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Haglili O, Sixsmith A, Star AP, Shmueli M, O'Rourke N. Perceived cognitive loss, symptomology, and psychological well-being with bipolar disorder. Int J Bipolar Disord 2024; 12:34. [PMID: 39367913 PMCID: PMC11456122 DOI: 10.1186/s40345-024-00357-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 09/23/2024] [Indexed: 10/07/2024] Open
Abstract
BACKGROUND Adults with bipolar disorder (BD) commonly present with cognitive deficits. Many also report subjective or perceived cognitive failures. For this study, we identified four distinct clusters of adults with BD on the basis of both BD symptoms (depression and hypo/mania) and perceived cognitive errors (i.e., forgetfulness, distractibility, false triggering). We hypothesized that participants reporting more BD symptoms and cognitive errors would report lower psychological well-being (i.e., self-efficacy, life scheme, life satisfaction). A second objective was to determine if and how clusters differed in terms of BD related factors (e.g., subtypes, sleep, medications) and sociodemographic differences such as age of participants. From the BADAS (Bipolar Affective Disorder and older Adults) Study, we identified 281adults with BD (M = 44.27 years of age, range 19-81), recruited via social media. RESULTS All clusters significantly differed across all grouping variables except symptoms of hypo/mania due to low frequency. Across clusters, perceived cognitive failures and BD symptoms increased in lockstep; that is, those reporting more cognitive errors also reported significantly higher symptoms of both depression and hypo/mania. As hypothesized, they also reported significantly lower psychological well-being. CONCLUSIONS Age did not significantly differ across clusters in contrast to existing research in which cognitive loss is objectively measured. That is, perceived cognitive errors are significantly associated with lower psychological well-being for both young and older adults with BD.
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Affiliation(s)
- Ophir Haglili
- Department of Psychology, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Andrew Sixsmith
- STAR Institute, Simon Fraser University, Vancouver, BC, Canada
| | - Ariel Pollock Star
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Moshe Shmueli
- Goldman School of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Norm O'Rourke
- Department of Psychology, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
- Multidisciplinary Center for Research on Aging, Faculty of Health Science, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
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2
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Hirakawa H, Terao T. The genetic association between bipolar disorder and dementia: a qualitative review. Front Psychiatry 2024; 15:1414776. [PMID: 39228919 PMCID: PMC11368786 DOI: 10.3389/fpsyt.2024.1414776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 08/05/2024] [Indexed: 09/05/2024] Open
Abstract
Bipolar disorder is a chronic disorder characterized by fluctuations in mood state and energy and recurrent episodes of mania/hypomania and depression. Bipolar disorder may be regarded as a neuro-progressive disorder in which repeated mood episodes may lead to cognitive decline and dementia development. In the current review, we employed genome-wide association studies to comprehensively investigate the genetic variants associated with bipolar disorder and dementia. Thirty-nine published manuscripts were identified: 20 on bipolar disorder and 19 on dementia. The results showed that the genes CACNA1C, GABBR2, SCN2A, CTSH, MSRA, and SH3PXD2A were overlapping between patients with bipolar disorder and dementia. In conclusion, the genes CACNA1C, GABBR2, SCN2A, CTSH, MSRA, and SH3PXD2A may be associated with the neuro-progression of bipolar disorder to dementia. Further genetic studies are needed to comprehensively clarify the role of genes in cognitive decline and the development of dementia in patients with bipolar disorder.
