Impact of number of episodes on neurocognitive trajectory in bipolar disorder patients: a 5-year follow-up study

• Published in: Psychological medicine Vol. 49; no. 8; pp. 1299 - 1307
• Main Authors: Sánchez-Morla, Eva María, López-Villarreal, Ana, Jiménez-López, Estela, Aparicio, Ana Isabel, Martínez-Vizcaíno, Vicente, Roberto, Rodriguez-Jimenez, Vieta, Eduard, Santos, José-Luis
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.06.2019
• Subjects: Adult; Bipolar disorder; Bipolar Disorder - psychology; Case-Control Studies; Cognition; Cognitive ability; Cognitive functioning; Cognitive impairment; Cross-sectional studies; Female; Follow-Up Studies; Humans; Longitudinal studies; Male; Memory; Memory, Short-Term; Mental disorders; Middle Aged; Neurocognition; Neuropsychological Tests; Original Articles; Prospective Studies; Psychosis; Psychotic Disorders - psychology; Psychotic symptoms; Regional government; Regression Analysis; Short term memory; Visual memory; follow-up; Bipolar disorder; cognition; neuroprogression
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291718001885

The neurocognitive trajectory in bipolar disorder (BD) is variable, with controversial findings, and most evidence come from cross-sectional studies. We aimed to examine the course of neurocognitive functioning in a sample of euthymic BD patients in comparison with a control group during a 5-year follow-up. Ninety-nine euthymic bipolar patients and 40 healthy controls were assessed using a comprehensive neurocognitive battery (six neurocognitive domains) at baseline (T1) and then at 5-year follow-up (T2) in a longitudinal study. No evidence of a progression in neurocognitive dysfunction was found either in cognitive composite index or in any of the neurocognitive domains for the whole cohort. However, there was a negative correlation between number of manic episodes and hospitalisations due to manic episodes and change in neurocognitive composite index (NCI) during the follow-up. Moreover, patients with higher number of manic and hypomanic episodes have a greater decrease in NCI, working memory and visual memory. History of psychotic symptoms was not related to the trajectory of neurocognitive impairment. Our results suggest that, although the progression of cognitive decline is not a general rule in BD, BD patients who have a greater number of manic or hypomanic episodes may constitute a subgroup characterised by the progression of neurocognitive impairment. Prevention of manic and hypomanic episodes could have a positive impact on the trajectory of cognitive function.