Comparison of neurocognitive deficit among euthymic bipolar I disorder patients, their first-degree relatives and healthy controls
DOI:
https://doi.org/10.18203/2349-3933.ijam20171513Keywords:
Endophenotype, Euthymic state, First-degree blood relatives of bipolar I disorder, Neurocognitive deficitAbstract
Background: Bipolar patients often suffer from debilitating cognitive impairment in different stages of the disease (manic, depressive or euthymic states). We assessed and compared the frequency of neurocognitive deficit among individual with bipolar I disorder but currently in euthymic state, their first-degree blood relatives and healthy controls. In addition, we also probed further into the type of neurocognitive deficit that can be seen among them and observed the influence of sociodemographic characteristics with the occurrence of neurocognitive deficit in individual with bipolar I disorder patient.
Methods: Patients (N=30) who fulfilled the diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV TR) criteria for bipolar I disorder but currently in remission were assessed for any neurological deficits using the standard instruments. In this study, 30 first-degree blood relatives of bipolar I disorder patients and selected 30 hospital staff as healthy controls were also assessed for neurological deficits.
Results: We did not find any significant frontal dysfunction among first-degree blood relatives of bipolar I disorder patient when compared with euthymic bipolar I disorder patients. Factor that significantly affected neurocognitive performance in the bipolar patients who were in euthymic state included age, total duration of illness and number of manic episode.
Conclusions: As neurocognitive impairment is associated with number of manic episode and total duration of illness; the objective of treatment should be to prolong remission and impart psychoeducation regarding nature of illness. On the contrary, anticipating definite cognitive impairment in first-degree blood relatives of bipolar I disorder patient when compared to healthy control warrants periodic neurocognitive testing and psychoeducation about deficit and medical intervention, if required.
References
Ferrier IN, Chowdhury R, Thompson JM, Watson S, Young AH. Neurocognitive function in unaffected first-degree relatives of patients with bipolar disorder: a preliminary report. Bipolar Disord. 2004;6(4):319-22.
Thompson JM, Gallagher P, Hughes JH, Watson S, Gray JM, Ferrier IN, et al. Neurocognitive impairment in euthymic patients with bipolar affective disorder. Br J Psychiatry. 2005;186:32-40.
Frantom LV, Allen DN, Cross CL. Neurocognitive endophenotypes for bipolar disorder. Bipolar Disord. 2008;10(3):387-99.
Bora E, Vahip S, Akdeniz F, Ilerisoy H, Aldemir E, Alkan M. Executive and verbal working memory dysfunction in first-degree relatives of patients with bipolar disorder. Psychiatry Res. 2008;161(3):318-24.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-I. 4th ed. Washington (DC): American Psychiatric Association; 1994.
Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133:429-35.
Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23(1):56-62.
Folstein MF, Folstein SE, McHugh PR. Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98.
Dubois B, Slachevsky A, Litvan I, Pillon B. The FAB: a frontal assessment battery at bedside. Neurology. 2000;55(11):1621-6.
Reitan RM. Validity of the trail making test as an indicator of organic brain damage. Perceptual and Motor Skills. 1958;8:271-6.
Elgamal SA, Roy EA, Sharratt MT. Age and verbal fluency: the mediating effect of speed of processing. Can Geriatr J. 2011;14(3):66-72.
Martínez-Arán A, Vieta E, Reinares M, Colom F, Torrent C, Sánchez-Moreno J, Benabarre A, et al. Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. Am J Psychiatry. 2004;161(2):262-70.
Bora E, Vahip S, Akdeniz F, Gonul AS, Eryavuz A, Ogut M, et al. The effect of previous psychotic mood episodes on cognitive impairment in euthymic bipolar patients. Bipolar Disord. 2007;9(5):468-77.
López-Jaramillo C, Lopera-Vásquez J, Gallo A, Ospina-Duque J, Bell V, Torrent C, et al. Effects of recurrence on the cognitive performance of patients with bipolar I disorder: implications for relapse prevention and treatment adherence. Bipolar Disord. 2010;12(5):557-67.
Vrabie M, Marinescu V, Talaşman A, Tăutu O, Drima E, Micluţia. Cognitive impairment in manic bipolar patients: important, understated, significant aspects. Ann Gen Psychiatry. 2015;25(14):41.
Arts B, Jabben N, Krabbendam L, van Os J. Meta-analyses of cognitive functioning in euthymic bipolar patients and their first-degree relatives. Psychol Med. 2008;38(6):771-85.
Jamrozinski K. Do euthymic bipolar patients have normal cognitive functioning? Curr Opin Psychiatry. 2010;23(3):255-60.
Muralidharan K, Torres IJ, Silveira LE, Kozicky JM, Bücker J, Fernando N. Impact of depressive episodes on cognitive deficits in early bipolar disorder: data from the systematic treatment optimization programme for early mania (STOP-EM). Br J Psychiatry. 2014;205(1):36-43
Robinson LJ, Thompson JM, Gallagher P, Goswami U, Young AH, Ferrier IN. A meta-analysis of cognitive deficits in euthymic patients with bipolar disorder. J Affect Disord. 2006;93(1-3):105-15.
Balanzá-Martínez V, Rubio C, Selva-Vera G, Martinez-Aran A, Sánchez-Moreno J, Salazar-Fraile J. Neurocognitive endophenotypes (endophenocognitypes) from studies of relatives of bipolar disorder subjects: a systematic review. Neurosci Biobehav Rev. 2008;32(8):1426-38.
