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

Lookup NU author(s): Emeritus Professor Nicol Ferrier, Dr Peter Gallagher, Dr Peter Moore

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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.


Publication metadata

Author(s): Gallagher P; Ferrier IN; Moore PB; Bourne C; Aydemir O; Balanza-Martinez V; Bora E; Brissos S; Cavanagh JTO; Clark L; Cubukcuoglu Z; Dias VV; Dittmann S; Fleck DE; Frangou S; Jones L; Kieseppa T; Martinez-Aran A; Melle I; Mur M; Pfennig A; Raust A; Senturk V; Simonsen C; Smith DJ; Bio DS; Soeiro-de-Souza MG; Stoddart SDR; Sundet K; Szoke A; Thompson JM; Torrent C; Zalla T; Craddock N; Andreassen OA; Leboyer M; Vieta E; Bauer M; Worhunsky PD; Tzagarakis C; Rogers RD; Geddes JR; Goodwin GM

Publication type: Article

Publication status: Published

Journal: Acta Psychiatrica Scandinavica

Year: 2013

Volume: 128

Issue: 3

Pages: 149-162

Print publication date: 25/04/2013

ISSN (print): 0001-690X

ISSN (electronic): 1600-0447

Publisher: Wiley-Blackwell

URL: http://dx.doi.org/10.1111/acps.12133

DOI: 10.1111/acps.12133


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