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Roux P, Frileux S, Vidal N, Aubin V, Belzeaux R, Courtet P, Dubertret C, Etain B, Haffen E, Leboyer M, Lefrere A, Llorca PM, M’Bailara K, Marlinge E, Olié E, Polosan M, Schwan R, The FACE-BD (FondaMental Academic Centers of Expertise for Bipolar Disorders) group, Brunet-Gouet E, Passerieux C. Relationships between cognition, functioning, and quality of life of euthymic patients with bipolar disorder: Structural equation modeling with the FACE-BD cohort. Eur Psychiatry 2024; 67:e78. [PMID: 39543921 PMCID: PMC11730061 DOI: 10.1192/j.eurpsy.2024.1789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 08/01/2024] [Accepted: 08/03/2024] [Indexed: 11/17/2024] Open
Abstract
BACKGROUND Quality of life is decreased in bipolar disorders (BD) and contributes to poor prognosis. However, little is known about the causal pathways that may affect it. This study aimed to explore health-related QoL (HRQoL) in BD and investigate its relationship with cognition and psychosocial functioning. METHODS This multicenter cross-sectional study used a neuropsychological battery to assess five cognition domains. Functioning was evaluated using global and domain-based tools, and health-related HRQoL was assessed using the EQ-5D-3L. Structural equation modeling was used to test whether the association between cognition and HRQoL would be mediated by functioning in BD while controlling for covariates such as residual depression, anxiety, antipsychotic medication, and psychotic features. RESULTS We included 1 190 adults with euthymic BD. The model provided a good fit for the data. In this model, the direct effect of cognition on HRQoL was not significant (β = - 0.03, z = -0.78, p = 0.433). The total effect of cognition on HRQoL was weak, albeit significant (β = 0.05, z = 3.6, p < 0.001), thus suggesting that cognition affected HRQoL only indirectly through functioning. Anxiety was associated with decreased functioning (β = -0.27, z = -7.4, p < 0.001) and QoL (β = -0.39, z = -11.8, p < 0.001). CONCLUSIONS These findings suggest that improving cognition may not directly lead to a higher HRQoL. Cognitive remediation is expected to improve HRQoL only through functioning enhancement. They also reveal the potential importance of functional remediation and reduction of comorbid anxiety symptoms in improving HRQoL in BD.
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Affiliation(s)
- P Roux
- Fondation FondaMental, Créteil, France
- Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie d’Adultes et d’Addictologie, Le Chesnay; Université Paris-Saclay; Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR1018, Villejuif, France
| | - S Frileux
- Fondation FondaMental, Créteil, France
- Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie d’Adultes et d’Addictologie, Le Chesnay; Université Paris-Saclay; Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR1018, Villejuif, France
| | - N Vidal
- Fondation FondaMental, Créteil, France
- Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie d’Adultes et d’Addictologie, Le Chesnay; Université Paris-Saclay; Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR1018, Villejuif, France
| | - V Aubin
- Fondation FondaMental, Créteil, France
- Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Av. Pasteur, Monaco
| | - R Belzeaux
- Fondation FondaMental, Créteil, France
- Pôle universitaire de psychiatrie, CHU de Montpellier, Montpellier, France
| | - P Courtet
- Fondation FondaMental, Créteil, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France
- AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie. Hopital Louis Mourier, Colombes, Inserm U1266, Faculté de Médecine, Université Paris Cité, France
| | - B Etain
- Fondation FondaMental, Créteil, France
- AP-HP, Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France; Université Paris Cité, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
| | - E Haffen
- Fondation FondaMental, Créteil, France
- Université de Franche-Comté, UR LINC, Département de Psychiatrie Clinique, CIC-1431 INSERM, CHU de Besançon, 25000Besançon, France
| | - M Leboyer
- Fondation FondaMental, Créteil, France
- Univ Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry Laboratory, Créteil, France; AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d’Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France
| | - A Lefrere
- Fondation FondaMental, Créteil, France
- Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France; INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - PM Llorca
- Fondation FondaMental, Créteil, France
- Centre Hospitalier et Universitaire, Département de Psychiatrie, Clermont-Ferrand, France; Université d’Auvergne, EA 7280, 63000Clermont-Ferrand, France
| | - K M’Bailara
- Fondation FondaMental, Créteil, France
- Centre Hospitalier Charles Perrens, Pôle PGU; LabPsy, UR4139 Université de Bordeaux, Bordeaux, France
| | - E Marlinge
- Fondation FondaMental, Créteil, France
- AP-HP, Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France; Université Paris Cité, INSERM UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France
| | - E Olié
- Fondation FondaMental, Créteil, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - M Polosan
- Fondation FondaMental, Créteil, France
- Université Grenoble Alpes, CHU de Grenoble et des Alpes, Grenoble Institut des Neurosciences (GIN) InsermU 1216, Grenoble, France
| | - R Schwan
- Fondation FondaMental, Créteil, France
- Université de Lorraine, Centre Psychothérapique de Nancy, Inserm U1254, Nancy, France
| | | | - E Brunet-Gouet
- Fondation FondaMental, Créteil, France
- Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie d’Adultes et d’Addictologie, Le Chesnay; Université Paris-Saclay; Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR1018, Villejuif, France
| | - C Passerieux
- Fondation FondaMental, Créteil, France
- Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie d’Adultes et d’Addictologie, Le Chesnay; Université Paris-Saclay; Université de Versailles Saint-Quentin-En-Yvelines; DisAP-DevPsy-CESP, INSERM UMR1018, Villejuif, France
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Yoldi-Negrete M, Fresán A, Jiménez-Rodríguez LI, Tirado-Durán EG. Cognition in Euthymic Patients with Bipolar Disorder: Do Not Forget to Account for Anxiety! Neuropsychiatr Dis Treat 2024; 20:1181-1189. [PMID: 38855382 PMCID: PMC11162183 DOI: 10.2147/ndt.s457186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/11/2024] [Indexed: 06/11/2024] Open
