Ecologically valid support for the link between cognitive and psychosocial functioning in bipolar disorder

Levy, Boaz; Medina, Anna Marie; Hintz, Kathryn; Weiss, Roger D.

doi:10.1016/j.psychres.2010.06.010

Cited by 13 publications

(7 citation statements)

References 32 publications

(26 reference statements)

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“…This concept refers to the degree to which classical neuropsychological tests are empirically related to measures of every‐day functioning. Thus, even though the tests used in this report are not designed with ‘ecological validity’ in mind, they may still be predictive of everyday functioning, as reported in several studies (51, 56–58).…”

Section: Discussionmentioning

confidence: 95%

Neurocognitive impairment and psychosocial functioning in bipolar II disorder

Solé

Bonnín

Torrent

et al. 2011

Acta Psychiatr Scand

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Sole´B, Bonnin CM, Torrent C, Balanza´-Martı´nez V, Tabare´s-Seisdedos R, Popovic D, Martı´nez-Ara´n A, Vieta E. Neurocognitive impairment and psychosocial functioning in bipolar II disorder.Objective: There is a growing body of evidence on neurocognitive impairment in euthymic bipolar patients, but this issue has been studied mostly in bipolar I disorder, data on bipolar II (BD-II) are scant and discrepant. The two aims of this study were to ascertain whether strictly defined euthymic BD-II patients would present neurocognitive disturbances and to evaluate their impact on functional outcome. Method: Forty-three BD-II patients and 42 demographically and educationally matched healthy subjects were assessed with a comprehensive neuropsychological test battery and with the Social and Occupational Functioning Assessment Scale (SOFAS). The euthymia criteria were reduced (Hamilton Rating Scale for Depression score £6 and a Young Mania Rating Scale score £6) to minimize the influence of subdepressive symptomatology on cognition and functioning. Results: BD-II patients showed a significantly lower performance on several measures of attention, learning and verbal memory, and executive function compared with healthy controls. Significant outcomes• Patients with bipolar II disorder in remission show cognitive dysfunction in attention, verbal memory, and executive functions.• The presence of subdepressive symptomatology and executive dysfunction may influence these patientsÕ psychosocial functioning.• Neurocognitive rehabilitation should be considered in each subtype of bipolar disorder to improve the functional outcome. Limitations• The cross-sectional design did not allow to draw conclusions regarding the stability of cognitive deficits in euthymic bipolar II patients.• The effect of medication and the impact of psychosis on neurocognition were not controlled for.• The directionality of the relationship between subclinical depressive symptoms and psychosocial dysfunction remain unclear.

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Section: Discussionmentioning

confidence: 95%

Neurocognitive impairment and psychosocial functioning in bipolar II disorder

Solé

Bonnín

Torrent

et al. 2011

Acta Psychiatr Scand

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“…In contrast, no associations were observed between cognitive performance and general function assessed with the GAF scale in depressed patients with BD (25). Studies that assessed patients in additional mood states (mania, hypomania) found that executive function (34,35), verbal learning, verbal memory (35) and attention (34) were related to poorer general function (GAF) across all mood states. In a single cross-sectional study on cognitive performance and general functioning, mood states (depressed, manic, euthymic) were assessed at multiple time points over 30 months in 25 patients with BD (24).…”

Section: Measures Of General Functional Impairmentmentioning

confidence: 89%

“…When social and occupational functioning were assessed, it was found that processing speed correlated positively with social function and verbal learning with occupational function across different mood states in patients with BD, which indicates an association between cognitive and social/ occupational function independent of mood states (33). Moreover, a higher likelihood of disability was observed in association with poorer performance in verbal memory, executive function and attention across all mood states (34).…”

Section: Measures Of General Functional Impairmentmentioning

confidence: 93%

“…Associations between cognitive performance and impairments in general function may be mood-state dependent. In a number of cross-sectional studies, poorer general function, assessed with the GAF scale in depressed patients with BD, has been associated with worse performance in several domains of cognitive function including executive function (24,34,35), verbal learning (24,33,35), verbal memory (34,35), attention (34), and reaction time (24). In contrast, no associations were observed between cognitive performance and general function assessed with the GAF scale in depressed patients with BD (25).…”

Section: Measures Of General Functional Impairmentmentioning

confidence: 99%

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A review on the impact of cognitive dysfunction on social, occupational, and general functional outcomes in bipolar disorder

2015

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Objectives Bipolar disorder (BD) is associated with significant impairment in cognitive performance across multiple domains of function that often persist after clinical recovery. It remains unclear, however, as to whether this process is related to the clinical status of BD being depressed, manic/hypomanic, or euthymic. In this review, we examine the literature on the cross‐sectional and longitudinal relationships between cognitive function and general function depending on the clinical phase of BD. Methods A systematic review of original research that studied both cognitive function and general function in adults (18–60 years), restricted to BD, was conducted in a total of 18 studies meeting inclusion/exclusion criteria. Results Results show cross‐sectional and prospective relationships between cognitive function and general function in patients with BD in both symptomatic and euthymic patients with BD. While studies using general measures of function (e.g., Global Assessment of Function scale) show more inconsistent associations with cognitive function, those employing assessments of domain specific function, suggest a consistent relationship between social and occupational function and cognitive performance. Executive function is commonly affected by cognitive deficits in these patients, but in addition a variety of domains show associations with functional outcomes (e.g., social function, occupational function). Notably, the emerging evidence suggests that cognitive function may be a better predictor of future general function than affective symptom severity. Conclusions Despite some inconsistencies, in sum the literature on the relationship between cognitive function and general function in BD implicates both cross‐sectional and longitudinal associations, both in symptomatic and euthymic patients with BD. And in terms of capturing these changes functional scales in particular domain‐specific measures seem superior to general measures.

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“…It is well known that cognition is compromised in individuals with BD, and that cognitive deficits contribute to the high levels of functional and psychosocial impairment associated with this disorder .…”

Section: The Bipolar Suicidality Model (Bsm)mentioning

confidence: 99%

Modeling bipolar disorder suicidality

et al. 2013

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The proposed Bipolar Suicidality Model (BSM) highlights the psychosocial precursors to suicidality in BD, while recognizing the key role of cognitive deficits and underlying functional neurobiological abnormalities. It usefully integrates our knowledge, and provides a novel perspective that is intended to meaningfully inform future research initiatives, and can lead to a better understanding of suicidality in bipolar disorder. Ultimately, it is hoped that it will facilitate the development of targeted interventions that diminish the risk of suicide in bipolar disorder.

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Ecologically valid support for the link between cognitive and psychosocial functioning in bipolar disorder

Cited by 13 publications

References 32 publications

Neurocognitive impairment and psychosocial functioning in bipolar II disorder

Neurocognitive impairment and psychosocial functioning in bipolar II disorder

A review on the impact of cognitive dysfunction on social, occupational, and general functional outcomes in bipolar disorder

Modeling bipolar disorder suicidality

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