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A Journal on Psychiatry, Psychology and Psychopharmacology
Official Journal of the Italian Society of Social Psychiatry
Indexed/Abstracted in: EMBASE, e-psyche, PsycINFO, Scopus, Emerging Sources Citation Index
Minerva Psichiatrica 2012 December;53(4):305-19
Cognitive impairment in bipolar disorder: an update
Latalova K. 1, 2, Prasko J. 1, 2
1 Faculty of Medicine and Dentistry, University Palacky Olomouc, Olomouc, Czech Republic;
2 Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic
AIM: The aim of this paper was to provide updated review of cognitive impairment in bipolar disorder.
METHODS: MEDLINE and PsycInfo data bases were searched for articles indexed by the combinations of MESH term or key word “bipolar disorder” with the following terms: “cognition”, “memory”, “neuropsychology”, “neuropsychological tests”, “lithium”, “anticonvulsants, “antipsychotics”, and “schizophrenia”. Constraints limiting time period of publications or their language were not applied. Reference lists of publications identified by these procedures were hand-searched for additional relevant citations.
RESULTS: There is evidence of lasting cognitive impairment in both forms (I and II) and in all phases of bipolar disorder, including the remission phase, particularly in the following domains: sustained attention, memory and executive functions. There is a growing need for clarification regarding the magnitude, clinical relevance and confounding variables of cognitive impairment in bipolar patients. The impact of bipolar illness on cognition can be influenced by age of onset, pharmacological treatments, familial risk factors, and clinical features. In addition to the mood state, cognitive performance in bipolar patients is influenced by seasonality.
CONCLUSION: Previous optimistic assumptions about the prognosis of bipolar disorder were based on the success of the control of mood symptoms by pharmacotherapy. However, it is now clear that the “remitted” euthymic bipolar patients have distinct impairments of executive function, verbal memory, psychomotor speed, and sustained attention.