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Affiliation(s)
- Hirofumi Hirakawa
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Oita, Japan
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3
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Quinlivan E, Renneberg B, Schreiter S, Friedel E, Shmuilovich O, Stamm T. Better than expected: the gap between self-reported and objective measures of cognitive performance in remitted bipolar disorder. Front Psychiatry 2023; 14:1258303. [PMID: 37791129 PMCID: PMC10544994 DOI: 10.3389/fpsyt.2023.1258303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/01/2023] [Indexed: 10/05/2023] Open
Abstract
Background Studies comparing objective and self-reported cognitive functioning as well as influencing factors in individuals with remitted bipolar disorder are scarce and contradictory. Methods The aim of this study was to compare executive functioning and other objective and self-reported cognitive impairment between 26 individuals with remitted bipolar disorder (15 BD I) and 24 healthy controls using a cross-sectional design. Executive functions were measured by the TAP Go/No-go subtest as well as the Stroop Task. Self-rated functioning was assessed using the Attention Deficit Experience Questionnaire. In addition, possible predictors of self-reported and objective cognitive functioning were examined to perform regression analyses. Results Individuals with remitted bipolar disorder did not differ significantly in executive functions or other objective cognitive domains from the healthy control group, but showed a significantly lower level of self-reported cognitive functioning and self-esteem. While self-esteem was the strongest predictor in healthy controls for self-reported cognitive functioning, severity of illness and subthreshold depressive mood were the most important predictors in individuals with remitted bipolar disorder. Conclusion The results once again demonstrate the cognitive heterogeneity in bipolar disorder. In the treatment of cognitive deficits, factors such as subthreshold depressive symptomatology and self-esteem should be focused on in addition to cognitive training in remitted patients.
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Affiliation(s)
- Esther Quinlivan
- Department of Psychiatry and Neurosciences, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany
| | - Babette Renneberg
- Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany
| | - Stefanie Schreiter
- Department of Psychiatry and Neurosciences, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Eva Friedel
- Department of Psychiatry and Neurosciences, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Olga Shmuilovich
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Thomas Stamm
- Department of Psychology, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
- Schloss Luetgenhof Hospital, Centre for Personal Medicine, Psychosomatics and Psychotherapy, Dassow, Germany
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4
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Siegel-Ramsay JE, Wu B, Bond M, Spelber D, Chiang KS, Lanza di Scalea T, Collier S, Smith T, Nunez L, Fuller E, Strakowski SM, Lippard E, Almeida JR. Subjective cognitive impairment and its relationship to sleep impairment, anxiety severity, and depressive symptoms in individuals with bipolar disorder. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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5
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Sánchez-Torres AM, Moreno-Izco L, Gil-Berrozpe GJ, Lorente-Omeñaca R, Zandio M, Zarzuela A, Peralta V, Cuesta MJ. Assessment of cognitive impairment in psychosis spectrum disorders through self-reported and interview-based measures. Eur Arch Psychiatry Clin Neurosci 2022; 272:1183-1192. [PMID: 35362774 DOI: 10.1007/s00406-022-01399-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 03/14/2022] [Indexed: 11/25/2022]
Abstract
Self-reported and interview-based measures can be considered coprimary measures of cognitive performance. We aimed to ascertain to what extent cognitive impairment in psychotic disorders, as assessed with a neuropsychological battery, is associated with subjective cognitive complaints compared to difficulties in daily activities caused by cognitive impairment. We assessed 114 patients who had a psychotic disorder with a set of neuropsychological tests and two additional measures: the Cognitive Assessment Interview-Spanish version (CAI-Sp) and the Frankfurt Complaint Questionnaire (FCQ). Patients also underwent a clinical assessment. The CAI-Sp correlated significantly with all the clinical dimensions, while the FCQ correlated only with positive and depressive symptoms. The CAI-Sp correlated significantly with all cognitive domains, except for verbal memory and social cognition. The FCQ was associated with attention, processing speed and working memory. The combination of manic and depressive symptoms and attention, processing speed, working memory and explained 38-46% of the variance in the patients' CAI-Sp. Education and negative symptoms, in combination with attention, processing speed, and executive functions, explained 54-59% of the CAI-Sp rater's variance. Only negative symptoms explained the variance in the CAI-Sp informant scores (37-42%). Depressive symptoms with attention and working memory explained 15% of the FCQ variance. The ability to detect cognitive impairment with the CAI-Sp and the FCQ opens the possibility to consider these instruments to approximate cognitive impairment in clinical settings due to their ease of application and because they are less time-consuming for clinicians.
