Neurocognitive profiles in treatment-resistant bipolar I and bipolar II disorder depression
Kessler, Ute; Schøyen, Helle Kristine; Andreassen, Ole Andreas; Eide, Geir Egil; Hammar, Åsa; Malt, Ulrik Fredrik; Ødegaard, Ketil Joachim; Morken, Gunnar; Sundet, Kjetil Søren; Vaaler, Arne Einar
Journal article, Peer reviewed
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http://hdl.handle.net/11250/300386Utgivelsesdato
2013Metadata
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Sammendrag
Background: The literature on the neuropsychological profiles in Bipolar disorder (BD) depression is sparse. The
aims of the study were to assess the neurocognitive profiles in treatment-resistant, acutely admitted BD depression
inpatients, to compare the neurocognitive functioning in patients with BD I and II, and to identify the demographic
and clinical illness characteristics associated with cognitive functioning.
Methods: Acutely admitted BD I (n = 19) and BD II (n = 32) inpatients who fulfilled the DSM-IV-TR criteria for a
major depressive episode were tested with the MATRICS Consensus Cognitive Battery (MCCB), the Wechsler
Abbreviated Scale of Intelligence, the National Adult Reading Test, and a battery of clinical measures.
Results: Neurocognitive impairments were evident in the BD I and BD II depression inpatients within all MCCB
domains. The numerical scores on all MCCB-measures were lower in the BD I group than in the BD II group, with a
significant difference on one of the measures, category fluency. 68.4% of the BD I patients had clinically significant
impairment (>1.5 SD below normal mean) in two or more domains compared to 37.5% of the BD II patients
(p = 0.045). A significant reduction in IQ from the premorbid to the current level was seen in BD I but not BD II
patients. Higher age was associated with greater neurocognitive deficits compared to age-adjusted published
norms.
Conclusions: A high proportion of patients with therapy-resistant BD I or II depression exhibited global
neurocognitive impairments with clinically significant severity. The cognitive impairments were more common in
BD I compared to BD II patients, particularly processing speed. These findings suggest that clinicians should be
aware of the severe neurocognitive dysfunction in treatment-resistant bipolar depression, particularly in BD I.
Keywords: Bipolar disorder depression, Cognitive functioning, MATRICS, IQ, Bipolar II disorder