Neuropsychological testing of cognitive impairment in euthymic bipolar disorder: An individual patient data meta-analysis

C. Bourne, O. Aydemir, V. Balanzá-Martínez, E. Bora, S. Brissos, J. T.O. Cavanagh, L. Clark, Z. Cubukcuoglu, V. V. Dias, S. Dittmann, I. N. Ferrier, D. E. Fleck, S. Frangou, P. Gallagher, L. Jones, T. Kieseppä, A. Martínez-Aran, I. Melle, P. B. Moore, M. MurA. Pfennig, A. Raust, V. Senturk, C. Simonsen, D. J. Smith, D. S. Bio, M. G. Soeiro-de-Souza, S. D.R. Stoddart, K. Sundet, A. Szöke, J. M. Thompson, C. Torrent, T. Zalla, N. Craddock, O. A. Andreassen, M. Leboyer, E. Vieta, M. Bauer, P. D. Worhunsky, C. Tzagarakis, R. D. Rogers, J. R. Geddes, G. M. Goodwin

Research output: Contribution to journalArticlepeer-review

299 Scopus citations

Abstract

Objective: An association between bipolar disorder and cognitive impairment has repeatedly been described, even for euthymic patients. Findings are inconsistent both across primary studies and previous meta-analyses. This study reanalysed 31 primary data sets as a single large sample (N = 2876) to provide a more definitive view. Method: Individual patient and control data were obtained from original authors for 11 measures from four common neuropsychological tests: California or Rey Verbal Learning Task (VLT), Trail Making Test (TMT), Digit Span and/or Wisconsin Card Sorting Task. Results: Impairments were found for all 11 test-measures in the bipolar group after controlling for age, IQ and gender (Ps ≤ 0.001, E.S. = 0.26-0.63). Residual mood symptoms confound this result but cannot account for the effect sizes found. Impairments also seem unrelated to drug treatment. Some test-measures were weakly correlated with illness severity measures suggesting that some impairments may track illness progression. Conclusion: This reanalysis supports VLT, Digit Span and TMT as robust measures of cognitive impairments in bipolar disorder patients. The heterogeneity of some test results explains previous differences in meta-analyses. Better controlling for confounds suggests deficits may be smaller than previously reported but should be tracked longitudinally across illness progression and treatment.

Original languageEnglish (US)
Pages (from-to)149-162
Number of pages14
JournalActa Psychiatrica Scandinavica
Volume128
Issue number3
DOIs
StatePublished - Sep 2013

Keywords

  • Bipolar disorder
  • Cognitive impairment
  • Neuropsychological tests
  • Review

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