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Affiliation(s)
| | - Lucía Moreno-Izco
- Navarra Institute of Health Research, IdiSNA, Pamplona, Spain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
| | | | | | - María Zandio
- Navarra Institute of Health Research, IdiSNA, Pamplona, Spain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
| | - Amalia Zarzuela
- Navarra Institute of Health Research, IdiSNA, Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Victor Peralta
- Navarra Institute of Health Research, IdiSNA, Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Manuel J Cuesta
- Navarra Institute of Health Research, IdiSNA, Pamplona, Spain.
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain.
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Baena-Oquendo S, García Valencia J, Vargas C, López-Jaramillo C. Neuropsychological aspects of bipolar disorder. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:218-226. [PMID: 36075855 DOI: 10.1016/j.rcpeng.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/10/2020] [Indexed: 06/15/2023]
Abstract
Bipolar disorder (BD) is a chronic condition with serious consequences on the health and functionality of patients who suffer from it, with a high heritability and segregation, and aprevalence of between 1% and 2%. Neuropsychological deficits have been implicated as a very important issue related to BD prognosis, so a review was conducted of these deficits, the related factors and their functional consequences. It has been determined that the presence of neuropsychological deficits can vary in patients with BD according to their mood state, with a great influence of depressive symptoms on the cognitive variability of patients with respect to the general population and differences with respect to patients in the manic phase. In euthymic patients, the most affected cognitive domains are those of memory, attention, and executive function, associated with a more severe disease, sociodemographic vulnerability factors, and stable over time. A relationship has been found between poor cognitive performance, especially executive dysfunction, and objective functional deficit. Furthermore, cognitive differences have been outlined between BD and other serious mental illnesses that are described in this review.
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Affiliation(s)
- Stephen Baena-Oquendo
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Jenny García Valencia
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Cristian Vargas
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
| | - Carlos López-Jaramillo
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
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7
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McBride EE, Greeson JM. Mindfulness, cognitive functioning, and academic achievement in college students:the mediating role of stress. CURRENT PSYCHOLOGY 2021; 42:10924-10934. [PMID: 34667426 PMCID: PMC8516329 DOI: 10.1007/s12144-021-02340-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2021] [Indexed: 11/30/2022]
Abstract
Higher trait mindfulness may be associated with better cognitive functioning and academic achievement in college students. Although mediating mechanisms are unclear, lower stress levels could explain this relationship. Participants: Cross-sectional online survey (n = 534; 33% non-white; Apr 2018 - Sep 2019). Path analysis tested Perceived Stress as a mediator between specific facets of trait mindfulness and three measures of self-reported cognitive functioning and academic achievement: Cognitive Abilities, Cognitive Concerns, and GPA. Perceived Stress fully or partially mediated the relationship between all facets of trait mindfulness and perceived cognitive functioning. Only Decentering, however, was associated with higher GPA as a function of lower stress. Lower stress can explain the link between higher trait mindfulness and better cognitive functioning, but not necessarily academic achievement. Future research is needed to address causality, examine objective measures of cognitive functioning, and extend this explanatory model to mindfulness training.
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Affiliation(s)
- Emma E. McBride
- Department of Psychology, College of Science and Mathematics, Rowan University, 201 Mullica Hill Road, Glassboro, NJ 08028 USA
| | - Jeffrey M. Greeson
- Department of Psychology, College of Science and Mathematics, Rowan University, 201 Mullica Hill Road, Glassboro, NJ 08028 USA
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8
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Exploring Clinical Correlates of Metacognition in Bipolar Disorders Using Moderation Analyses: The Role of Antipsychotics. J Clin Med 2021; 10:jcm10194349. [PMID: 34640367 PMCID: PMC8509459 DOI: 10.3390/jcm10194349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 11/17/2022] Open
Abstract
The determinants of metacognition are still poorly understood in bipolar disorders (BD). We aimed to examine the clinical determinants of metacognition, defined as the agreement between objective and subjective cognition in individuals with BD. The participants consisted of 281 patients with BD who underwent an extensive neuropsychological battery and clinical evaluation. To assess subjective cognition, participants provided a general rating of their estimated cognitive difficulties. Clinical characteristics of BD were also recorded, along with medication. We studied the potential moderation of the association between cognitive complaints and global objective cognitive performance by several clinical variables with ordinal logistic regressions. Depression and impulsivity were associated with greater cognitive complaints. The only variable that moderated the relationship between objective and subjective cognition in the global model was the prescription of antipsychotics. Patients taking antipsychotics had a poorer association between cognitive complaints and objective neuropsychological performance. This result suggests a role for dopamine in the modulation of metacognitive performance, and calls for the systematic control of antipsychotic medication in future studies documenting metacognitive deficits in severe and persistent mental disorders. Depression and impulsivity should be investigated as potential therapeutic targets for individuals with BD and cognitive complaints, before proposing an extensive neuropsychological evaluation.
