Journal
PSYCHOLOGICAL MEDICINE
Volume 49, Issue 8, Pages 1299-1307Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291718001885
Keywords
Bipolar disorder; cognition; follow-up; neuroprogression
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Funding
- Madrid's Regional Government [B2017/BMD-3740 AGES CM 2-CM]
- European Union Structural Funds
- Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM) of the Instituto de Salud Carlos III
- Fondo de Investigaciones Sanitarias, FIS [PI16/00359]
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Background. The neurocognitive trajectory in bipolar disorder (BD) is variable, with controversial findings, and most evidence come from cross-sectional studies. We aimed to examine the course of neurocognitive functioning in a sample of euthymic BD patients in comparison with a control group during a 5-year follow-up. Methods. Ninety-nine euthymic bipolar patients and 40 healthy controls were assessed using a comprehensive neurocognitive battery (six neurocognitive domains) at baseline (T1) and then at 5-year follow-up (T2) in a longitudinal study. Results. No evidence of a progression in neurocognitive dysfunction was found either in cognitive composite index or in any of the neurocognitive domains for the whole cohort. However, there was a negative correlation between number of manic episodes and hospitalisations due to manic episodes and change in neurocognitive composite index (NCI) during the follow-up. Moreover, patients with higher number of manic and hypomanic episodes have a greater decrease in NCI, working memory and visual memory. History of psychotic symptoms was not related to the trajectory of neurocognitive impairment. Conclusions. Our results suggest that, although the progression of cognitive decline is not a general rule in BD, BD patients who have a greater number of manic or hypomanic episodes may constitute a subgroup characterised by the progression of neurocognitive impairment. Prevention of manic and hypomanic episodes could have a positive impact on the trajectory of cognitive function.
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