Parental Reports of Executive Dysfunction in Adolescents with Bipolar Disorder

Abstract

Bipolar disorder (BPD) is a serious mental illness that affects children and adolescents at a rate similar to that seen in adults. Extremely little is known, however, about cognitive functioning in childhood and adolescent BPD. The present study represents an initial effort to examine executive functioning in adolescents with BPD who are in a manic or mixed mood state, by collecting data from caregivers about the participants' performance on everyday tasks thought to be mediated by executive functioning abilities, using the Behavior Rating Inventory of Executive Function. In comparison to healthy volunteers, adolescents with BPD exhibited significant elevations across all of the measured functional domains. These elevations were evident even in adolescents with BPD who did not have comorbid ADHD, although they were most prominent in those with comorbidity. The findings suggest that adolescents with BPD have functional deficits on tasks requiring executive functioning skills that are not explicable solely on the basis of comorbid ADHD.

Self-Injurious Behavior in Adolescent Girls

“…Our results do not confirm previous interpretations that neuropsychological problems predispose patients to SIB [29,30] but support observations that EF are unspecifically disturbed in a variety of psychiatric conditions [31,[33][34][35][36][37][38][39] . In our sample, absence of trauma and psychically healthy parents seemed to protect against SIB [58] .…”

“…Other important structures involved in the regulation of affect and emotion are the anterior cingulate, hippocampus and amygdala [28] . Problems of behavior and emotion regulation and executive function (EF) deficits have been described in patients with PTSD and borderline personality disorder (BPD) [29] , in children and adolescents with suicidal behavior [30] , depressive and bipolar disorders [31] , obsessive-compulsive disorder [32] , Tourette syndrome [33] , psychotic and psychopathologic disorders [34] , conduct disorders [35] , psychopathies [36] , attention deficit hyperactivity disorder [37,38] , and disruptive, delinquent and aggressive behavior [39] .…”

Caudate Nucleus Volume and Cognitive Performance: Are They Related in Childhood Psychopathology?

“…Executive functioning and attention deficits were also expected in the ASD group compared to the TD group. Based on the limited literature on executive function deficits in children with BD (Castillo et al 2000;Shear et al 2002) and on the high co-morbidity of BD with ADHD (West et al 1995;Wozniak et al 1995), we tentatively expected that similar neuropsychological deficits would be found in the BD and ASD groups, although this was not central to the current study. Finally, caudate nucleus volume was hypothesized to predict neuropsychological performance in the areas of executive function and attention.…”

“…Like with ASD, children diagnosed with BD often display executive and attention deficits (Castillo et al 2000;Shear et al 2002;West et al 1995;Wozniak et al 1995). However, the overall clinical and diagnostic profile of BD differs substantially from ASD.…”

Review of magnetic resonance imaging and spectroscopy studies in children with bipolar disorder

“…Such a cognitive task requires processes including response inhibition, interference resolution and behavioral conflict resolution, which have been associated with the DLPFC and cingulate gyrus [67][68][69][70]. Impairments in executive processing have been associated with both BD alone [71] and with ADHD [72], a disorder that is highly comorbid with pediatric BD. In the Blumberg study, two of the ten subjects with BD had a comorbid diagnosis of ADHD and one patient was on stimulant medication at the time of scanning.…”