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9
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Torres IJ, Hidiroglu C, Mackala SA, Ahn S, Yatham LN, Ozerdem E, Michalak EE. Metacognitive knowledge and experience across multiple cognitive domains in euthymic bipolar disorder. Eur Psychiatry 2021; 64:e36. [PMID: 34082855 PMCID: PMC8204590 DOI: 10.1192/j.eurpsy.2021.31] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Metacognitive knowledge (MK; general awareness of cognitive functioning) and metacognitive experience (ME; awareness of cognitive performance on a specific cognitive task) represent two facets of metacognition that are critical for daily functioning, but are understudied in bipolar disorder. This study was conducted to evaluate MK and ME across multiple cognitive domains in individuals diagnosed with bipolar disorder and unaffected volunteers, and to investigate the association between metacognition and quality of life (QoL). Methods Fifty-seven euthymic participants with bipolar disorder and 55 demographically similar unaffected volunteers provided prediction and postdiction ratings of cognitive task performance across multiple cognitive domains. Self-ratings were compared to objective task performance, and indices of MK and ME accuracy were generated and compared between groups. Participants rated QoL on the Quality of Life in Bipolar Disorder Scale (QoL.BD). Results Metacognitive inaccuracies in both MK and ME were observed in participants with bipolar disorder, but only in select cognitive domains. Furthermore, most metacognitive inaccuracies involved underestimation of cognitive ability. Metacognitive indices were minimally associated with medication variables and mood symptoms, but several indices were related to QoL. Conclusions Individuals with bipolar disorder demonstrate inaccuracies in rating their cognitive functioning and in rating their online cognitive task performance, but only on select cognitive functions. The tendency to underestimate performance may reflect a negative information processing bias characteristic of mood disorders. Metacognitive variables were also predictive of QoL, indicating that further understanding of cognitive self-appraisals in persons with bipolar disorder has significant clinical relevance.
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Affiliation(s)
- Ivan J Torres
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Mental Health and Substance Use Services, Vancouver, British Columbia, Canada
| | - Ceren Hidiroglu
- Department of Psychology, Dokuz Eylul University, Izmir, Turkey
| | - Sylvia A Mackala
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sharon Ahn
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eysegul Ozerdem
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Erin E Michalak
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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10
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Simjanoski M, Jansen K, Mondin TC, Pedrotti Moreira F, Vieira IS, da Silva RA, Souza LDDM, Frey BN, Cardoso TDA, Kapczinski F. Cognitive complaints in individuals recently diagnosed with bipolar disorder: A cross-sectional study. Psychiatry Res 2021; 300:113894. [PMID: 33836469 DOI: 10.1016/j.psychres.2021.113894] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 03/19/2021] [Indexed: 11/25/2022]
Abstract
AIM To assess the differences in subjective cognitive dysfunction between major depressive disorder (MDD) and recently diagnosed Bipolar Disorder (BD) across euthymia and mood episodes. METHODS This is a cross-sectional study corresponding to the second wave of a longitudinal study. The first wave consisted of subjects aged between 18 and 60 diagnosed with MDD. In the follow up after three years (second wave), conversion from MDD to BD diagnosis was assessed by qualified psychologists using the Mini International Neuropsychiatric Interview (MINI-Plus). Subjects were categorized in four diagnostic groups: euthymic MDD, MDD in a current mood episode, euthymic BD, and BD in a current mood episode. All subjects completed the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA), an instrument specifically designed for detecting subjective cognitive deficits in BD. RESULTS The total sample (n = 468) included 410 subjects with MDD and 58 individuals recently diagnosed with BD. We subdivided the 2 groups based on their current mood state, and found a significant difference in COBRA total scores between euthymic BD individuals (median 17.00 [IQR: 8.75 - 20.75]) and euthymic MDD subjects (median 8.00 [IRQ: 5.00 - 14.00], p = 0.002), showing higher subjective cognitive dysfunction in individuals recently diagnosed with BD. The differences remained significant after adjusting for the presence of lifetime psychotic symptoms. We found no differences between MDD and BD during an acute mood episode. LIMITATION The small sample size of individuals with BD. CONCLUSION The findings suggest a higher presence of subjective cognitive complaints among individuals recently diagnosed with BD in comparison to individuals with MDD during euthymia.
