Neurocognition and functional outcome in patients with psychotic, non-psychotic bipolar I disorder, and schizophrenia. A five-year follow-up

Abstract

Background:Bipolar disorder (BD) and schizophrenia (SZ) are characterized by neurocognitive and functional deficits with marked heterogeneity. It has been suggested that BD with a history of psychotic symptoms (BD-P) could constitute a phenotypically homogeneous subtype characterized by greater neurocognitive and functional impairments, or by a distinct trajectory of such deficits. The aim of this study was to compare the neurocognitive and functional course of euthymic BD-P, euthymic BD patients without a history of psychosis (BD-NP), stabilized patients with schizophrenia and healthy subjects, during a five-year follow-up.Methods:Neurocognitive and psychosocial function was examined in 100 euthymic patients with BD (50 BD-P, 50 BD-NP), 50 stabilized patients with schizophrenia (SZ), and 51 healthy controls (HC) at baseline (T1), and after a 5-year follow-up (T2).Results:The course of both neurocognitive performance and functional outcome of patients with SZ and BD (BD-P and BD-NP) is stable. The profile of neurocognitive impairment of patients with SZ or BD (BD-P and BD-NP), is similar, with only quantitative differences circumscribed to certain domains, such as working memory. The subgroup of patients with BD-NP does not show functional deterioration.Conclusions:We have not found evidence of progression in the neurocognitive or psychosocial impairment in any of the three groups of patients, although it cannot be dismissed the possibility of a subset of patients with a progressive course. Other longitudinal studies with larger samples and longer duration are necessary to confirm these findings.

Neurocognitive impairment and evidence-based treatment options in Bipolar disorder

“…In this frame, an important role is attributed to the neurocognitive impairment in the specific clinical course of BD [ 107 , 108 ]. As previously mentioned, there is a deleterious effect of psychotic symptoms [ 105 ] but otherwise the data in favor of a neurodegeneration are not consistent, and this is why the progression is characterized as ‘possible’ [ 109 , 110 ]. It seems that eventually BD patients come to manifest a neurocognitive deficit similar in qualitative as well as in quantitative terms to patients with schizophrenia (Fig.…”

Long-term trajectory of cognitive performance in people with bipolar disorder and controls: 6-year longitudinal study

“…Second, Sánchez-Morla 10 found stable cognitive performance in 76 patients with bipolar disorder and 40 controls, the majority of whom had been accounted for by Santos and colleagues. 12 Third, Jiménez-López 31 investigated both cognitive functioning and functional outcomes in patients with a history of psychotic symptoms ( n = 44) with patients with bipolar disorder without such symptoms ( n = 34) and found no evidence of progression in any of the groups. Finally, López-Villarreal 13 examined the same cohort, and also found stable cognitive performance except for executive functioning that was slightly improved.…”

“…Our findings add to other longitudinal studies that have failed to link cognitive decline to manic episodes. In fact, longitudinal studies have not been able to link any clinical feature to the course of cognitive functioning, 12,31 except for a correlation between a single test (reaction time of CPT-II) and illness duration, 11 and the one association with manic and hypomanic episodes mentioned above. 10 Several studies have defined cognitive subtypes [14][15][16]38,39 to explain the significant heterogeneity of cognitive functioning in bipolar disorder.…”

The association of metacognition with emotion recognition and perspective taking in a Russian sample with psychosis

“…Measures of global psychopathology, one domain of neurocognition, and verbal memory were included as potential covariates. Neurocognition was included given its relative prominence and links to function and outcomes in psychosis (e.g., Jiménez‐López et al, 2019).…”