Prevalence and determinants of cognitive impairment in the euthymic phase of bipolar disorders: results from the FACE-BD cohort

Roux, Paul; Étain, Bruno; Cannavo, Anne-Sophie; Aubin, V.; Aouizerate, Bruno; Azorin, Jean‐Michel; Bellivier, Frank; Belzeaux, Raoul; Bougerol, Thierry; Cussac, I.; Courtet, Philippe; Kahn, Jean‐Pierre; Leboyer, Marion; M’Baïlara, Katia; Payet, Marion Perrin; Olié, Émilie; Henry, Chantal; Passerieux, Christine

doi:10.1017/s0033291718001186

Cited by 21 publications

(14 citation statements)

References 32 publications

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“…Furthermore, medication was not included in the models, although it has been reported to have an impact on cognition in bipolar disorder. 2 We only included in our models the concurrent level of depressive symptoms measured by MADRS, and did not include potential mood episodes that could have occurred between evaluations.…”

Section: Discussionmentioning

confidence: 99%

“…Bipolar disorder is a prevalent and disabling mental disorder. 1 Bipolar disorder is associated with mild cognitive impairments, 2,3 which persist during periods of euthymia, with a prevalence between 4 and 67% 2 defined at usual clinically defined thresholds. Patients with bipolar disorder also experience deficits in psychosocial functioning, which persist during periods of euthymia.…”

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confidence: 99%

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Longitudinal relationships between cognition and functioning over 2 years in euthymic patients with bipolar disorder: a cross-lagged panel model approach with the FACE-BD cohort

et al. 2019

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Background Longitudinal studies of the relationship between cognition and functioning in bipolar disorder are scarce, although cognition is thought to be a key determinant of functioning. The causal structure between cognition and psychosocial functioning in bipolar disorder is unknown. Aims We sought to examine the direction of causality between cognitive performance and functional outcome over 2 years in a large cohort of euthymic patients with bipolar disorder. Method The sample consisted of 272 adults diagnosed with bipolar disorder who were euthymic at baseline, 12 and 24 months. All participants were recruited via the FondaMental Advanced Centers of Expertise in Bipolar Disorders. We used a battery of tests, assessing six domains of cognition at baseline and 24 months. Residual depressive symptoms and psychosocial functioning were measured at baseline and 12 and 24 months. The possible causal structure between cognition and psychosocial functioning was investigated with cross-lagged panel models with residual depressive symptoms as a covariate. Results The analyses support a causal model in which cognition moderately predicts and is causally primary to functional outcome 1 year later, whereas psychosocial functioning does not predict later cognitive performance. Subthreshold depressive symptoms concurrently affected functioning at each time of measure. Conclusions Our results are compatible with an upward causal effect of cognition on functional outcome in euthymic patients with bipolar disorder. Neuropsychological assessment may help specify individual prognoses. Further studies are warranted to confirm this causal link and evaluate cognitive remediation, before or simultaneously with functional remediation, as an intervention to improve functional outcome. Declaration of interest None.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Longitudinal relationships between cognition and functioning over 2 years in euthymic patients with bipolar disorder: a cross-lagged panel model approach with the FACE-BD cohort

et al. 2019

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“…However, we believe that such an overestimation bias may have been controlled by the fact that the distribution-based estimates were computed on a sample of patients with stable functioning. The influence of mood symptoms (Bonnín et al ., 2014 ), medication (Roux et al ., 2019 ) and trauma (Jimenez et al ., 2017 ) has not been assessed in this study and these are variables that could have influenced the patient outcomes. Another significant limitation was the lack of a psychometrically validated MCID for the two gold-standard anchor measures (CGI-S and GAF), which were determined based on the expertise of the authors and how the two scales were elaborated and clinically anchored.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, more than half the individuals with BD experience significant functional impairment in several domains, such as family and social life and work, outside the acute phases of the illness (Sanchez-Moreno et al ., 2017 ). Some patients also present significant cognitive impairments even in the euthymic phase of the disorder (Roux et al ., 2019 ). Traditionally, outcomes for patients with BD have been defined as the reduction of mood symptoms.…”

Section: Introductionmentioning

confidence: 99%

Minimum clinically important differences for the Functioning Assessment Short Test and a battery of neuropsychological tests in bipolar disorders: results from the FACE-BD cohort

