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Predictors of the discrepancy between objective and subjective cognition in bipolar disorder: a novel methodology

Lookup NU author(s): Dr Peter GallagherORCiD, Dr Lucy Robinson



ObjectiveThe poor relationship between subjective and objective cognitive impairment in bipolar disorder (BD) is well-established. However, beyond simple correlation, this has not been explored further using a methodology that quantifies the degree and direction of the discrepancy. This study aimed to develop such a methodology to explore clinical characteristics predictive of subjective-objective discrepancy in a large BD patient cohort.MethodsData from 109 remitted BD patients and 110 healthy controls were pooled from previous studies, including neuropsychological test scores, self-reported cognitive difficulties, and ratings of mood, stress, socio-occupational capacity, and quality of life. Cognitive symptom sensitivity' scores were calculated using a novel methodology, with positive scores reflecting disproportionately more subjective complaints than objective impairment and negative values reflecting disproportionately more objective than subjective impairment (stoicism').ResultsMore subsyndromal depressive and manic symptoms, hospitalizations, BD type II, and being male positively predicted sensitivity', while higher verbal IQ predicted more stoicism'. Sensitive' patients were characterized by greater socio-occupational difficulties, more perceived stress, and lower quality of life.ConclusionObjective neuropsychological assessment seems especially warranted in patients with (residual) mood symptoms, BD type II, chronic illness, and/or high IQ for correct identification of cognitive deficits before commencement of treatments targeting cognition.

Publication metadata

Author(s): Miskowiak KW, Petersen JZ, Ott CV, Knorr U, Kessing LV, Gallagher P, Robinson L

Publication type: Article

Publication status: Published

Journal: Acta Psychiatrica Scandinavica

Year: 2016

Volume: 134

Issue: 6

Pages: 511-521

Print publication date: 01/12/2016

Online publication date: 20/09/2016

Acceptance date: 25/08/2016

Date deposited: 11/01/2017

ISSN (print): 0001-690X

ISSN (electronic): 1600-0447

Publisher: Wiley-Blackwell


DOI: 10.1111/acps.12649


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