Neurocognitive predictors of long-term clinical course in bipolar disorder

The aim of this study was to estimate whether neurocognitive deficits are predictors of the long-term clinical course of patients with bipolar disorder.

A total of 76 outpatients with bipolar disorder performed a neurocognitive assessment at baseline and were followed for a period of at least 48 months. The clinical course during the follow-up period was documented by two measures: (1) number of affective episodes and (2) time spent ill.

Patients had lower performance than controls in the domains of verbal memory and executive functions, and they were followed-up for a mean period of 70.73 months. Global cognitive deficits (performance 1.5 standard deviations below the mean in two or more cognitive domain) were independent predictors of both hypo/manic episode density and time spent with hypo/manic symptoms during follow-up. On the contrary, no neurocognitive measure showed a relationship with depressive morbidity during follow-up.

Our findings suggest that cognitive deficits could be useful for predicting hypo/manic morbidity in the long-term clinical course. Theoretical and clinical implications of these findings are discussed.