Cognitive functioning in bipolar disorder: Subtypes looking impact of premorbid IQ, obstetric complications and psychotropic drugs

STREJILEVICH S.A., MARTINO D.J., MARENGO E., IGOA A., PERINOT L., SCÁPOLA M., AIS E.

Santiago, Chile

Congreso; 2nd International Congress of Biological Psychiatry; 2007

Introduction: Background: Cognitive impairments have been associated with functional outcome in patients with bipolar disorder (BD). However, while functional outcome is very heterogeneous, nowadays it is not clear if cognitive impairments are also heterogeneous and which are the vari- ables that determinate it. Objectives: To examine the relationship between cognitive impairments and exposition to psychotropic drugs, obstetric complications history, and clinical and functional variables in patients with BD. Method: Forty patients with BD type I or II and twenty healthy controls matched by age and educational level were included. In addition to SCID, YMRS, HDRS, and GAF , clinical evaluation included measures of exposi- tion to psychotropic drugs and obstetric complications history. All subjects completed an extensive neuropsychological battery selected to asses pre- morbid IQ, verbal memory, attention, psychomotor speed, language, executive functions, and facial emotion recognition. Results: No differences in clinical and cognitive measures were found between patients with BDI and BDII. Patients with BD taken as a whole had lower performance than healthy controls in psychomotor speed, verbal memory and executive functions that were associated with GAF scores. However, while 37% had impairments in 1-2 and 19% in 3 or more cognitive domains, 44% had not deficits in any cognitive domain. BD patients with cognitive impairments had lower GAF scores and pre- morbid IQ than those that did not have cognitive impairments. Obstetric complications history and years of exposition to antipsychotic drugs were associated with impairments in psychomotor speed and executive func- tions measures. Conclusion: Cognitive impairments could not be homogeneous among BD patients. A subgroup of patients with BD could present cognitive impairments associated with psychosocial functioning that could be inde- pendent of clinical subtype (BDI vs. BDII). BD patients with low premorbid IQ, obstetric complications history, and high exposition to antipsychotic drugs could represent a subgroup with lower cognitive performance and functional outcome.