Abstract
Purpose Despite the high prevalence of anxiety disorders in BD and its known impact on cognitive performance, the presence and severity of anxious symptoms is not systematically evaluated in studies on cognition in BD. Our aim was to determine if attention and/or inhibition of cognitive interference in euthymic patients with type I Bipolar Disorder (BD-I) is affected by symptoms of anxiety. Patients and Methods Eighty-seven euthymic BD-I patients were included. Patients with comorbidities other than Generalized Anxiety Disorder (GAD) or Panic Disorder (PD) were excluded. State anxiety was measured with the Brief Inventory of Anxious Responses and Situations (ISRA-B). Subjective cognitive performance was evaluated with the COBRA scale, attention with the Digit-Span Forward task and inhibition of cognitive interference was assessed with the StroopTest interference score. Multiple linear regression models were used to test if anxious symptoms were associated with attention or inhibition of cognitive interference, considering other known contributors for cognitive impairment. Results Attention was unaffected by anxiety symptoms, but the overall regression for inhibition of cognitive interference was significant: years of schooling (β=1.12, p = 0.001), cognitive complaints (β=0.44, p = 0.008), and anxiety (β=-0.21, p = 0.017) explained 15% of the interference score of the Stroop test (R2 = 0.15). Conclusion Beyond residual affective symptoms, anxious symptoms seem to affect inhibition of cognitive interference. We recommend routine testing of anxiety when considering cognitive evaluations, especially when screening for cognitive deficits.
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Affiliation(s)
- María Yoldi-Negrete
- Clinical Epidemiology Laboratory, Clinical Research Directorate, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Ana Fresán
- Clinical Epidemiology Laboratory, Clinical Research Directorate, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Laura Ivone Jiménez-Rodríguez
- Department of Psychology, Neuropsychology, Clinical Services Directorate, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Elsa Georgina Tirado-Durán
- Department of Psychology, Neuropsychology, Clinical Services Directorate, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
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Gornushenkov ID, Kulikova VS, Pluzhnikov IV, Barkhatova AN, Alekhseeva AG. [Features of cognitive impairment in bipolar affective disorder]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:15-19. [PMID: 39072561 DOI: 10.17116/jnevro202412406115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
The study of cognitive impairment in bipolar disorder (BD) combined with anxiety-phobic disorders, as the most common comorbid pathology, is a new, little-studied and relevant direction for further research on BD, promising for clarifying the neurobiological mechanisms of the disease and improving the quality of the diagnostic process. By searching for combinations of the keywords «bipolar disorder», «anxiety disorders», «cognitive impairment», «cognitive dysfunction», «meta-analysis» and «review» in the databases «PubMed» and «Google Scholar», meta-analyses, analytical, review and original relevant research articles were identified. A generalization of the information accumulated in the literature indicates a) the presence in BD of both phase-dependent and persistent cognitive impairments that also occur during the period of euthymia, b) different structure and severity of neurocognitive disorders in cases of «pure» BD and anxiety-phobic disorders, c) the unique structure of cognitive impairment in BD with comorbid anxiety-phobic disorders, which incorporates the features of neurocognitive impairments that are characteristic of both disorders and have the greatest severity compared to them. The results of this review are of interest for planning further empirical studies of this topic on the Russian patient population.
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Affiliation(s)
- I D Gornushenkov
- Mental Health Research Center of the Russian Academy of Medical Sciences, Moscow, Russia
| | - V S Kulikova
- Mental Health Research Center of the Russian Academy of Medical Sciences, Moscow, Russia
| | - I V Pluzhnikov
- Mental Health Research Center of the Russian Academy of Medical Sciences, Moscow, Russia
| | - A N Barkhatova
- Mental Health Research Center of the Russian Academy of Medical Sciences, Moscow, Russia
| | - A G Alekhseeva
- Mental Health Research Center of the Russian Academy of Medical Sciences, Moscow, Russia
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He Z, Li M, Liu C, Ma X. Common Predictive Factors of Social Media Addiction and Eating Disorder Symptoms in Female College Students: State Anxiety and the Mediating Role of Cognitive Flexibility/Sustained Attention. Front Psychol 2022; 12:647126. [PMID: 35422727 PMCID: PMC9002102 DOI: 10.3389/fpsyg.2021.647126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
This study aimed to investigate the common predictive factors between social media addiction (SMA) and eating disorder symptoms (EDS), in a group of Chinese female college students. A total of 216 students completed the behavioral assessments of cognitive flexibility and sustained attention, as well as the questionnaires on anxiety, social media dependence, and eating disorders. The results indicate that SMA is significantly correlated with EDS. Structural equation modeling was used to test the model in which state anxiety, cognitive flexibility, and sustained attention predicted social gain and EDS. Additionally, the results confirmed the mediating role of cognitive flexibility and sustained attention between state anxiety and SMA/EDS in the participants. The findings revealed that in the sample group, state anxiety was related to SMA and EDS through cognitive flexibility and sustained attention. These proposals reflect the significance of improving cognitive flexibility/sustained attention and reducing state anxiety to prevent EDS and SMA in female college students.
