Neuropsychological testing of cognitive impairment in euthymic bipolar disorder: an individual patient data meta-analysis

Bourne, C. et al. (2013) Neuropsychological testing of cognitive impairment in euthymic bipolar disorder: an individual patient data meta-analysis. Acta Psychiatrica Scandinavica, 128(3), pp. 149-162. (doi:10.1111/acps.12133)

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Abstract

Objective: An association between bipolar disorder and cognitive impairment has repeatedly been described, even for euthymic patients. Findings are inconsistent both across primary studies and previous meta-analyses. This study reanalysed 31 primary data sets as a single large sample (N = 2876) to provide a more definitive view.

Method: Individual patient and control data were obtained from original authors for 11 measures from four common neuropsychological tests: California or Rey Verbal Learning Task (VLT), Trail Making Test (TMT), Digit Span and/or Wisconsin Card Sorting Task.

Results: Impairments were found for all 11 test-measures in the bipolar group after controlling for age, IQ and gender (Ps ≤ 0.001, E.S. = 0.26–0.63). Residual mood symptoms confound this result but cannot account for the effect sizes found. Impairments also seem unrelated to drug treatment. Some test-measures were weakly correlated with illness severity measures suggesting that some impairments may track illness progression.

Conclusion: This reanalysis supports VLT, Digit Span and TMT as robust measures of cognitive impairments in bipolar disorder patients. The heterogeneity of some test results explains previous differences in meta-analyses. Better controlling for confounds suggests deficits may be smaller than previously reported but should be tracked longitudinally across illness progression and treatment.

Item Type:Articles
Keywords:Bipolar disorder; cognitive impairment;
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cavanagh, Professor Jonathan and Smith, Professor Daniel
Authors: Bourne, C., Aydemir, Ö., Balanzá-Martínez, V., Bora, E., Brissos, S., Cavanagh, J.T.O., Clark, L., Cubukcuoglu, Z., Dias, V.V., Dittmann, S., Ferrier, I.N., Fleck, D.E., Frangou, S., Gallagher, P., Jones, L., Kieseppa, T., Martínez-Aran, A., Melle, I., Moore, P.B., Mur, M., Pfennig, A., Raust, A., Senturk, V., Simonsen, C., Smith, D.J., Bio, D.S., Soeiro-de-Souza, M.G., Stoddart, S.D.R., Sundet, K., Szöke, A., Thompson, J.M., Torrent, C., Zalla, T., Craddock, N., Andreassen, O.A., Leboyer, M., Vieta, E., Bauer, M., Worhunsky, P.D., Tzagarakis, C., Rogers, R.D., Geddes, J.R., and Goodwin, G.M.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
Journal Name:Acta Psychiatrica Scandinavica
ISSN:0001-690X
ISSN (Online):1600-0447

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