Autobiographical Memory and Episodic Specificity Across Different Affective States in Bipolar Disorder

Abstract

Autobiographical memory is essential to ground a sense of self-identity, contributing to social functioning and the development of future plans, and being an essential source for the psychiatric interview. Previous studies have suggested loss of autobiographical episodic specificity in unipolar depression, but relatively fewer investigations have been conducted in bipolar disorder (BD) patients, particularly across different mood states. Similarly, there is a scarcity of systematic investigations about mood-congruent and mood-dependent memory in relation to autobiographical memory in BD. Considering this, a total of 74 patients with BD (24 in euthymia, 26 in mania, and 24 in depression) responded with autobiographical memories to cue words belonging to four categories: mania, depression, BD, and neutral. Episodic specificity was scored according to the Autobiographical Interview, with high intra- and inter-rater reliability. Results indicated that patients in mania generally re-experience more episodic details than those in depression. Depressed bipolar patients reported fewer details of perception and less time integration of memories than those in euthymia or mania. Words linked to depression and BD induced greater episodic re-experiencing than neutral words, just as words about BD provided greater episodic re-experiencing and more details of emotion/thoughts than words about mania. Words linked to depression provoked more time details about the recalled episodes than words on BD or neutral themes. No mood-congruent or mood-dependent effects were observed. Current findings may improve the ability of clinicians to conduct psychiatric interviews and the diagnosis of BD, with special attention to how memory details are generated across different mood states of the condition. Additionally, interventions to foster autobiographical recollection in BD may be developed, similar to what has already been done in the context of schizophrenia.

Suicidality and Disability in Bipolar Disorder

“…In our sample, higher illness severity acted as a significant predictor of episodic memory specificity in BD. This result contradicts those in the literature that show that more severe depression is related to fewer episodic memory details 3,10,22 . However, it is important to notice that we had patients in different mood states in our sample, with 20 individuals in euthymia, 23 in depression, and 20 in mania.…”

“…According to the scientific literature, autobiographical memory is usually more generalized during depressive bipolar and depressive unipolar episodes 3,10,22 . Further, Da Silva et al 10 studied episodic memory specificity in different mood states of BD and found that depressed bipolar patients reported fewer details of perception and less time integration of memories than those in euthymia or mania. The results of the present study are in line with these findings,…”

“…Individuals with BD have high rates of psychiatric and medical comorbidity, which contributes to increased utilization of healthcare resources (Sajatovic, 2005). A study showed that treatment to prevent the recurrence of BD episodes is the most effective way to reduce costs (Dean et al, 2004) Da Silva et al (2021) reported an analysis of official data obtained from the Citizen Information Service of the National Social Security Institute (SIC INSS) regarding sick leave and ill-health pensions in Brazil from January to November 2020 and they showed that mental illness was the fourth leading cause of ill health retirement and the third leading cause of temporary sick leave. The authors also analyzed official data provided by the Unified Benefits Information System (Sistema Único de Informações de Benefícios, SUIBE) regarding all active benefits paid to people with mental disorders.…”

“…De Assis et al ( 2021) reported that depressed BD patients recall memories with fewer perceptual details and fragmented time integration, however, patients in mania generated memories with higher episodic detail, indicating this mood state may lead to more vivid re-experiencing. The authors suggest that as autobiographical memory represents the main source for patients to describe their past experience, its impairments may have an important impact on the clinical interview, as well as on the diagnosis of BD, with special attention to how memory details are generated across different mood states of the condition (da Silva et al, 2021).…”

“…However, according to Sweeney et al 9 , depressed bipolar patients have cognitive impairments that are restricted to the domain of episodic memory, whereas bipolar patients in mixed/manic states of illness have widespread deficits across multiple cognitive domains. Also, the specificity of episodic memory can vary across different mood states, with patients in mania re-experiencing more autobiographical details than those in depression 10 .…”