The Maudsley Bipolar Disorder Project

Donaldson, Stuart; Goldstein, Laura H.; Landau, Sabine; Raymont, Vanessa; Frangou, Sophia

doi:10.4088/jcp.v64n0116

Cited by 112 publications

(13 citation statements)

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“…Dittmann et al [12] found that age and medication are relevant variables influencing all cognitive domains in BD patients. The negative impact of medication on cognitive performance revealed in our stepwise regression analyses is well in accordance with the study results of Donaldson et al [13] and Savitz et al [41]; for differing findings cf. Roiser et al [39].…”

Section: Discussionsupporting

confidence: 93%

Cognitive impairment in patients with a schizoaffective disorder: a comparison with bipolar patients in euthymia

et al. 2010

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Objectives Several studies have shown persistent neurocognitive impairment in patients with a bipolar affective disorder (BD) even in euthymia as well as in patients with a schizoaffective disorder (SAD). The aim of our study was to compare the neuropsychological performance between these two groups. Confounding variables were controlled to enhance our understanding of cognitive dysfunction in both BD and SAD. Methods Several domains of neurocognitive function, executive function, memory, attention, concentration and perceptuomotor function were examined in 28 euthymic SAD patients and 32 BD patients by using a neuropsychological test battery. The Hamilton Depression Rating Scale (HAMD), Montgomery-Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) were used to evaluate the patients' clinical status. Data analysis was performed by using a multivariate analysis of covariance (ANCOVA/MANCOVA). Results Euthymic SAD patients showed greater cognitive impairment than euthymic BD patients in the tested domains including declarative memory and attention. Putative significant group differences concerning cognitive flexibility vanished when controlled for demographic and clinical variables. Age and medication were robust predictors to cognitive performance of both SAD and BD patients. Conclusions Our results point out the worse cognitive outcome of SAD compared to BD patients in remission. Remarkably, the variance is higher for some of the test results between the groups than within each group, this being discussed in light of the contradictive concept of SAD.

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Section: Discussionsupporting

confidence: 93%

Cognitive impairment in patients with a schizoaffective disorder: a comparison with bipolar patients in euthymia

et al. 2010

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“…Previous studies have reported both improvements in neurocognitive impairments with antipsychotic treatment in SCZ and BD (26) but negative impact on cognition have also been reported in BD (53, 54). In SCZ patients, some studies reported that the administration of typical antipsychotic medication provides only modest-to-moderate gains in multiple cognitive domains (55, 56), while other studies found no correlation between antipsychotic medication dose and neurocognitive functioning in BD and SCZ (9, 18, 57).…”

Section: Discussionmentioning

confidence: 95%

Neurocognitive Functioning in Schizophrenia and Bipolar Disorder: Clarifying Concepts of Diagnostic Dichotomy vs. Continuum

2013

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The Kraepelinian dichotomy posits that patients with schizophrenia (SCZ) and bipolar disorder (BD) present as two separate psychotic entities such that they differ in terms of clinical severity including neurocognitive functioning. Our study aimed to specifically compare and contrast the level of neurocognitive functioning between SCZ and BD patients and identify predictors of their poor neurocognitive functioning. We hypothesized that patients with SCZ had a similar level of neurocognitive impairment compared with BD. About 49 healthy controls (HC), 72 SCZ, and 42 BD patients who were matched for age, gender, and premorbid IQ were administered the Brief Assessment of Cognition battery (BAC). Severity of psychopathology and socio-occupational functioning were assessed for both patients groups. Both BD and SCZ groups demonstrated similar patterns of neurocognitive deficits across several domains (verbal memory, working memory, semantic fluency, processing speed) compared with HC subjects. However, no significant difference was found in neurocognitive functioning between BD and SCZ patients, suggesting that both patient groups suffer the same degree of neurocognitive impairment. Patients with lower level of psychosocial functioning [F(1,112) = 2.661, p = 0.009] and older age [F(1,112) = −2.625, p = 0.010], not diagnosis or doses of psychotropic medications, predicted poorer overall neurocognitive functioning as measured by the lower BAC composite score. Our findings of comparable neurocognitive impairments between SCZ and BD affirm our hypothesis and support less the Kraepelinian concept of dichotomy but more of a continuum of psychotic spectrum conditions. This should urge clinicians to investigate further the underlying neural basis of these neurocognitive deficits, and be attentive to the associated socio-demographic and clinical profile in order to recognize and optimize early the management of the widespread neurocognitive deficits in patients with SCZ and BD.

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“…Some studies have shown a cognitive improvement after antipsychotic treatments [18, 19], in acute mania [20], in euthymic bipolar patients [21] and in acute [22] or stable [23] schizophrenic patients. In contrast, negative impacts of neuroleptics and other psychotropic treatments on cognition have also been demonstrated [24]. Some studies suggest that atypical antipsychotics are safer than conventional neuroleptics with regard to cognition [20, 21].…”

Section: Methodsmentioning

confidence: 99%

Specificity of Cognitive Deficits in Bipolar Disorder versus Schizophrenia

Daban

Martínez-Àran

Torrent

et al. 2006

Psychother Psychosom

184

138

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Background: More and more epidemiological, genetic and neuroimaging studies show similarities between bipolar disorder (BD) and schizophrenia (SZ). Cognitive functions are known to be highly impaired in SZ and are increasingly studied in BD. When both populations are compared, the conclusions appear to be contradictory. The purpose of this review is to help define the profile of cognitive deficits in BD and in SZ. Methods: A systematic review of the literature of neuropsychological studies comparing BD and SZ was made, beginning in January 1990 and ending in January 2005. Thirty-eight studies met the required quality criteria and were included in this review. Results: Bipolar patients exhibit extensive cognitive abnormalities with a pattern of deficits that is not unique to this disease. However, when compared to schizophrenic patients, bipolar patients demonstrate a lesser degree of deficits, particularly concerning premorbid and current intelligence quotient and perhaps attention, verbal memory and executive functions. When looking into effect sizes, there seem to be different profiles even in studies finding no significant differences. Conclusions: The neuropsychological differences reported between both groups could be due to the presence of psychotic features, to environmental factors (stressful events, duration of the disease and number of hospitalisations) and could also be related to differences during the neurodevelopmental phase. Further studies should confirm whether these results are truly related to different neurobiological backgrounds.

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The Maudsley Bipolar Disorder Project

Cited by 112 publications

References 0 publications

Cognitive impairment in patients with a schizoaffective disorder: a comparison with bipolar patients in euthymia

Cognitive impairment in patients with a schizoaffective disorder: a comparison with bipolar patients in euthymia

Neurocognitive Functioning in Schizophrenia and Bipolar Disorder: Clarifying Concepts of Diagnostic Dichotomy vs. Continuum

Specificity of Cognitive Deficits in Bipolar Disorder versus Schizophrenia

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