Patients with affective disorders frequently report problems with attention, concentration and memory, although little research has investigated subjective cognitive complaints relative to objective neuropsychological deficits. We compared subjective (self-rated) cognition and objective (clinician-rated) neuropsychological functioning in 37 DSM-IV bipolar outpatients. Subjects completed three standardized self-report inventories: the Cognitive Difficulties Scale (CDS), Cognitive Failures Questionnaire (CFQ), and Patient's Assessment of Own Functioning (PAOF). These were followed by a systematic neuropsychological test battery. More than 75% of our sample of bipolar patients displayed some cognitive deficits, most notably in the domains of verbal learning and memory. In general, patients' self-reports of impairment failed to reliably predict objective neuropsychological deficits. Mood ratings for mania and depression were not significantly correlated with any of the self-report inventories or the objective neuropsychological variables. The findings suggest that most bipolar patients demonstrate objective signs of cognitive impairment, but they are unable to report them accurately, at least using available self-report inventories. Such discrepancies could relate to impaired insight, efforts to conceal deficits, or to subthreshold affective symptoms.
"ion of objective cognitive deficits in bipolar patients with cognitive complaints . Our demonstration of a poor correlation between measures of global objective cognitive function and subjective measures of cognition is consistent with other studies by our group ( Demant et al . , 2015 ; Svendsen et al . , 2012 ) and others ( Arts et al . , 2011 ; Burdick et al . , 2005 ) . However , we found significant weak to moderate correlation between objectively measured working memory and executive skills and cognitive complaints , similar to findings of Rosa et al . ( 2013 ) . However , in contrast with Rosa et al . ( 2013 ) , we found no correlation between measures of verbal learning and memory and cognitive"
"Indeed, it is unlikely that our finding of poor or no correlations between subjective and objective measures represents a type II error since our sample size was relatively large (n¼77) in comparison with other studies in the field in which sample sizes of bipolar patients ranged from n¼15–60 (Burdick et al., 2005; Martinez-Aran et al., 2005; Svendsen et al., 2012). In keeping with our findings, several other studies using self-assessment tools also found no significant correlation with objective cognitive measures (Burdick et al., 2005; van der Werf-Eldering et al., 2011; Svendsen et al., 2012), suggesting that patients may be unable to correctly evaluate their own cognitive function. On the other hand, the highly structured nature and limited naturalistic validity of objective cognitive tests may also limit the ability of these tests to capture patients' cognitive difficulties in reallife scenarios. "
"Regardless of whether differences in neurocognitive functioning are quantitative or qualitative, the heterogeneity found in this study could have important clinical implications. First, this diversity provides further evidence that justifies the use of neurocognitive assessments as part of the routine examination of patients with BD (Burdick et al., 2005; Martinez-Arán et al., 2005). Furthermore, our results bring additional support to the notion that cognitive status is one of the constraints of the level of functional recovery achieved by patients during euthymic periods (Huxley and Baldessarini, 2007). "
[Show abstract][Hide abstract] ABSTRACT: Background:
Cross-sectional and meta-analytic studies showed that patients with bipolar disorder (BD) had neurocognitive impairments even during periods of euthymia. The aim of this study was to estimate the prevalence of BD patients with and without clinically significant cognitive impairments, as well as to analyze clinical and functional variables in these subgroups.
Hundred patients with BD and 40 healthy controls were assessed with an extensive neurocognitive assessment. Soft (some cognitive domain with a performance below 1.5 SD of the mean) and hard (at least two domains with values below 2 SD of the mean) criteria were utilized to define clinically significant cognitive impairments.
Using both soft and hard criteria, the prevalence of clinically significant cognitive impairments was higher in people with BD than in healthy controls. 70% of patients only showed failures of small effect (d=0.21-0.35) in 2 measures of executive functions. Moreover, 30% of patients were indistinguishable from healthy subjects in terms of both neurocognitive and psychosocial functioning. On the contrary, 30% of the sample showed more severe cognitive deficits than those usually reported in literature and had the worst psychosocial functioning.
The fact that cognitive impairments are very heterogeneous among euthymic patients with BD could contribute to understanding differences in functional outcome. Theoretical and practical implications of these findings are discussed.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.