then plateaued.
- Executive functioning recovery was observed in patients with co-occurring alcohol/substance abuse.
- Discontinuation of antipsychotic medication was linked to better verbal memory outcomes.
Conclusions:
- Bipolar disorder patients demonstrate favorable cognitive outcomes in the initial three years post-manic episode, challenging the notion of cognitive neuroprogression.
- Antipsychotic treatment cessation may correlate with improved cognitive function, warranting further research into medication effects.
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