Differentiating bipolar disorders from unipolar depression by applying the Brief Assessment of Cognition in Affective Disorders

Lee, Chiou-Yng; Wang, Liang‐Jen; Lee, Y.; Hung, Chi‐Fa; Huang, Yu‐Chi; Lee, M.-I.; Lee, S.-Y.

doi:10.1017/s003329171700229x

Cited by 21 publications

(22 citation statements)

References 37 publications

(53 reference statements)

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“…Previous studies have identified cognitive impairments in both asymptomatic BP and MDD, with some studies noting that impairments are significantly worse in BP . Although a few studies have found no significant differences between the two patients groups, the findings from our study suggest that BP patients have significantly greater cognitive impairment relative to HCs in three of five cognitive domains tested impulsivity, memory, and executive function—but not in attention or information processing.…”

Section: Discussioncontrasting

confidence: 72%

“…However, findings have been inconsistent as to whether any specific cognitive differences exist between the disorders, partly because relatively few studies have compared them directly and in the same mood state—in particular euthymia . For example, two recent studies found that in remission, cognitive abilities were relatively similar across the two disorders whereas other studies have also reported greater cognitive deficits in BP . In this study, Lee et al (2018) found that both MDD and BP participants performed worse than healthy controls on all cognitive measures whereas BP participants performed worse than MDD in working memory and inhibition tests.…”

Section: Introductionmentioning

confidence: 58%

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Investigating the neural basis of cognitive control dysfunction in mood disorders

et al. 2019

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Objectives: Dysfunction of cognitive control is a feature of both bipolar disorder (BP) and major depression (MDD) and persists through to remission. However, it is unknown whether these disorders are characterized by common or distinct disruptions of cognitive control function and its neural basis. We investigated this gap in knowledge in asymptomatic BP and MDD participants, interpreted within a framework of normative function.Methods: Participants underwent fMRI scans engaging cognitive control through a working memory task and completed a cognitive battery evaluating performance across multiple subdomains of cognitive control, including attention, impulsivity, processing speed, executive function, and memory. Analysis was performed in two stages: (i) cognitive control-related brain activation and deactivation were correlated with cognitive control performance in 115 healthy controls (HCs), then, (ii) significantly correlated regions from (i) were compared between 25 asymptomatic BP, 25 remitted MDD, and with 25 different HCs, matched for age and gender.Results: Impulsivity and executive function performance were significantly worse in BP compared to both MDD and HCs. Both BP and MDD had significantly poorer memory performance compared to HCs. Greater deactivation of the medial prefrontal cortex (MPFC) during the fMRI task was associated with better executive function in healthy controls. Significantly less deactivation in this region was present in both BP and MDD compared to HCs. Conclusions:Failure to deactivate the MPFC, a key region of the default mode network, during working memory processing is a shared neural feature present in both bipolar and major depression and could be a source of common cognitive dysfunction. K E Y W O R D Sbipolar disorders, cognitive control, depression, euthymic, fMRI activation | 287 BREUKELAAR Et AL.

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Section: Discussioncontrasting

confidence: 72%

Section: Introductionmentioning

confidence: 58%

Investigating the neural basis of cognitive control dysfunction in mood disorders

et al. 2019

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“…Affective performance biases such as problems with pessimistic attributional style, automatic thoughts, levels of neuroticism and attentional control problems in MDD patients during remission had been discussed before (Cerny et al., 2019). As for delayed recognition, it is worth noting that unipolar depression patients committed more non-affective false alarms during delayed recognition compared to patients with bipolar disorder and healthy controls (Lee et al., 2018b). This result may be due to the fact that depressed patients tend to process negative information preferably (Siegle & Hasselmo, 2002).…”

Section: Discussionmentioning

confidence: 99%

“…Our research team established the normative data of the Chinese version of the BACS (Wang et al., 2017), which provides satisfactory psychometric properties (Wang et al., 2016). Furthermore, a previous study suggested that the Chinese BAC-A may contribute to differentiating unipolar depressive disorder from bipolar disorder patients in clinical settings (Lee et al., 2018b).…”

Section: Methodsmentioning

confidence: 99%

“…Previous studies have demonstrated the potential benefit of differentiating patients with bipolar disorder from those with unipolar depression at euthymic status through BAC-A (Lee et al., 2018b). Nevertheless, the effects of the different characteristics of depressive disorder and psychotropic medications on the performance of BAC-A have not yet been clearly identified.…”

Section: Introductionmentioning

confidence: 99%

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Defining cognitive profiles of depressive patients using the Brief Assessment of Cognition in Affective Disorders

Chen

Lee

et al. 2019

PeerJ

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Background Cognitive impairments in patients with depressive disorders have a negative impact on their daily skill functioning and quality of life. In this study, we evaluated the cognitive profiles and associated factors of patients with depressive disorders with the Brief Assessment of Cognition in Affective Disorders (BAC-A). Methods This cross-sectional study consisted of 75 patients with depressive disorders (56 patients with major depressive disorder (MDD) and 19 patients with depressive disorder NOS or dysthymic disorder (non-MDD)). We evaluated the participants’ cognitive functions at euthymic status using the BAC-A. The BAC-A includes six subtests derived from the Brief Assessment of Cognition in Schizophrenia (BAC-S) and Affective Processing Tests. The current severity of depressive symptoms was assessed with the 17-item Hamilton Depression Rating Scale (HAMD-17), and we recorded any psychotropic drugs being used by the patients. Results We observed no differences in cognitive profiles in the MDD group and non-MDD group after adjusting for educational levels, severity of depression, and psychotropic drugs. Instead, the HAMD-17 scores were negatively correlated to cognitive performance in working memory, motor speed, verbal fluency, attention and processing speed, executive function, composite score, and the six indexes of the Affective Processing Test measured by the BAC-A. A longer illness duration was associated with worse performance of four indexes of the Affective Processing Test. Furthermore, benzodiazepine use was associated with a worse performance of verbal memory, and antidepressant use was associated with better motor speed performance. Conclusion The current severity of depressive symptoms and psychotropic drugs being taken, not the diagnosis category, are associated with cognitive impairments in patients with depressive disorders. Clinicians should pay particular attention to managing residual depressive symptoms and prescribing adequate psychotropic drugs in order to eliminate depressive patients’ cognitive deficits.

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The Italian version of the Brief Assessment of Cognition in Affective Disorders: performance of patients with bipolar disorder and healthy controls

Rossetti

Perlini

Abbiati

et al. 2022

Comprehensive Psychiatry

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Differentiating bipolar disorders from unipolar depression by applying the Brief Assessment of Cognition in Affective Disorders

Abstract: We have found that UD patients may exhibit an intermediate performance between healthy subjects and BD patients in working memory and emotional inhibition tests. The BAC-A can potentially assist in differentiating BD patients from UD patients at euthymic status in clinical settings.

Cited by 21 publications

References 37 publications

Investigating the neural basis of cognitive control dysfunction in mood disorders

Investigating the neural basis of cognitive control dysfunction in mood disorders

Defining cognitive profiles of depressive patients using the Brief Assessment of Cognition in Affective Disorders

The Italian version of the Brief Assessment of Cognition in Affective Disorders: performance of patients with bipolar disorder and healthy controls

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