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Affiliation(s)
- Mario Simjanoski
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Karen Jansen
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Thaíse Campos Mondin
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil; Pró-Reitoria de Assuntos Estudantis (PRAE), Universidade Federal de Pelotas, RS, Brazil
| | - Fernanda Pedrotti Moreira
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Igor Soares Vieira
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil; Centro Universitário Estácio de Sergipe, SE, Brazil
| | - Ricardo Azevedo da Silva
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Luciano Dias de Mattos Souza
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Benicio N Frey
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada; Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Taiane de Azevedo Cardoso
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil
| | - Flávio Kapczinski
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil.
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Rouy M, Saliou P, Nalborczyk L, Pereira M, Roux P, Faivre N. Systematic review and meta-analysis of metacognitive abilities in individuals with schizophrenia spectrum disorders. Neurosci Biobehav Rev 2021; 126:329-337. [PMID: 33757817 DOI: 10.1016/j.neubiorev.2021.03.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/15/2021] [Accepted: 03/15/2021] [Indexed: 12/22/2022]
Abstract
Metacognitive deficits are well documented in schizophrenia spectrum disorders as a decreased capacity to adjust confidence to performance in a cognitive task. Because metacognitive ability directly depends on task performance, metacognitive deficits might be driven by lower task performance among patients. To test this hypothesis, we conducted a Bayesian meta-analysis of 42 studies comparing metacognitive abilities in 1425 individuals with schizophrenia compared to 1256 matched controls. We found a global metacognitive deficit in schizophrenia (g = -0.57, 95 % CrI [-0.72, -0.43]), which was driven by studies which did not control task performance (g = -0.63, 95 % CrI [-0.78, -0.49]), and inconclusive among controlled-studies (g = -0.23, 95 % CrI [-0.60, 0.16], BF01 = 2.2). No correlation was found between metacognitive deficit and clinical features. We provide evidence that the metacognitive deficit in schizophrenia is inflated due to non-equated task performance. Thus, efforts should be made to develop experimental protocols accounting for lower task performance in schizophrenia.
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Affiliation(s)
- Martin Rouy
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France.
| | - Pauline Saliou
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
| | - Ladislas Nalborczyk
- Univ. Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, 38000, Grenoble, France
| | - Michael Pereira
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
| | - Paul Roux
- Service universitaire de psychiatrie d'adulte et d'addictologie du Centre Hospitalier de Versailles, CESP, Equipe DisAP-DevPsy, INSERM, Université Paris-Saclay et Université de Versailles Saint-Quentin-En-Yvelines, France
| | - Nathan Faivre
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France
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12
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Baena-Oquendo S, Valencia JG, Vargas C, López-Jaramillo C. Neuropsychological Aspects of Bipolar Disorder. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 51:S0034-7450(20)30092-5. [PMID: 33735035 DOI: 10.1016/j.rcp.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/10/2020] [Indexed: 11/25/2022]
Abstract
Bipolar disorder (BD) is a chronic condition with serious consequences on the health and functionality of patients who suffer from it, with a high heritability and segregation, and a prevalence of between 1% and 2%. Neuropsychological deficits have been implicated as a very important issue related to BD prognosis, so a review was conducted of these deficits, the related factors and their functional consequences. It has been determined that the presence of neuropsychological deficits can vary in patients with BD according to their mood state, with a great influence of depressive symptoms on the cognitive variability of patients with respect to the general population and differences with respect to patients in the manic phase. In euthymic patients, the most affected cognitive domains are those of memory, attention, and executive function, associated with a more severe disease, sociodemographic vulnerability factors, and stable over time. A relationship has been found between poor cognitive performance, especially executive dysfunction, and objective functional deficit. Furthermore, cognitive differences have been outlined between BD and other serious mental illnesses that are described in the review.