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Affiliation(s)
- Zhonghua He
- School of Journalism and New Media, Xi’an Jiaotong University, Xi’an, China
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Oh DH, Park DH, Ryu SH, Ha JH, Jeon HJ. Psychological predictors of bipolarity in panic disorder. World J Psychiatry 2021; 11:242-252. [PMID: 34168971 PMCID: PMC8209537 DOI: 10.5498/wjp.v11.i6.242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/06/2021] [Accepted: 05/24/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Panic disorders frequently occur with affective disorders, particularly bipolar disorder. Patients with panic disorder and bipolar disorder are more likely to present with severe symptoms, such as high rates of suicidal behavior, poor symptomatic and functional recovery, and poor drug responses.
AIM To investigate the psychological characteristics of panic disorder patients related to bipolarity.
METHODS A total of 254 patients (136 men and 118 women, mean age = 33.48 ± 3.2 years) who were diagnosed with panic disorder were included in the study. Panic disorder with bipolarity (BP+) was defined as a score of ≥ 7 on the Korean version of the Mood Disorder Questionnaire (K-MDQ), and a score lower than 7 was considered as a panic disorder without bipolarity (BP-). Self-report questionnaires were analyzed to examine their association with bipolarity. Psychological tests used in the study were the Mood Disorder Questionnaire (MDQ), Panic Disorder Severity Scale, Beck Depression Inventory, State-Trait Anxiety Inventory (STAI), Temperament and Character Inventory (TCI), and Minnesota Multiphasic Personality Inventory (MMPI). Statistical analyses were performed to evaluate the correlation between bipolarity of panic disorder patients and various psychological test results indicative of psychological characteristics.
RESULTS Patients with a K-MDQ score of 7 or more were considered to have a history of manic or hypomanic episodes (BP+ group, n = 128), while patients with K-MDQ scores below 7 were defined as those without bipolarity (BP- group, n = 126). The BP+ group were more likely to be unmarried (single 56.2% vs 44.4%, P = 0.008) and younger (30.78 ± 0.59 vs 37.11 ± 3.21, P < 0.001). Additionally, the BP+ group had significantly higher scores on psychological assessment scales, such as the hypochondriasis, psychopathic deviate, masculinity-femininity, psychasthenia, schizophrenia, and hypomania (Ma) in MMPI, and novelty seeking, harm avoidance and self-transcendence in TCI, and STAI (state and trait) compared to the BP- group. In logistic regression analysis, depression in MMPI, self-directedness in TCI, and age were negatively associated with MDQ score, meanwhile, Ma in MMPI and STAI (trait) were positively associated with MDQ score.
CONCLUSION The result of this study suggests that almost 50% of patients with panic disorder are likely to have hypomanic or manic symptoms, and certain psychological factors are associated bipolarity in panic disorder.
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Affiliation(s)
- Da Hye Oh
- Department of Psychiatry, Konkuk University Medical Center, Seoul 05030, South Korea
| | - Doo-Heum Park
- Department of Psychiatry, Konkuk University Medical Center, Seoul 05030, South Korea
- Department of Psychiatry, Konkuk University School of Medicine, Seoul 05029, South Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, Konkuk University Medical Center, Seoul 05030, South Korea
- Department of Psychiatry, Konkuk University School of Medicine, Seoul 05029, South Korea
| | - Jee Hyun Ha
- Department of Psychiatry, Konkuk University Medical Center, Seoul 05030, South Korea
- Department of Psychiatry, Konkuk University School of Medicine, Seoul 05029, South Korea
| | - Hong Jun Jeon
- Department of Psychiatry, Konkuk University Medical Center, Seoul 05030, South Korea
- Department of Psychiatry, Konkuk University School of Medicine, Seoul 05029, South Korea
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Hsieh MH, Chien YL, Gau SSF. Mismatch negativity and P3a in drug-naive adults with attention-deficit hyperactivity disorder. Psychol Med 2021; 52:1-11. [PMID: 33706818 PMCID: PMC9772912 DOI: 10.1017/s0033291720005516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/15/2020] [Accepted: 01/04/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Individuals with attention-deficit hyperactivity disorder (ADHD) often display over-response to stimuli that are irrelevant to the ongoing task, and their attentional abilities disproportionately worsen in the presence of competing stimuli. Auditory event-related potentials (ERPs) such as mismatch negativity (MMN) and P3a using the passive oddball paradigm have been studied in children and adolescents with ADHD. Still, there is no such data for adults with ADHD. This study aimed to compare the MMN and P3a and their clinical and neurocognitive correlations between drug-naive adults with ADHD and control adults. METHODS We recruited 52 adults with ADHD (26.5 ± 6.2 years), and 62 age-matched controls (25.6 ± 5.6 years). They received the psychiatric interviews, auditory ERP, the Conners' continuous performance test (CCPT), and the Cambridge gambling test (CGT). They also completed the questionnaires about ADHD symptoms and real-world executive functions. MMN and P3a were assessed during a passive duration-deviant auditory oddball paradigm from the midline electrodes Cz. RESULTS Adults with ADHD demonstrated smaller Cz MMN amplitude, more severe ADHD symptoms, poorer attention profiles (CCPT), and a wide range of executive dysfunctions than controls. As for the correlates, Cz peak amplitude of MMN correlated with inattention symptoms, executive dysfunctions, attentional vigilance (CCPT), and decision-making (CGT) in ADHD adults but only with decision-making in controls. CONCLUSIONS Our findings that smaller amplitude of MMN and its differential associated pattern with inattention, real-world executive dysfunction, and decision-making, in drug-naive adults with ADHD from adult controls, provide evidence to support the potential electrophysiological biomarker for adult ADHD.
