Bipolar is a mental health condition marked by periods of mania or hypomania followed or preceded by periods of depression. Many people with bipolar can go long periods of time without experiencing significant symptoms. However, the impairments that exist in bipolar during acute phases may persist even during relatively stable periods. But until now, no study has looked at longitudinal data to determine if these impairments persist and if so, to what extent.
To close this gap in literature, E. Mora of the Hospital Santa Maria at the University of Lleida and the Biomedicine Research Institute in Spain recently conducted a longitudinal study that compared cognitive capacity and impairment in a sample of individuals with bipolar I and bipolar II at two different points in time six years apart. The goal of the research was to see what impairments were most prevalent and which ones had the highest degree of persistence and severity.
Mora recruited 54 individuals for the study, 28 with bipolar and 26 without. All were evaluated for cognitive capacity in the areas of executive function, processing speed, visual and verbal memory and attention. The clinical participants had been episode free for at least three months prior to the assessments. The results revealed that cognitive impairment persisted long after the participants experienced remission. Among the areas most impacted were processing speed and cognitive function.
Additionally, Mora found that areas of psychosocial functioning affecting neuropsychological activity were also heavily impacted. Also, the longer the participant had bipolar, the slower their processing speeds. Accordingly, as symptoms deteriorated in some over time, so did cognitive capacity and psychosocial functioning.
Another interesting finding was based on clinical evaluation: responses related to occupation were indicative of significant impairment in those with bipolar compared to those without. This could provide the first glimpse into why, despite symptom absence, people with bipolar continue to have high rates of unemployment.
Although this research was thorough, it was limited in several ways. First, some of the participants were on medication that could have contributed to cognitive decline. Second, comorbid conditions and other external stressors and factors were not considered in the analysis. Despite these shortcomings, this research adds much needed data to the long-term impact of bipolar. Mora added, “The present study helps to elucidate the evolution of cognitive dysfunction in a sample of patients with bipolar disorder.”
Mora, E., et al. (2013). Persistence of cognitive impairment and its negative impact on psychosocial functioning in lithium-treated, euthymic bipolar patients: A 6-year follow-up study. Psychological Medicine 43.6 (2013): 1187-96. ProQuest.Web.
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