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Affiliation(s)
- Stephen Baena-Oquendo
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Jenny García Valencia
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Cristian Vargas
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
| | - Carlos López-Jaramillo
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
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13
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Cotrena C, Damiani Branco L, Milman Shansis F, Paz Fonseca R. "Influence of modifiable and non-modifiable variables on functioning in bipolar disorder: a path analytical study". Int J Psychiatry Clin Pract 2020; 24:398-406. [PMID: 32692269 DOI: 10.1080/13651501.2020.1779307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the influence of modifiable (mood, cognitive reserve, cognitive performance) and non-modifiable factors (diagnosis, suicide attempts, substance use, age) on self-reported functioning in BD. METHODS 103 adults with no mood disorders and 95 individuals with BD completed the WHODAS 2.0, in addition to a neuropsychological battery and diagnostic assessments. Path analysis was then used to analyse the relationships between modifiable and non-modifiable predictors of functioning in the sample. RESULTS Cognitive reserve and age had an indirect influence on individual functioning, mediated by cognitive performance. The influence of diagnosis and depressive symptoms on functioning was partly direct, and partly mediated by cognition. The presence of psychiatric comorbidities in addition to BD also had a significant influence on individual functioning. CONCLUSIONS Initiatives focussed on modifiable factors such as depressive symptoms and cognitively stimulating activities, which increase cognitive reserve, may be a useful complement to existing treatments and help patients achieve functional recovery. KEY POINTS Individual functioning was influenced by cognitive performance, cognitive reserve, age, diagnosis and depressive symptoms. Executive functioning mediated the influence of age and cognitive reserve on individual functioning. Interventions focussed on depressive symptoms and cognitive stimulation may help patients achieve functional recovery.
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Affiliation(s)
- Charles Cotrena
- Graduate Department of Psychology, School of Health Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS)
| | - Laura Damiani Branco
- Graduate Department of Psychology, School of Health Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS)
| | | | - Rochele Paz Fonseca
- Graduate Department of Psychology, School of Health Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS)
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Dhillon S, Videla-Nash G, Foussias G, Segal ZV, Zakzanis KK. On the nature of objective and perceived cognitive impairments in depressive symptoms and real-world functioning in young adults. Psychiatry Res 2020; 287:112932. [PMID: 32272334 DOI: 10.1016/j.psychres.2020.112932] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 02/09/2020] [Accepted: 03/18/2020] [Indexed: 01/29/2023]
Abstract
Cognitive impairments in depression contribute to disability. According to prevailing cognitive theories, one's perception related to cognitive ability can cause and maintain depression, and related outcomes. Here, we investigate the degree to which perceived cognitive impairment predicts functional impairment above and beyond objective neurocognition. A sample of young adults (n = 123) completed a battery of tests measuring objective cognitive ability, perceived cognitive function (e.g., Perceived Deficits Questionnaire), disability (e.g., World Health Organization Disability Assessment Schedule) and depressive symptoms (Beck Depression Inventory-2). Hierarchical multiple regression analyses tested the incremental variance that perceived cognitive impairment accounts for above and beyond neuropsychological test measures and disability related to depression. Results show that perceived cognitive impairment accounts for significant incremental variance in depressive symptoms beyond neuropsychological test scores; disability measures were significantly associated with depressive symptoms, as was perceived cognitive impairment. Individuals with depression and related disorders are more likely to report cognitive impairments and experience diminished cognitive ability - relative to healthy controls - regardless of objective impairments, highlighting the importance of considering, measuring, and treating this perceived cognitive impairment, that is, Cognitive Impairment Bias (Dhillon and Zakzanis, 2019).