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Affiliation(s)
- Ming H. Hsieh
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Graduate Institute of Brain and Mind Sciences, and Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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Huang CC, Chang YH, Wang TY, Lee SY, Chen SL, Chen PS, Lane HY, Yang YK, Lu RB. Effects of mood episodes and comorbid anxiety on neuropsychological impairment in patients with bipolar spectrum disorder. Brain Behav 2020; 10:e01813. [PMID: 32864897 PMCID: PMC7667309 DOI: 10.1002/brb3.1813] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/20/2020] [Accepted: 08/04/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Cases of patients with bipolar disorder (BD) having neuropsychological impairment have been reported, although inconsistently. The possibility of comorbidity with anxiety disorder (AD) has been suggested. The association between mood episodes and AD comorbidity on neuropsychological performance is unclear and thus was investigated in the current study. METHODS All participants were informed about and agreed to participate in this study. Patients with BD were recruited from outpatient and inpatient settings, and healthy controls (HCs) were recruited as a comparison group. Six hundred and twenty-eight participants (175 HCs and 453 BD-56 BDI and 397 BDII) were studied based on their current mood episode, namely, depressive (BDd ), manic/hypomanic (BDm), mixed (BDmix), and euthymic (BDeu), compared with/without AD comorbidity (164 with AD). RESULTS Compared to HCs, all BD groups had significantly more impaired neuropsychological profiles, but the BDeu group was found to have less impairment in memory and executive function than the episodic BD groups. The percentage of AD comorbidity in BDd, BDm, BDmix, and BDeu was 33.9%, 40.3%, 33.0%, and 35.6%, respectively (χ2 = 1.61, p > .05). The results show that AD plays a different role in neuropsychological impairment across various mood episodes in BD. CONCLUSION Memory impairment and executive dysfunction may be state-like cognitive phenotypes and are affected by AD comorbidity during mixed and depressive episodes in BD, while sustained attention deficiencies are more like trait markers, regardless of mood episodes, and persist beyond the course of the illness. The AD comorbidity effect on attentional deficit is greater when suffering from a manic episode.
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Affiliation(s)
- Chih-Chun Huang
- Department of Psychiatry, Dou-Liou Branch, National Cheng Kung University Hospital, Yunlin, Taiwan
| | - Yun-Hsuan Chang
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung City, Taiwan.,Department of Medical Research, China Medical University Hospital, Taichung City, Taiwan.,Department of Psychiatry, National Cheng Kung University, Tainan City, Taiwan
| | - Tzu-Yun Wang
- Department of Psychiatry, National Cheng Kung University, Tainan City, Taiwan
| | - Sheng-Yu Lee
- Department of Psychiatry, National Cheng Kung University, Tainan City, Taiwan.,Department of Psychiatry, Kaohsiung Veteran's General Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shiou-Lan Chen
- Department of Psychiatry, National Cheng Kung University, Tainan City, Taiwan.,Graduate Institute of Medicine & M.Sc. Program in Tropical Medicine, College of Medicine, Kaohsiung Medical University (KMU), Kaohsiung, Taiwan.,Department of Medical Research, KMU Hospital, Kaohsiung, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University, Tainan City, Taiwan.,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsien-Yuan Lane
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung City, Taiwan.,Department of Psychiatry and Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, Dou-Liou Branch, National Cheng Kung University Hospital, Yunlin, Taiwan.,Department of Psychiatry, National Cheng Kung University, Tainan City, Taiwan.,Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Ru-Band Lu
- Department of Psychiatry, National Cheng Kung University, Tainan City, Taiwan.,Yanjiao Furen Hospital, Hebei, China
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Lu RB, Chang YH, Wang TY, Lee SY, Chen PS, Yang YK. The aldehyde dehydrogenase 2 polymorphisms on neuropsychological performance in bipolar II disorder with or without comorbid anxiety disorder. PLoS One 2018; 13:e0192229. [PMID: 29425204 PMCID: PMC5806854 DOI: 10.1371/journal.pone.0192229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 01/18/2018] [Indexed: 01/26/2023] Open
Abstract
Anxiety disorders (ADs), the most common comorbid illnesses with bipolar disorder (BP) has been reported to associate with dopamine system. Dopamine, metabolized to 3,4-dihydroxyphenylacetic acid (DOPAC) by aldehyde dehydrogenase 2 (ALDH2), and the distribution of the ALDH2*1/*1, and ALDH2*1/*2+ALDH*2/*2 alleles in the Han Chinese general population is relatively equal. The association between dopamine metabolic enzymes and cognitive performance in patients with bipolar II disorder (BP-II) comorbid with AD is unclear. This study proposed to explore the role of ALDH2 polymorphisms on neuropsychological performance between BP-II comorbid with or without AD. One hundred ninety-seven BP-II patients with and without a comorbid AD were recruited and compared with 130 healthy controls (HCs). A polymerase chain reaction and a restriction fragment length polymorphism analysis were used to determine genotypes for ALDH2, and study participants underwent neuropsychological tests. An interaction between AD comorbidity and the ALDH2 polymorphisms was found in different domain of cognitive dysfunction in the BP-II patients. The ALDH2 polymorphisms might have different effects on the neuropsychological performance of BP-II patients with and without comorbid AD.
