Memory in bipolar I disorder linked to early functional outcomes
MedWire News: Results from a Canadian study show that memory function is significantly associated with functional, but not clinical, outcomes after 6 months of treatment in bipolar I disorder patients who have experienced a first manic episode.
Writing in the journal Psychological Medicine, I Torres (University of British Columbia, Vancouver) and team explain that "although cognitive deficits in bipolar disorder have been associated with diminished functional outcome, this relationship has been studied primarily through cross-sectional designs, and has not been studied in patients early in the course of illness."
To address this, the team studied 53 recently diagnosed patients with bipolar I disorder, aged an average of 22 years, who were enrolled in the Systematic Treatment Optimization Program for Early Mania.
All the participants were assessed for verbal/pre-morbid intellectual functioning, learning/memory, visual-spatial/non-verbal reasoning, attention/processing speed, and executive function within 3 months of their first manic episode.
They were also assessed at baseline and 6 months later using the Multidimensional Scale of Independent Functioning (MSIF) and the DSM-IV Global Assessment of Functioning Scale (GAF). Symptom ratings and mood episode monitoring were used to assess clinical outcomes at 6 months.
The researchers found no significant association between cognitive functioning at baseline and clinical outcomes at 6 months.
However, baseline memory, particularly verbal learning/memory, was significantly associated with functional outcomes at 6 months using the MSIF, even after accounting for the severity of mood symptoms and the presence of substance abuse disorder.
The researchers also found that depression ratings at 6 months, but not cognitive variables, were significantly associated with GAF scores at 6 months.
Torres and team conclude: "The present study revealed a significant and robust association between baseline memory functioning and future psychosocial functioning in newly diagnosed patients with bipolar disorder."
They add: "The next steps should include replication of these findings, extension of the follow-up period, and determination of how either progression or alleviation of cognitive deficits early in the course of illness continue to relate to both clinical and functional outcome."
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By Mark Cowen