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Affiliation(s)
- Sonya Dhillon
- Graduate Department of Psychological Clinical Science, University of Toronto, Canada.
| | | | - George Foussias
- Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Zindel V Segal
- Graduate Department of Psychological Clinical Science, University of Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Konstantine K Zakzanis
- Graduate Department of Psychological Clinical Science, University of Toronto, Canada; Department of Psychology, University of Toronto, Toronto, Canada
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Luo X, Zhu Y, Lu D, Zong K, Lin X. Subjective cognitive dysfunction in patients with bipolar disorder: The prevalence, related factors and effects on predicting psychosocial functioning and suicidal ideation. Psychiatry Res 2020; 284:112669. [PMID: 31740217 DOI: 10.1016/j.psychres.2019.112669] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 10/28/2019] [Accepted: 10/28/2019] [Indexed: 01/10/2023]
Abstract
Persistent cognitive deficits are prevalent during all stages of bipolar disorder (BD). However, few studies have examined subjective cognitive complaints in patients with BD. This study aimed to investigate the prevalence and relevant factors of subjective cognitive functioning and its potential effects on predicting psychosocial functioning and suicidal ideation in BD. Ninety-two patients with BD type I (including 42 depressed patients and 50 euthymic patients) and 60 healthy individuals were recruited for this study. All participants were assessed with a battery of neuropsychological tests examining attention and processing speed, visual memory, working memory and executive functions, as well as the Cognitive Complaints in Bipolar Disorder Rating Assessment, the Global Assessment of Functioning scale and the Beck Scale for Suicide Ideation. Bipolar patients exhibited worse subjective cognitive dysfunction compared with healthy individuals, and depressed patients expressed more cognitive complaints than euthymic bipolar patients. In bipolar group, psychosocial functioning, suicidal ideation and occupational status were the main relevant factors of subjective cognitive functioning. Subjective cognitive functioning could also predict psychosocial functioning and suicidal ideation. Depressive symptoms moderated the associations between objective cognitive functioning and suicidal ideation, but could not moderate the correlations between cognitive functioning and psychosocial functioning. These findings suggest that subjective cognitive assessment should be further emphasized in clinical practice.
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Affiliation(s)
- Xia Luo
- School of Nursing, Sun Yat-sen University, Guangzhou 510078, China
| | - Yinghua Zhu
- School of Nursing, Sun Yat-sen University, Guangzhou 510078, China
| | - Dali Lu
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen 361012, China
| | - Kunlun Zong
- Department of Psychiatry,The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Xiaoling Lin
- School of Nursing, Sun Yat-sen University, Guangzhou 510078, China.
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Neurocognitive impairment and evidence-based treatment options in Bipolar disorder. Ann Gen Psychiatry 2020; 19:54. [PMID: 32983247 PMCID: PMC7513501 DOI: 10.1186/s12991-020-00304-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 09/17/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The current paper briefly summarizes the literature on the neurocognitive deficit and its treatment in BD patients. METHODS The material was chosen on the basis of previous systematic reviews the author has taken part in. RESULTS The data so far suggest that the deficit is qualitatively similar but quantitatively milder in comparison to schizophrenia, it is present already since the first episode, is weakly related to mood symptoms and somewhat stronger to psychotic symptoms, it probably determines much of the disability and treatment is problematic. This deficit is also present during periods of euthymia. The possible adverse effect of psychotropic medication is rather small if any at all and is confounded by the specific clinical symptoms, for which medication is used for their treatment. This is especially true concerning antipsychotics and psychotic symptoms. The origin and the etiopathogenesis of the core neurocognitive impairment remain elusive. The presence of a neurodegenerative and of a neurodevelopmental component has both data in favor and against and they are both the focus of debate. CONCLUSIONS Treatment of the neurocognitive deficit and restoration of functioning is problematic. The data are limited and treatment options are few and with a weak overall effect. Pharmacological treatments, ECT and rTMS present some hard data, while the literature is inconclusive concerning psychotherapeutic interventions.