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Affiliation(s)
- Ru-Band Lu
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yun-Hsuan Chang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
- * E-mail: ,
| | - Tzu-Yun Wang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Sheng-Yu Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Psychiatry, Kaohsiung Veteran’s General Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Psychiatry, Faculty of Medicine, Kaohsiung Medical University Kaohsiung, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Kanady JC, Soehner AM, Klein AB, Harvey AG. Reply to: Insomnia-related sleep disruptions, cognition and detailed concurrent anxiety testing during the inter-episode phase of bipolar disorder: A Herculean task or a necessity? J Psychiatr Res 2017; 95:78-79. [PMID: 28803144 DOI: 10.1016/j.jpsychires.2017.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 08/07/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Jennifer C Kanady
- San Francisco VA Medical Center, 4150 Clement St., San Francisco, CA 94121, USA
| | - Adriane M Soehner
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 Ohara St, Pittsburgh, PA 15213, USA
| | - Alexandra B Klein
- VA Boston Healthcare System, 150 S, Huntington Ave, Boston, MA 02130, USA
| | - Allison G Harvey
- Department of Psychology, University of California, Berkeley, 3321 Tolman Hall, Berkeley, CA 94720, USA.
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Lin YJ, Yang LK, Gau SSF. Psychiatric comorbidities of adults with early- and late-onset attention-deficit/hyperactivity disorder. Aust N Z J Psychiatry 2016; 50:548-56. [PMID: 26460330 DOI: 10.1177/0004867415609423] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE We evaluated the psychiatric comorbidities in adults who were diagnosed with Diagnostic and Statistical Manual of Mental disorders, 5th edition attention-deficit/hyperactivity disorder as a function of recalled symptom onset before and after the age of 7 years and whether the childhood attention-deficit/hyperactivity disorder symptoms were associated with psychiatric comorbidities. METHOD In all, 214 adults who were diagnosed with Diagnostic and Statistical Manual of Mental disorders, 5th edition attention-deficit/hyperactivity disorder and 174 non-attention-deficit/hyperactivity disorder controls (aged 17-40 years) received psychiatric interviews to confirm their previous and current attention-deficit/hyperactivity disorder status and other psychiatric diagnoses. Demographics and risks of lifetime psychiatric disorders were compared among three groups: (1) attention-deficit/hyperactivity disorder, onset <7 years (early-onset); (2) attention-deficit/hyperactivity disorder, onset between 7 and 12 years (late-onset) and (3) non-attention-deficit/hyperactivity disorder controls. We also tested the effects of attention-deficit/hyperactivity disorder symptoms on the risk of later psychiatric comorbidities by Cox regression analyses. RESULTS Regardless of the age of onset, attention-deficit/hyperactivity disorder was significantly associated with a wide range of psychiatric comorbidities. There were similar comorbid patterns between early- and late-onset attention-deficit/hyperactivity disorder. Regardless of attention-deficit/hyperactivity disorder diagnosis, increased severity of attention-deficit/hyperactivity disorder symptoms was associated with higher risks of oppositional defiant disorder, conduct disorder, dysthymia and sleep disorder but not major depression, which was associated with the attention-deficit/hyperactivity disorder diagnosis. CONCLUSION Our findings suggest that elevating the threshold of age of onset to 12 years in Diagnostic and Statistical Manual of Mental disorders, 5th edition would not over-diagnose attention-deficit/hyperactivity disorder in the adult population. Recalled childhood attention-deficit/hyperactivity disorder symptom severity was correlated with conduct disorder, oppositional defiant disorder, dysthymia and sleep disorders.
