Effect of alcohol and illicit substance use on verbal memory among individuals with bipolar disorder

Abstract

Background Cognitive impairment is a well-established feature of bipolar disorder (BD). Comorbid BD and substance use leads to poor psychosocial and clinical outcomes. However, knowledge on the neurocognitive functioning of individuals with dual diagnosis is limited. The aim of this study is to assess the cognitive performance of subjects with BD, BD with comorbid alcohol use disorder (AUD), and BD with comorbid illicit substance use disorders (SUD) as compared to healthy individuals. Methods We included 270 inpatients and outpatients with BD and 211 healthy controls. The diagnostic of BD and substance use disorder was assessed using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders Axis I. Demographic and clinical information were also collected. The cognitive assessment included the Wechsler Test of Adult Reading (WTAR), and a revised version of the California Verbal Learning Test (CVLT) as part of the South Texas Assessment of Neurocognition (STAN). Results The STAN was administered to 134 BD patients (100 female, M±SD: 37.37±12.74 years), 72 BD patients with AUD (40 female, M±SD: 38.42±11.82), 64 BD patients with SUD (39 female, M±SD: 34.50±10.57), and 211 healthy controls with no lifetime history of mental illness and substance use (127 female, M±SD: 34.80±12.57 years). In terms of clinical characteristics, BD+SUD showed a marginally earlier onset of illness compared to BD. Compared to HC, BD performed poorly in the immediate recall and short-delay free tests of the CVLT, while BD patients with AUD and SUD showed significant memory deficits in both the immediate recall and recognition components of the CVLT. There were no differences in memory performance between BD and BD with either AUD or SUD. Conclusions A history of substance use disorders is associated with an earlier onset of BD. BD has marked effects on processes underlying the encoding of new information, while comorbid substance use in BD impairs more specifically the recognition of previously presented information. Future longitudinal studies should evaluate the effects of AUD and SUD on illness progression and therapeutic outcomes.

Three‐year longitudinal cognitive functioning in patients recently diagnosed with bipolar disorder

“…Similar to our previous study, we found poorer 1‐year outcomes in executive functioning in patients with a history of substance/alcohol abuse ; however, between one and 3 years, these patients made preferential cognitive gains so that they were indistinguishable from those without history of alcohol/substance abuse at the 3‐year point. These findings are generally consistent with a body of literature showing that alcohol and substance abuse comorbidity in bipolar disorder associates with more prominent cognitive impairment . However, the present data suggest that history of substance use may delay, rather than arrest the early recovery in cognitive functioning.…”

Maintenance treatment trends, therapeutic outcomes and their association with clinical features in remitted bipolar disorder

“…This greater comorbidity might be attributed to our long-term-followed and complex study population. Comorbid alcohol and substance use disorders were speculated to be frequent in bipolar disorder (Cardoso et al, 2016). Current study showed lower ratios of these disorders in study group, which might be related to cultural and social determinants, and higher numbers of female patients.…”

The Importance of a Multi-Disciplinary Approach to the Endometriotic Patients: The Relationship between Endometriosis and Psychic Vulnerability

“…Genetic and family studies have likewise suggested a considerable overlap and interaction between the two disorders, which raises the likelihood probability that early onset bipolar disorder and substance abuse disorder share at least some common genetic vulnerabilities [ 136 ]. People with BD are more exposed to substance use disorders (SUDs: non-medical use of, or dependence on drugs and/or alcohol), while, viewed from the opposite perspective, a history of SUDs is associated with an earlier onset of BD [ 131 , 137 ]. People diagnosed with BD are more susceptible to a greater use of cocaine, amphetamines, opiates, cannabinoids and hallucinogens, in comparison with other psychiatric disorders such as schizophrenia [ 138 , 139 , 140 , 141 , 142 , 143 ].…”