Persistent Cognitive Impairment Found in Bipolar

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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  • Bryan


    August 24th, 2013 at 4:22 AM

    I would definitely be a little wary of the ways that medication s could influence the findings. I am not bipolar and yet I know that if I have to take any kind of meds they can seriously effect me in really weird ways, especially if I some other crazy stuff going on in life too. Yes bipolar is going to leave an impact on you long after you have had an episode but there are other things that are going to leave a lasting footprint too that do not need to be discounted.

  • Macy


    August 25th, 2013 at 12:09 PM

    Very much possible that some of the effects may remain long after the symptoms have gone.But could this also be due to some sort of a tuning of the mind?The brain does get used to certain things and it could be true about the effects of a disorder too?Maybe the brain takes longer than the body to actually get used to the absence of symptoms and hence the deficits are seen even after symptoms have gone?

  • blair


    August 26th, 2013 at 3:53 AM

    Proof positive the impact that mental illness has on us in ways that we rarely think about.
    I think that in many ways the thought is always that if we take our medications and attend therapy sessins then we can beat this. And this is somewhat true. But then you have to look at all of the residual effects that are then there for us to deal with. Effects on cognitive functioning? Who would have necessarily thought that this was a possibility? And this is probably just the tip of the iceberg, as more money fress up and more research is done there is bound to be even more discoveries showing even more detriments to the brain and mental functioning than what was previously realized.

  • taylor


    August 26th, 2013 at 11:01 PM

    this is depressing.a mate had bipolar years ago and he still has trouble staying employed.we were college friends but even to this day his bipolar from years ago seems to be controlling his there hope?

  • John S

    John S

    October 22nd, 2016 at 12:29 PM

    This article is helpful but depressing for me as a person who suffers from bipolar affective disorder, because I do believe I have experienced significant cognitive impairment over the last 30 years of living with the illness!!!

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