Executive dysfunction and cognitive subgroups in a large sample of euthymic patients with bipolar disorder

Abstract Bipolar disorder (BP), at the group level, is associated with significant but modest cognitive deficits, including executive dysfunction. Among executive functions, response inhibition deficits have been suggested to be particularly relevant to BP. However, BP is associated with significant...

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Bibliographic Details
Published in:European neuropsychopharmacology 2016-08, Vol.26 (8), p.1338-1347
Main Authors: Bora, Emre, Hıdıroğlu, Ceren, Özerdem, Ayşegül, Kaçar, Ömer Faruk, Sarısoy, Gökhan, Civil Arslan, Filiz, Aydemir, Ömer, Cubukcuoglu Tas, Zeynep, Vahip, Simavi, Atalay, Adnan, Atasoy, Nuray, Ateşci, Figen, Tümkaya, Selim
Format: Article
Language:English
Subjects:
Adult
Antipsychotic Agents - therapeutic use
Bipolar disorder
Bipolar Disorder - classification
Bipolar Disorder - drug therapy
Bipolar Disorder - physiopathology
Bipolar Disorder - psychology
Cognition Disorders - epidemiology
Cognition Disorders - etiology
Cognition Disorders - physiopathology
Cognition Disorders - psychology
Cognitive heterogeneity
Cross-Sectional Studies
Diagnostic and Statistical Manual of Mental Disorders
Educational Status
Executive Function
Female
Hospitals, University
Humans
Inhibition (Psychology)
Internal Medicine
Latent class analysis
Male
Middle Aged
Neurocognition
Outpatient Clinics, Hospital
Prevalence
Psychiatric Status Rating Scales
Psychiatry
Severity of Illness Index
Statistics as Topic
Turkey - epidemiology
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Summary:Abstract Bipolar disorder (BP), at the group level, is associated with significant but modest cognitive deficits, including executive dysfunction. Among executive functions, response inhibition deficits have been suggested to be particularly relevant to BP. However, BP is associated with significant heterogeneity in neurocognitive performance and level of functioning. Very few studies have investigated neurocognitive subgroups in BP with data-driven methods rather than arbitrarily defined criteria. Other than having relatively small sample sizes, previous studies have not taken into consideration the neurocognitive variability in healthy subjects. Five-hundred-fifty-six euthymic patients with BP and 416 healthy controls were assessed using a battery of cognitive tests and clinical measures. Neurocognitive subgroups were investigated using latent class analysis, based on executive functions. Four neurocognitive subgroups, including a good performance cluster, two moderately low-performance groups, which differ in response inhibition and reasoning abilities, and a severe impairment cluster were found. In comparison to healthy controls, BP patients were overrepresented in severe impairment cluster (27% vs 5.3%) and underrepresented in good performance cluster. BP patients with lower educational attainment and older age were significantly more likely to be members of cognitively impaired subgroups. Antipsychotic use was less common in good performance cluster. These results suggest that there is a considerable overlap of cognitive functions between BP and healthy controls. Neurocognitive differences between BP and healthy controls are driven by a subgroup of patients who have severe and global, rather than selective, cognitive deficits.
ISSN:0924-977X
1873-7862
DOI:10.1016/j.euroneuro.2016.04.002