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Armstrong M, Kaufman J, Maciarz J, Sullivan D, Kim J, Koppelmans V, Langenecker S, Weisenbach SL. The relationship between personality and cognition in older adults with and without early-onset depression. Front Psychiatry 2024; 15:1337320. [PMID: 39050920 PMCID: PMC11266124 DOI: 10.3389/fpsyt.2024.1337320] [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: 11/12/2023] [Accepted: 06/17/2024] [Indexed: 07/27/2024] Open
Abstract
Introduction It is well established that personality traits impact cognition, as certain personality factors are associated with performance in specific cognitive domains. However, the findings on the relationships between the Big Five traits and cognition are mixed. Additionally, few studies have explored these relationships in older adults with a history of depression. The present study aimed to (a) evaluate the impact of the Big Five personality traits in older adults with and without a lifetime history of depression; and (b) test the hypotheses that higher trait neuroticism would correlate negatively with cognitive performance, while openness to experience would correlate positively with cognition. Methods The sample consisted of 138 participants between the ages of 55 and 78 (M = 65.56, SD = 6.36). Sixty-two participants met criteria for current or remitted Major Depressive Disorder, while 76 had no history of depression or other mental health disorders. Participants underwent comprehensive neuropsychological testing. Personality was assessed using the NEO Personality Inventory-Revised (NEO-PI-R), while depression status was determined using the Structured Clinical Interview for DSM-5 (SCID-5). Following a series of Pearson correlations of cognitive variables and the five personality factors, linear regression models were estimated for each significant correlation. Demographic variables (i.e., age, education and sex) were entered in block 1, depression status (never vs. ever) was entered in block 2, and the personality factor score, or sub-facet was entered in block 3. Results Neuroticism was not associated with cognitive performance on any outcome measure. The facets Openness to Feelings and Openness to Values were positively related to phonemic fluency. Further Openness to Values was positively related to cognitive flexibility. Discussion Our results suggest that older people who are (a) more capable of identifying and understanding their feelings and the feelings of others, and (b) who are more willing to re-examine social, political, and religious values perform stronger on tasks measuring verbal fluency and cognitive flexibility, which are aspects of executive functioning. Interventions that aim to enhance open mindedness in older adults may have a parallel impact on improving executive functioning, though this would need to be examined prospectively.
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Affiliation(s)
- Megan Armstrong
- Stony Brook University, Stony Brook Medicine, Stony Brook, NY, United States
| | - Jack Kaufman
- University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Jeremy Maciarz
- McLean Hospital, Mass General Brigham, Belmont, MA, United States
| | - Daniel Sullivan
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Joseph Kim
- Brigham and Women’s Hospital, Mass General Brigham, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Cambridge, MA, United States
| | - Vincent Koppelmans
- Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
| | - Scott Langenecker
- Department of Psychiatry, Ohio State University, Columbus, OH, United States
| | - Sara L. Weisenbach
- Stony Brook University, Stony Brook Medicine, Stony Brook, NY, United States
- McLean Hospital, Mass General Brigham, Belmont, MA, United States
- Department of Psychiatry, Harvard Medical School, Cambridge, MA, United States
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Fleischmann E, Dalkner N, Fellendorf FT, Bengesser SA, Lenger M, Birner A, Queissner R, Platzer M, Tmava-Berisha A, Maget A, Wagner-Skacel J, Stross T, Schmiedhofer F, Smolle S, Painold A, Reininghaus EZ. The Big Five as Predictors of Cognitive Function in Individuals with Bipolar Disorder. Brain Sci 2023; 13:brainsci13050773. [PMID: 37239245 DOI: 10.3390/brainsci13050773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/02/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023] Open
Abstract
The connection between cognitive function and the "Big Five" personality traits (openness, conscientiousness, extraversion, agreeableness, and neuroticism) in the general population is well known; however, studies researching bipolar disorder (BD) are scarce. Therefore, this study aimed to investigate the Big Five as predictors of executive function, verbal memory, attention, and processing speed in euthymic individuals with BD (cross-sectional: n = 129, including time point t1; longitudinal: n = 35, including t1 and t2). Participants completed the NEO Five-Factor Inventory, the Color and Word Interference Test, the Trail Making Test, the d2 Test of Attention Revised, and the California Verbal Learning Test. The results showed a significant negative correlation between executive function and neuroticism at t1. Changes in cognitive function between t1 and t2 did not correlate with and could not be predicted by the Big Five at t1. Additionally, worse executive function at t2 was predicted by higher neuroticism and lower conscientiousness at t1, and high neuroticism was a predictor of worse verbal memory at t2. The Big Five might not strongly impact cognitive function over short periods; however, they are significant predictors of cognitive function. Future studies should include a higher number of participants and more time in between points of measurement.