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Affiliation(s)
- Yu-Ju Lin
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan Department of Psychiatry, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Li-Kuang Yang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan Department of Psychiatry, National Defense Medical Center, Tri-Service General Hospital, Beitou Branch, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan Graduate Institute of Brain and Mind Sciences, Graduate Institute of Clinical Medicine, and Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
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11
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Ely AV, Wierenga CE, Kaye WH. Anxiety Impacts Cognitive Inhibition in Remitted Anorexia Nervosa. EUROPEAN EATING DISORDERS REVIEW 2016; 24:347-51. [DOI: 10.1002/erv.2451] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 02/26/2016] [Accepted: 03/23/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Alice V. Ely
- Department of Psychiatry; University of California San Diego; San Diego CA USA
| | | | - Walter H. Kaye
- Department of Psychiatry; University of California San Diego; San Diego CA USA
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12
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Solé B, Jiménez E, Torrent C, Del Mar Bonnin C, Torres I, Reinares M, Priego Á, Salamero M, Colom F, Varo C, Vieta E, Martínez-Arán A. Cognitive variability in bipolar II disorder: who is cognitively impaired and who is preserved. Bipolar Disord 2016; 18:288-299. [PMID: 27112120 DOI: 10.1111/bdi.12385] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 01/26/2016] [Accepted: 02/08/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Although it is well established that euthymic patients with bipolar disorder can have cognitive impairment, substantial heterogeneity exists and little is known about the extent and severity of impairment within the bipolar II disorder subtype. Therefore, the main aim of this study was to analyze cognitive variability in a sample of patients with bipolar II disorder. METHODS The neuropsychological performance of 116 subjects, including 64 euthymic patients with bipolar II disorder and 52 healthy control subjects, was examined and compared by means of a comprehensive neurocognitive battery. Neurocognitive data were analyzed using a cluster analysis to examine whether there were specific groups based on neurocognitive patterns. Subsequently, subjects from each cluster were compared on demographic, clinical, and functional variables. RESULTS A three-cluster solution was identified with an intact neurocognitive group (n = 29, 48.3%), an intermediate or selectively impaired group (n = 24, 40.0%), and a globally impaired group (n = 7, 11.6%). Among the three clusters, statistically significant differences were observed in premorbid intelligence quotient (p = 0.002), global functional outcome (p = 0.021), and leisure activities (p = 0.001), with patients in the globally impaired cluster showing the lowest attainments. No differences in other clinical characteristics were found among the groups. CONCLUSIONS These results confirm that neurocognitive variability is also present among patients with bipolar II disorder. Approximately one-half of the patients with bipolar II disorder were cognitively impaired, and among them 12% were severely and globally impaired. The identification of different cognitive profiles may help to develop cognitive remediation programs specifically tailored for each cognitive profile.
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Affiliation(s)
- Brisa Solé
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Esther Jiménez
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Carla Torrent
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Caterina Del Mar Bonnin
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Imma Torres
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - María Reinares
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Ángel Priego
- Department of Psychiatry and Psychology, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, Barcelona, Catalonia, Spain
| | - Manel Salamero
- Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS CIBERES, Barcelona, Catalonia, Spain
| | - Francesc Colom
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Cristina Varo
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Anabel Martínez-Arán
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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13
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Lin YJ, Lo KW, Yang LK, Gau SSF. Validation of DSM-5 age-of-onset criterion of attention deficit/hyperactivity disorder (ADHD) in adults: Comparison of life quality, functional impairment, and family function. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 47:48-60. [PMID: 26318976 DOI: 10.1016/j.ridd.2015.07.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 07/21/2015] [Accepted: 07/25/2015] [Indexed: 06/04/2023]
Abstract
The newly published Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) elevates the threshold of the ADHD age-of-onset criterion from 7 to 12 years. This study evaluated the quality of life and functional impairment of adults with ADHD who had symptoms onset by or after 7 years and examined the mediation effect of family function and anxiety/depression symptoms between ADHD diagnosis and quality of life and functional impairment. We assessed 189 adults with ADHD and 153 non-ADHD controls by psychiatric interview and self-administered reports on the Adult ADHD Quality of Life Scale, Weiss Functional Impairment Rating Scale, Family APGAR, and Adult Self Report Inventory-4. The ADHD group was divided into early-onset ADHD (onset <7 years, n=147) and late-onset ADHD (onset between 7 and 12 years, n=42). The mediation analysis was conducted to verify the mediating factors from ADHD to functional impairment and quality of life. The late-onset ADHD had more severe functional impairment at work and poorer family support than early-onset ADHD while they had comparable impairment at other domains. Less perceived family support and current anxiety/depressive symptoms partially mediated the link between ADHD diagnosis and quality of life/functional impairment both in early- and late-onset ADHD. Our data support decreased quality of life and increased functional impairment in adult ADHD, regardless of age of onset, and these adverse outcomes may be mediated by family support and anxiety/depression at adulthood. Our findings also imply that the new DSM-5 ADHD criteria do not over-include individuals without impairment.
