Bipolar-ADHD comorbidity: screening for differences in neurocognition and virtual reality-based cognitive performance

Area of Science:

• Neuroscience
• Psychiatry
• Cognitive Psychology

Background:

• Comorbid attention-deficit/hyperactivity disorder (ADHD) complicates diagnosis in bipolar disorder (BD) due to overlapping cognitive symptoms.
• Accurate identification of ADHD in BD patients is crucial for effective treatment and management.

Purpose of the Study:

• To investigate the utility of virtual reality (VR)-based cognitive assessment in detecting sustained attention impairment in BD patients with comorbid ADHD (BD+ADHD).
• To evaluate if VR assessments mimicking daily life cognitive challenges can aid in differentiating BD+ADHD from BD alone.

Main Methods:

• A cross-sectional study involving 49 remitted BD outpatients, with 14 diagnosed with comorbid ADHD (BD+ADHD).
• Participants completed the Cognition Assessment in Virtual Reality (CAVIR) test, including a sustained attention task with distractions, and the Screen for Cognitive Impairment in Psychiatry (SCIP).
• Mood symptoms, functioning, subjective cognition, and quality of life were assessed.

Main Results:

• BD+ADHD participants showed significantly greater deficits in sustained attention on the CAVIR test compared to BD patients without ADHD.
• Deficits in VR-based sustained attention correlated with self-reported concentration difficulties in the BD+ADHD group.
• Exploratory analyses indicated greater impairment in working memory and verbal learning, and more subjective cognitive complaints in BD+ADHD individuals.

Conclusions:

• Ecologically valid VR tests assessing sustained attention with distracting stimuli can be a valuable tool for identifying individuals with BD and comorbid ADHD.
• VR-based cognitive assessments offer a promising approach to improve diagnostic accuracy for complex psychiatric comorbidities.