Halstead-Reitan Category Test in bipolar and unipolar affective disorders. Relationship to age and phase of illness

Unipolar and bipolar affectively disturbed patients were administered the Halstead-Reitan category test when in an unmedicated acutely depressed phase and during recovery. Controls consisted of normal volunteers and spouses. Spouse controls were tested at intervals similar to those of the patients and were utilized to control for age, sex, education, and socioeconomic status. Results showed that depressives in the acute depressed state made significantly more errors did controls. Older bipolar patients made significantly more errors than did controls. Older bipolar patients made significantly more errors than younger bipolar or younger unipolar patients. In the recovered state the order remained the same. In spite of a decrease in error scores the older bipolar group remained in the abnormal range, whereas the younger groups scored in the normal range with few exceptions. These data suggest that impaired cognitive functioning may be a factor in the disability associated with the major affective disorders in addition to the distorted affective component usually emphasized. Furthermore, in the case of older bipolar patients, the deficit is more severe and may persist beyond the disappearance of affective signs, suggesting that factors associated with age may play an important role in conjunction with other factors associated with bipolar illness.