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Affiliation(s)
- Yu-Ju Lin
- Department of Psychiatry, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; Department of Psychiatry, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, New Taipei City 220, Taiwan; Department of Psychiatry, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan.
| | - Kuan-Wu Lo
- Department of Psychiatry, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; School of Medicine, College of Medicine, National Taiwan University, No. 1, Jen-Ai Road Section 1, Taipei 100, Taiwan.
| | - Li-Kuang Yang
- Department of Psychiatry, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; Department of Psychiatry, Tri-Service General Hospital, Beitou Branch, No. 60, Xin-ming Road, Beitou District, Taipei 100, Taiwan.
| | - Susan Shur-Fen Gau
- Department of Psychiatry, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; Department of Psychiatry, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan.
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Martino DJ, Strejilevich SA, Marengo E, Ibañez A, Scápola M, Igoa A. Toward the identification of neurocognitive subtypes in euthymic patients with bipolar disorder. J Affect Disord 2015; 167:118-24. [PMID: 24955563 DOI: 10.1016/j.jad.2014.05.059] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 05/18/2014] [Accepted: 05/29/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cross-sectional and meta-analytic studies showed that patients with bipolar disorder (BD) had neurocognitive impairments even during periods of euthymia. The aim of this study was to estimate the prevalence of BD patients with and without clinically significant cognitive impairments, as well as to analyze clinical and functional variables in these subgroups. METHODS Hundred patients with BD and 40 healthy controls were assessed with an extensive neurocognitive assessment. Soft (some cognitive domain with a performance below 1.5 SD of the mean) and hard (at least two domains with values below 2 SD of the mean) criteria were utilized to define clinically significant cognitive impairments. RESULTS Using both soft and hard criteria, the prevalence of clinically significant cognitive impairments was higher in people with BD than in healthy controls. 70% of patients only showed failures of small effect (d=0.21-0.35) in 2 measures of executive functions. Moreover, 30% of patients were indistinguishable from healthy subjects in terms of both neurocognitive and psychosocial functioning. On the contrary, 30% of the sample showed more severe cognitive deficits than those usually reported in literature and had the worst psychosocial functioning. CONCLUSIONS The fact that cognitive impairments are very heterogeneous among euthymic patients with BD could contribute to understanding differences in functional outcome. Theoretical and practical implications of these findings are discussed.
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Affiliation(s)
- Diego J Martino
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Gurruchaga 2463, 1°"C", 1425 Ciudad Autónoma de Buenos Aires, Argentina; National Council of Scientific and Technical Research (CONICET), Argentina.
| | - Sergio A Strejilevich
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Gurruchaga 2463, 1°"C", 1425 Ciudad Autónoma de Buenos Aires, Argentina; Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina
| | - Eliana Marengo
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Gurruchaga 2463, 1°"C", 1425 Ciudad Autónoma de Buenos Aires, Argentina; National Council of Scientific and Technical Research (CONICET), Argentina
| | - Agustín Ibañez
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Gurruchaga 2463, 1°"C", 1425 Ciudad Autónoma de Buenos Aires, Argentina; National Council of Scientific and Technical Research (CONICET), Argentina; Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales University, Santiago, Chile; Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR), New South Wales, Australia
| | - María Scápola
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Gurruchaga 2463, 1°"C", 1425 Ciudad Autónoma de Buenos Aires, Argentina
| | - Ana Igoa
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Gurruchaga 2463, 1°"C", 1425 Ciudad Autónoma de Buenos Aires, Argentina
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15
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Volkert J, Kopf J, Kazmaier J, Glaser F, Zierhut KC, Schiele MA, Kittel-Schneider S, Reif A. Evidence for cognitive subgroups in bipolar disorder and the influence of subclinical depression and sleep disturbances. Eur Neuropsychopharmacol 2015; 25:192-202. [PMID: 25156468 DOI: 10.1016/j.euroneuro.2014.07.017] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 07/18/2014] [Accepted: 07/26/2014] [Indexed: 01/29/2023]
Abstract
Recent research in bipolar disorder (BD) points to the relevance and persistence of cognitive deficits even in euthymia. Up to now, the mechanisms behind why some bipolar patients (BP) do not reach their former level of cognitive performance and psychosocial functioning while others remit completely, are not understood. In this study we aimed to identify a "cognitive deficit" vs. "non-deficit" subgroup within BD by using an extensive neuropsychological test battery. The test performance of 70 euthymic outpatients (BD-I and II, recruited as a sample of convenience from our bipolar disorder programme) was compared to 70 matched, healthy controls (HC). Furthermore, we investigated the association between demographic/clinical variables and the cognitive performance of BP. As expected, our sample of euthymic BP performed significantly worse than HC in psychomotor speed, divided attention, working memory, verbal memory, word fluency and problem solving. However, 41.4% of the patients did not have any neurocognitive deficits at all, and whether or not a patient belonged to the non-deficit group was not influenced by disease severity. Instead, our results demonstrate that patients suffering from persistent sleep disturbances and sub-threshold depressive symptomatology show more severe cognitive dysfunctions. In addition, antipsychotic treatment and comorbid anxiety disorder were associated with cognitive deficits. In sum, these results suggest that a major part of cognitive impairment is due to current symptomatology, especially sleep disorder and sub-syndromal depression. Rigorous treatment of these symptoms thus might well improve cognitive deficits and, as a consequence, overall functioning in BD.
