Neurocognitive dysfunction and psychosocial outcome in patients with bipolar I disorder at 15-year follow-up

• Published in: Acta psychiatrica Scandinavica Vol. 122; no. 6; pp. 499 - 506
• Main Authors: Burdick, K. E., Goldberg, J. F., Harrow, M.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.12.2010; Blackwell
• Subjects: Adult; Adult and adolescent clinical studies; Biological and medical sciences; Bipolar disorder; Bipolar Disorder - diagnosis; Bipolar Disorder - epidemiology; Bipolar Disorder - psychology; Bipolar disorders; Chicago - epidemiology; Clinical outcomes; Cognition; Cognition & reasoning; Cognition Disorders - diagnosis; Cognition Disorders - epidemiology; Cognition Disorders - psychology; Cognitive ability; Comorbidity; Depression; Depressive Disorder - diagnosis; Depressive Disorder - epidemiology; Depressive Disorder - psychology; Employment - psychology; Employment - statistics & numerical data; Executive Function; Female; Follow-Up Studies; Humans; Information processing; Learning; Longitudinal Studies; Male; Medical sciences; Mood; Mood disorders; Neuropsychological Tests - statistics & numerical data; Neuropsychology; outcome; Prospective Studies; Psychiatric Status Rating Scales - statistics & numerical data; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Severity of Illness Index; Social Adjustment; Social interactions; Social psychology; Treatment Outcome; Chicago; Mood disorder; Human; Executive function; Cognitive disorder; Follow up study; Depression; Bipolar disorder; Cognition; Psychosocial factor; outcome
• ISSN: 0001-690X; 1600-0447; 1600-0447
• DOI: 10.1111/j.1600-0447.2010.01590.x

Burdick KE, Goldberg JF, Harrow M. Neurocognitive dysfunction and psychosocial outcome in patients with bipolar I disorder at 15‐year follow‐up. Objective:  Despite increasing interest in cognitive dysfunction in bipolar disorder, little is known about its impact on functional outcome relative to affective symptoms. Method:  A total of 33 bipolar I subjects were evaluated at index hospitalization and prospectively followed up 15 years later. Affective symptoms, cognition, global functioning, work, and social adjustment were assessed at follow‐up and analyzed by linear regression. Results:  Global functional impairment was significantly associated with poor performance on a cognitive measure of processing speed (WAIS Digit Symbol). Digit symbol performance also was the sole significant predictor of social functioning. Neither symptom severity nor course of illness features significantly contributed to global and social functioning. In contrast, verbal learning deficits, recent depression, and lifetime hospitalizations all were independently associated with work disability. Conclusion:  Processing speed is robustly associated with social and global functioning in bipolar disorder. Poor work functioning is significantly related to subsyndromal depression, course of illness, and verbal learning deficits. Cognitive and mood symptoms warrant consideration as independent determinants of functioning in patients with bipolar disorder many years after an index manic episode.