Learning and memory in bipolar and unipolar major depression: effects of aging. Neuropsychiatry Neuropsychol Behav Neurol

Department of Biological Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, New York 10032, USA.
Neuropsychiatry, neuropsychology, and behavioral neurology 11/2000; 13(4):246-53.
Source: PubMed


The goal of this study was to examine the effects of aging on neuropsychological functions in bipolar and unipolar major depression.
Earlier studies suggested that neurocognitive deficits in mood disorder patients correlate with duration and severity of illness and also that bipolar disorder has a more virulent course than unipolar disorder. We hypothesized that elderly patients with bipolar disorder will demonstrate greater neurocognitive dysfunction than young patients with bipolar disorder and elderly patients with unipolar disorder.
A battery of tests of general intelligence and learning and memory was administered to 79 inpatients with major depression referred for electroconvulsive therapy. With patients 60 years of age and older defined as elderly, there were 29 young and 24 elderly unipolar patients and 13 young and 13 elderly bipolar patients.
Unipolar and bipolar patients did not differ in measures of general intelligence or global cognitive status. Generally, across tests of memory, young bipolar patients exhibited the best performance and elderly bipolar patients exhibited the poorest performance.
The results suggest that over the course of their illness, patients with bipolar disorder experience greater deterioration in memory functions than patients with unipolar disorder. Longitudinal studies are required to support the preliminary findings of this cross-sectional study.

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    • "Though non-linguistic cognitive performances have been extensively explored, only a few studies specifically focus on language issues in BD (Goodwin and Jamison, 2007; Cuesta and Peralta, 2011; Radanovic et al., 2013; Wang et al., 2011). At a behavioral level, patients with BD exhibit impaired performances in denomination tasks (Burt et al., 2000; Radanovic et al., 2013), in sentence completion task (Wang et al., 2011) and during semantic priming (Andreou et al., 2013). However, behavioral examination of bipolar patients does not allow us to precisely characterize the nature of neurolinguistics disturbances because these remain intertwined with nonlinguistic cognitive processes (Wang et al., 2011). "
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    ABSTRACT: Thought and language disturbances are crucial clinical features in Bipolar Disorders (BD), and constitute a fundamental basis for social cognition. In BD, clinical manifestations such as disorganization and formal thought disorders may play a role in communication disturbances. However, only few studies have explored language disturbances in BD at a neurophysiological level. Two main Event-Related brain Potentials (ERPs) have been used in language comprehension research: the N400 component, elicited by incongruous word with the preceding semantic context, and the Late Positive Component (LPC), associated with non-specifically semantic and more general cognitive processes. Previous studies provided contradictory results regarding N400 in mood disorders, showing either preserved N400 in depression or dysthymia, or altered N400 in BD during semantic priming paradigm. The aim of our study was to explore N400 and LPC among patients with BD in natural speech conditions. ERPs from 19 bipolar type I patients with manic or hypomanic symptomatology and 19 healthy controls were recorded. Participants were asked to listen to congruous and incongruous complete sentences and to judge the match between the final word and the sentence context. Behavioral results and ERPs data were analyzed. At the behavioral level, patients with BD show worst performances than healthy participants. At the electrophysiological level, our results show preserved N400 component in BD. LPC elicited under natural speech conditions shows preserved amplitude but delayed latency in difference waves. Small size of samples, absence of schizophrenic group and medication status. In contrast with the only previous N400 study in BD that uses written semantic priming, our results show a preserved N400 component in ecological and natural speech conditions among patients with BD. Possible implications in terms of clinical specificity are discussed.
    Journal of Affective Disorders 04/2014; 158:161-71. DOI:10.1016/j.jad.2013.11.013 · 3.38 Impact Factor
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    • "Regarding semantic abilities, only four studies were found, which report poor performance of bipolar patients in the WAIS- Vocabulary subtest (Broadhead and Jacoby, 1990; Burt et al., 2000). None of them comprised purely euthymic patients, except for Broadhead and Jacoby (Broadhead and Jacoby, 1990), reporting " recovered " patients prior to their hospital discharge. "
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    ABSTRACT: BACKGROUND: There is increasing evidence that bipolar disorder is also associated with neuropsychological impairments persisting during euthymia, thus representing a trait-like feature of the disease. Language and speech abnormalities are also present in bipolar disorder, especially in verbal fluency and verbal memory. However, there is a lack of studies in the literature investigating different levels of linguistic processing (phonological, syntactical, and semantic) in a single cohort of euthymic bipolar patients. Based on previous findings of pervasive language impairment in euthymic elderly bipolar patients, the aim of this study was to comprise a more thorough investigation on the subject. METHODS: We studied 19 euthymic bipolar patients aged 60 and above, and 20 cognitively healthy subjects using the Arizona Battery for Communication Disorders of Dementia (ABCD) and the Test for Reception of Grammar Version 2 (TROG-2) in order to assess the phonological, syntactic, and semantic domains of language. RESULTS: Bipolar patients performed poorer than controls in Linguistic Expression (p=0.011), in Linguistic Comprehension (Following Commands; p=0.025 and Reading Comprehension of Sentences; p=0.007), and in the TROG-2 (p=0.006). LIMITATIONS: The small sample comprising only elderly patients; the lack of statistical power to analyze the potential effect of individual medications on the cognitive performance. CONCLUSIONS: Our data demonstrate that linguistic impairment is present in euthymic bipolar patients, affecting mostly syntactic and lexical-semantic abilities, both in comprehension and production of language. These deficits are interrelated with other cognitive skills also known to be affected in bipolar disorder, such as executive functions and episodic memory.
    Journal of Affective Disorders 06/2013; 150(2). DOI:10.1016/j.jad.2013.04.035 · 3.38 Impact Factor
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    • "It is not surprising that complex mood disorders tend to be associated with more severe neuropsychological deficits. For example, existing research demonstrates that bipolar disorder patients show stronger neuropsychological deficits compared to unipolar depressed patients (Burt et al. 2000). However, results are somewhat inconsistent among the literature as research has also shown that neuropsychological deficits are similar between bipolar and unipolar depressed patients or that differences in neuropsychological functioning rather relate to the profile of neuropsychological deficits (Taylor Tavares et al. 2007). "
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    ABSTRACT: Neuropsychological research in patients with affective disorders shows heterogeneous results with regard to the severity and profile of cognitive impairments. In this paper we hypothesize that the investigation of clinical (subtypes, comorbidity, traumatization, personality, severity, diurnal swings, course, duration, age of onset, biased processing, rumination, motivation, experience of failure, sleep, suicidal tendencies, computer attitudes), demographic (age, education, gender) and neurobiological factors (structural and functional brain changes, glucocorticoids, medication, ECT) that are related to cognitive performance has specified the understanding of severity and profile of neuropsychological impairments. We reviewed the literature pertaining to clinical, demographic and neurobiological factors following Pubmed and PsychInfo databases using different combinations of general key-terms including "Affective Disorder," "Depression," "Mania," "Neuropsychological," "Neurobiological," "Moderator," and "Review" as well as more specific demographic, clinical and neurobiological search terms. Findings from the literature show that the consideration of these factors has improved knowledge about the severity of neuropsychological impairments in patients with affective disorders whereas the neuropsychological profile is still poorly understood. Despite limited understanding, however, the existent results provide promising suggestions for the development of treatment programs.
    Neuropsychology Review 06/2011; 21(4):337-59. DOI:10.1007/s11065-011-9171-0 · 4.59 Impact Factor
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