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Affiliation(s)
- J Volkert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, D-97080 Wuerzburg, Germany.
| | - J Kopf
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, D-97080 Wuerzburg, Germany
| | - J Kazmaier
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, D-97080 Wuerzburg, Germany
| | - F Glaser
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, D-97080 Wuerzburg, Germany
| | - K C Zierhut
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, D-97080 Wuerzburg, Germany
| | - M A Schiele
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, D-97080 Wuerzburg, Germany
| | - S Kittel-Schneider
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, D-97080 Wuerzburg, Germany
| | - A Reif
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, D-97080 Wuerzburg, Germany
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16
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Relationship between neurocognitive functioning and episode recurrences in bipolar disorder. J Affect Disord 2013; 147:345-51. [PMID: 23232419 DOI: 10.1016/j.jad.2012.11.037] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 11/20/2012] [Indexed: 12/23/2022]
Abstract
BACKGROUND The relationship between neurocognitive impairment and clinical course in bipolar disorder (BD) is inconclusive. The aim of this study was to compare time to recurrence between patients with and without clinically significant cognitive impairment. METHODS Seventy euthymic patients with BD were included. Based on baseline neurocognitive performance, patients were divided into those with (n=49) and those without (n=21) clinically significant cognitive impairment. Both groups of patients were prospectivelly assessed by a modified life chart method during a mean of 16.3 months. RESULTS Patients with some cognitive domain compromised had an increased risk of suffering any recurrence (HR: 3.13; CI 95%: 1.64-5.96), hypo/manic episodes (HR: 2.42; CI 95%: 1.13-5.19), or depressive episodes (HR: 3.84, CI 95%: 1.66-8.84) compared with those patients without clinically significant cognitive impairment. These associations remained significant after adjusting for several potential counfounders such as number of previous episodes, time since last episode, clinical subtype of BD, exposure to antipsychotics, and subclinical symptoms. LIMITATIONS We classified patients as with or without clinically significant cognitive impairment, although deficits in different cognitive domains may not be equivalent in terms of risk of recurrence. CONCLUSIONS The results did not support the hypothesis that the experience of successive episodes is related to a progressive neurocognitive decline. On the contrary, cognitive impairment could be the cause more than the consequence of poorer clinical course. Alternatively, a specific subgroup of patients with clinically significant cognitive impairment and a progressive illness in terms of counts of recurrence and shortening of wellness intervals might explain the association showed in this study.
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Billingsley-Marshall RL, Basso MR, Lund BC, Hernandez ER, Johnson CL, Drevets WC, McKee PA, Yates WR. Executive function in eating disorders: the role of state anxiety. Int J Eat Disord 2013; 46:316-21. [PMID: 23354876 DOI: 10.1002/eat.22086] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVE We examined the influence of depression and anxiety on executive function in individuals with a DSM-IV diagnosis of anorexia nervosa-restricting type, anorexia nervosa-binge-eating/purging type, bulimia nervosa, or eating disorder not otherwise specified. METHOD We assessed 106 women after their inpatient treatment in an eating disorders program. All participants were nutritionally stable at the time of testing. RESULTS Thirty percent of the total sample showed impaired performance on one or more tests of executive function. No differences in executive function were observed among diagnostic groups. Anxiety scores accounted for significant variance in performance for all groups. DISCUSSION Executive function deficits were found in a minority of our sample, with significant variance in performance accounted for by self-reported anxiety. State anxiety appears to contribute to diminished executive function in women with eating disorders.
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Chang CT, Chang YH, Yung-Wei Wu J, Lee SY, Chen SL, Chen SH, Chu CH, See Chen P, Hui Lee I, Lieh Yeh T, Tzeng NS, Huang SY, Yang YK, Yang HF, Lu RB. Neuropsychological functions impairment in different subtypes of bipolar disorder with or without comorbid anxiety disorders. Psychiatry Res 2012; 200:246-51. [PMID: 22748188 DOI: 10.1016/j.psychres.2012.06.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 06/01/2012] [Accepted: 06/10/2012] [Indexed: 01/27/2023]
Abstract
Bipolar disorder (BP) patients with comorbid anxiety disorders (ADs) showed more severe clinical characteristics and psychosocial function impairment, worse response to treatment, and more substance use than those without AD. However, few studies focus on differences in neuropsychological function between BP-I and BP-II and patients with and without AD. Seventy-nine BP patients in their interepisode state classified into four groups-BP-I without AD (BP-I(-AD)) (n=22), BP-I with AD (BP-I(+AD)) (n=20), BP-II without AD (BP-II(-AD)) (n=18), BP-II with AD (BP-II(+AD)) (n=19), and healthy controls (HC) (n=30)-were given neuropsychological tests. BP-I(+AD) patients did less well than BP-I(-AD) patients, but only in working memory. BP-II(+AD) patients did less well than the BP-II(-AD) patients in visual immediate memory, visual delayed memory, working memory, and psychomotor speed. BP-I(+AD) has limited effects on neuropsychological performance. However, significant effects were found only in BP-II(+AD) patients compared with BPII(-AD) patients. We hypothesized that comorbid AD worsens neuropsychological performance more in BP-II than in BP-I patients.
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