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Miranda M, Morici JF, Zanoni MB, Bekinschtein P. Brain-Derived Neurotrophic Factor: A Key Molecule for Memory in the Healthy and the Pathological Brain. Front Cell Neurosci 2019; 13:363. [PMID: 31440144 PMCID: PMC6692714 DOI: 10.3389/fncel.2019.00363] [Citation(s) in RCA: 722] [Impact Index Per Article: 144.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 07/25/2019] [Indexed: 12/13/2022] Open
Abstract
Brain Derived Neurotrophic Factor (BDNF) is a key molecule involved in plastic changes related to learning and memory. The expression of BDNF is highly regulated, and can lead to great variability in BDNF levels in healthy subjects. Changes in BDNF expression are associated with both normal and pathological aging and also psychiatric disease, in particular in structures important for memory processes such as the hippocampus and parahippocampal areas. Some interventions like exercise or antidepressant administration enhance the expression of BDNF in normal and pathological conditions. In this review, we will describe studies from rodents and humans to bring together research on how BDNF expression is regulated, how this expression changes in the pathological brain and also exciting work on how interventions known to enhance this neurotrophin could have clinical relevance. We propose that, although BDNF may not be a valid biomarker for neurodegenerative/neuropsychiatric diseases because of its disregulation common to many pathological conditions, it could be thought of as a marker that specifically relates to the occurrence and/or progression of the mnemonic symptoms that are common to many pathological conditions.
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Affiliation(s)
- Magdalena Miranda
- Laboratory of Memory Research and Molecular Cognition, Institute for Cognitive and Translational Neuroscience, Instituto de Neurología Cognitiva, CONICET, Universidad Favaloro, Buenos Aires, Argentina
| | - Juan Facundo Morici
- Laboratory of Memory Research and Molecular Cognition, Institute for Cognitive and Translational Neuroscience, Instituto de Neurología Cognitiva, CONICET, Universidad Favaloro, Buenos Aires, Argentina
| | - María Belén Zanoni
- Laboratory of Memory Research and Molecular Cognition, Institute for Cognitive and Translational Neuroscience, Instituto de Neurología Cognitiva, CONICET, Universidad Favaloro, Buenos Aires, Argentina
| | - Pedro Bekinschtein
- Laboratory of Memory Research and Molecular Cognition, Institute for Cognitive and Translational Neuroscience, Instituto de Neurología Cognitiva, CONICET, Universidad Favaloro, Buenos Aires, Argentina
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Toyoshima K, Inoue T, Masuya J, Ichiki M, Fujimura Y, Kusumi I. Evaluation Of Subjective Cognitive Function Using The Cognitive Complaints In Bipolar Disorder Rating Assessment (COBRA) In Japanese Adults. Neuropsychiatr Dis Treat 2019; 15:2981-2990. [PMID: 31695389 PMCID: PMC6804676 DOI: 10.2147/ndt.s218382] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 10/02/2019] [Indexed: 01/09/2023] Open
Abstract
PURPOSE To examine the relationship between depressive symptoms, subjective cognitive function, and quality of life in Japanese adults using the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA). PATIENTS AND METHODS We evaluated 585 adult community volunteers using the Patient Health Questionnaire-9 (PHQ-9) for evaluation of depressive symptoms and the COBRA for evaluation of subjective cognitive function. We additionally used the 8-item Short-Form Health Survey and the Sheehan Disability Scale to evaluate the quality of life (QoL). RESULTS Measures of subjective cognitive function were significantly correlated with depressive symptoms and QoL. Structural equation modeling demonstrated that depressive symptoms directly and indirectly decreased QoL via their effects on subjective cognitive dysfunction. Measures of depressive symptoms were more closely related to QoL than were measures of subjective cognitive function. LIMITATIONS Study participants were general adult population community volunteers and included healthy people; thus, these results may not be generalizable to patients with depression or bipolar disorder. In addition, the cross-sectional design of this study prevented the identification of causal relationships among the parameters. CONCLUSION Changes in subjective cognitive function may affect QoL via depressive symptoms. Evaluations of subjective cognitive function may help identify factors that reduce QoL.
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Affiliation(s)
- Kuniyoshi Toyoshima
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| | - Jiro Masuya
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| | - Masahiko Ichiki
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| | - Yota Fujimura
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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