Cognitive and psychosocial impairment in remitted bipolar patients

Flávia Moreira Lima; Letícia S. Czepielewski; Clarissa S. Gama; Flávio Kapczinski; Adriane R. Rosa

doi:10.18682/pd.v14i2.354

Flávia Moreira Lima Laboratory of Molecular Psychiatry, INCT for Translational Medicine—CNPq, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Post Graduate Program in Medicine, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Letícia S. Czepielewski Laboratory of Molecular Psychiatry, INCT for Translational Medicine—CNPq, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Post Graduate Program in Medicine, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Clarissa S. Gama Laboratory of Molecular Psychiatry, INCT for Translational Medicine—CNPq, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Post Graduate Program in Medicine, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Flávio Kapczinski Laboratory of Molecular Psychiatry, INCT for Translational Medicine—CNPq, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Post Graduate Program in Medicine, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Adriane R. Rosa Department of Pharmacology, Universidade Federal do Rio Grande do Sul Porto Alegre, Brazil Centro de Investigación Biomédica en Red de Salud Mental, (CIBERSAM), Madrid

DOI: https://doi.org/10.18682/pd.v14i2.354

Keywords: euthymic bipolar disorder, cognition, psychosocial functioning

Abstract

There is growing evidence showing that bipolar disorder is associated with persistent cognitive deficits. However, the exact meaning and impact of cognitive deficits in bipolar disorder is still not entirely known, even though they have been associated with poor psychosocial functioning. This study aims to summarize cognitive and psychosocial functioning findings of remitted bipolar patients. We conducted an extensive Medline search of the published English literature for the period January 2000- March 2014 using a variety of search terms to find relevant articles. Bibliographies of retrieved papers were further analysed for publications of interest. Our results showed that: (1) all mood states of bipolar disorder are associated with cognitive impairment. However, the euthymic state is associated with less impairment than the other states; (2) there is a strong association between clinical factors (i.e, duration of illness, number of episodes, residual mood symptoms, comorbidities) and cognitive impairment in euthymic bipolar patients, although these factors do not account fully for these deficits; (3) cognitive deficits, in particular, verbal learning and executive dysfunctions may contribute to poor functioning. In conclusion, our review suggests that cognitive deficits are strongly associated with mood episodes; such deficits persist, in lower degree, during remission. Impairment on cognitive performance may explain, in part, poor long-term functioning in remitted bipolar patients. It highlights that psychosocial interventions in combination with pharmacotherapy should be considered to improve cognition and enhance the level of functioning. Therefore, studies assessing the efficacy of novel strategies focused on cognitive and functional status are an important area of future investigation in bipolar disorder.

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