Roux

Brunet-Gouet

Ehrminger

et al. 2020

Epidemiol Psychiatr Sci

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Aims Establishing the minimum clinically important difference (MCID) in functioning and cognition is essential to the interpretation of the research and clinical work conducted in bipolar disorders (BD). The present study aimed to estimate the MCID for the Functioning Assessment Short Test (FAST) and a battery of neuropsychological tests in BD. Methods Anchor-based and distributive methods were used to estimate the MCID for the FAST and cognition using data from a large, multicentre, observational cohort of individuals with BD. The FAST and cognition were linked with the Clinical Global Impressions Scale-Severity (CGI-S) and Global Assessment of Functioning (GAF) using an equipercentile method. The magnitude of the standard error measurement (s.e.m.) provided another estimate of the MCID. Results In total, 570 participants were followed for 2 years. Cross-sectional CGI-S and GAF scores were linked to a threshold ⩽7 on the FAST for functional remission. The MCID for the FAST equalled 8- or 9-points change from baseline using the CGI-S and GAF. One s.e.m. on the FAST corresponded to 7.6-points change from baseline. Cognitive variables insufficiently correlated with anchor variables (all ρ <0.3). One s.e.m. for cognitive variables corresponded to a range of 0.45 to 0.93-s.d. change from baseline. Conclusions These findings support the value of the estimated MCID for the FAST and cognition and may be a useful tool to evaluate cognitive and functional remediation effects and improve patient functional outcomes in BD. The CGI-S and GAF were inappropriate anchors for cognition. Further studies may use performance-based measures of functioning instead.

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“…Despite optimal treatment with mood stabilizers and second-generation antipsychotics, social and neurocognitive dysfunction in BD remains a serious problem. It is reported that 60-70% of BD patients have varying degrees of impairment in social and occupational functions (Henry et al,2015) and BD patients still suffer from impairment of attention, memory, information processing speed and executive function even in the stable period (Roux et al,2019). Social functioning is traditionally involved in autonomy, study, work, have leisure time, and engage in social relationships (Zarate et al,2000).…”

Section: Introductionmentioning

confidence: 99%

The Functional Impairment of Different Subtypes and Occupational States in Euthymic Patients With Bipolar Disorder

Liu

wang

et al. 2021

Preprint

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Background The aim was to explore the associations between clinical symptoms, demographic variables, social and neurocognitive functioning in euthymic patients with bipolar disorder (BD) stratified by subgroups of DSM-IV BD (BD-type I and BD-type II) and occupational status(employed/unemployed), and to highlight the significance of occupational status when assessing social and neurocognitive functioning in euthymic BD patients. Methods A total of 81 euthymic BD patients were participated in the study. The severity of the depressive and manic/hypomanic symptoms was measured using the 17-item Hamilton Depression Rating Scale (HDRS-17) and the Young Mania Rating Scale (YMRS), respectively. Social functioning and neurocognitive functioning were evaluated by the Functioning Assessment Short Test (FAST) and neurocognitive measures, respectively. Results Employed BD patients displayed greater social functioning (autonomy, occupational functioning, interpersonal relationship domain) and better verbal learning performance and speed of processing than unemployed BD patients. The correlation between neurocognitive functioning and social functioning was stronger in the employed group than in the unemployed group. There were no significant differences in neurocognitive and social functioning between the BD-I and BD-II groups, and the correlation between neurocognitive functioning and social functioning was similar between the BD-I and BD-II groups. Conclusion Employed BD patients may present greater occupational functioning and interpersonal relationships, as well as better verbal learning performance and speed of processing.

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Prevalence and determinants of cognitive impairment in the euthymic phase of bipolar disorders: results from the FACE-BD cohort

Cited by 21 publications

References 32 publications

Longitudinal relationships between cognition and functioning over 2 years in euthymic patients with bipolar disorder: a cross-lagged panel model approach with the FACE-BD cohort

Longitudinal relationships between cognition and functioning over 2 years in euthymic patients with bipolar disorder: a cross-lagged panel model approach with the FACE-BD cohort

Minimum clinically important differences for the Functioning Assessment Short Test and a battery of neuropsychological tests in bipolar disorders: results from the FACE-BD cohort

The Functional Impairment of Different Subtypes and Occupational States in Euthymic Patients With Bipolar Disorder

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