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Affiliation(s)
- Eva Fleischmann
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Styria, Austria
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Styria, Austria
| | - Frederike T Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Styria, Austria
| | - Susanne A Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Styria, Austria
| | - Melanie Lenger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Styria, Austria
| | - Armin Birner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Styria, Austria
| | - Robert Queissner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Styria, Austria
| | - Martina Platzer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Styria, Austria
| | - Adelina Tmava-Berisha
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Styria, Austria
| | - Alexander Maget
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Styria, Austria
| | - Jolana Wagner-Skacel
- Department of Medical Psychology and Psychotherapy, Medical University of Graz, 8036 Graz, Styria, Austria
| | - Tatjana Stross
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Styria, Austria
| | - Franziska Schmiedhofer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Styria, Austria
| | - Stefan Smolle
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Styria, Austria
| | - Annamaria Painold
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Styria, Austria
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, 8036 Graz, Styria, Austria
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Hanke N, Penzel N, Betz LT, Rohde M, Kambeitz-Ilankovic L, Kambeitz J. Personality traits differentiate patients with bipolar disorder and healthy controls - A meta-analytic approach. J Affect Disord 2022; 302:401-411. [PMID: 35041870 DOI: 10.1016/j.jad.2022.01.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 01/08/2022] [Accepted: 01/13/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Expression of specific personality traits has been associated with the presence and disease course of bipolar disorder (BD) in multiple studies. However, until today findings are inconsistent and potentially confounding factors such as age and gender as well as the limited sample size of previous studies make it difficult to generalize these findings. To overcome these limitations and to specify the role of personality traits in the context of BD, we performed a meta-analysis in patients with BD and healthy controls (HC), focusing on the traits of the big three and the big five: Neuroticism (N), Extraversion (E), Openness (O), Conscientiousness (C), Agreeableness (A) and Psychoticism (P). METHODS Two online databases (Pubmed and Web of Science) were searched systematically to identify relevant articles, including publications up to December 31, 2019. From studies that met our inclusion criteria (n = 18), we extracted relevant data of patients with BD (n = 1694) and HC (n = 2153) and calculated effect sizes for each personality trait. Further, we performed moderator analysis on gender, age, quality score and years of publication. RESULTS Our results indicate that patients with BD exhibit higher scores on N (large positive effect size; n = 18, g = 1.44, 95%-CI : 1.11 to 1.77) and lower scores on C (medium negative effect size; n = 6, g = -0.78, 95%-CI: -1.13 to -0.43) and E (small negative effect size; n = 13, g = -0.38, 95%-CI: -0.52 to -0.23) compared to HC. We found a moderating effect of mean age on the effect size of N with smaller differences in N levels between patients with BD and HC in older samples (-0.0437, z = - 3.96, p <0.0001). Our results were robust with respect to potential publication biases and the inclusion of potentially confounding factors such as gender, age, quality score and years of publication. LIMITATIONS Due to the lack of available data no subgroup analysis on the effect of mood states of patients and subtypes of BD could be performed. Moreover, our analyses are based on cross-sectional data so that findings should be interpreted with care, especially concerning causal conclusions. CONCLUSIONS Patients with BD showed differences in several personality traits compared to HC. Our results provide the basis for future research with focus on personality and psychopathology in patients with BD. Identifying the interaction between expressions of personality traits and BD might provide novel approaches in prevention and therapy.
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Affiliation(s)
- Natalie Hanke
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Straße 62, Cologne 50931, Germany
| | - Nora Penzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Straße 62, Cologne 50931, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Linda T Betz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Straße 62, Cologne 50931, Germany
| | - Melanie Rohde
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Straße 62, Cologne 50931, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Straße 62, Cologne 50931, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Kerpener Straße 62, Cologne 50931, Germany.
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Montejo L, Torrent C, Jiménez E, Martínez-Arán A, Blumberg HP, Burdick KE, Chen P, Dols A, Eyler LT, Forester BP, Gatchel JR, Gildengers A, Kessing LV, Miskowiak KW, Olagunju AT, Patrick RE, Schouws S, Radua J, Bonnín CDM, Vieta E. Cognition in older adults with bipolar disorder: An ISBD task force systematic review and meta-analysis based on a comprehensive neuropsychological assessment. Bipolar Disord 2022; 24:115-136. [PMID: 34978124 DOI: 10.1111/bdi.13175] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES We aim to characterize the cognitive performance in euthymic older adults with bipolar disorder (OABD) through a comprehensive neuropsychological assessment to obtain a detailed neuropsychological profile. METHODS We conducted a systematic search in MEDLINE/Pubmed, Cochrane, and PsycInfo databases. Original studies assessing cognitive function in OABD (age ≥50 years ) containing, at a minimum, the domains of attention/processing speed, memory, and executive functions were included. A random-effects meta-analysis was conducted to summarize differences between patients and matched controls in each cognitive domain. We also conducted meta-regressions to estimate the impact of clinical and socio-demographic variables on these differences. RESULTS Eight articles, providing data for 328 euthymic OABD patients and 302 healthy controls, were included in the meta-analysis. OABD showed worse performance in comparison with healthy controls, with large significant effect sizes (Hedge's g from -0.77 to -0.89; p < 0.001) in verbal learning and verbal and visual delayed memory. They also displayed statistically significant deficits, with moderate effect size, in processing speed, working memory, immediate memory, cognitive flexibility, verbal fluency, psychomotor function, executive functions, attention, inhibition, and recognition (Hedge's g from -0.52 to -0.76; p < 0.001), but not in language and visuoconstruction domains. None of the examined variables were associated with these deficits. CONCLUSIONS Cognitive dysfunction is present in OABD, with important deficits in almost all cognitive domains, especially in the memory domain. Our results highlight the importance of including a routine complete neuropsychological assessment in OABD and also considering therapeutic strategies in OABD.
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Affiliation(s)
- Laura Montejo
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Carla Torrent
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Esther Jiménez
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Anabel Martínez-Arán
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Hilary P Blumberg
- Mood Disorders Research Program, Yale School of Medicine, New Haven, Connecticut, USA
| | - Katherine E Burdick
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Peijun Chen
- Section of Geriatric Psychiatry, Department of Psychiatry & VISN10 Geriatric Research, Education and Clinical Center, VA Northeast Ohio Healthcare System Cleveland VA Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Annemieke Dols
- GGZ inGeest, Department of Psychiatry, Amsterdam UMC, location VU Medical Center, Amsterdam Neuroscience, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Lisa T Eyler
- Department of Psychiatry, University of California, San Diego, California, USA
- Desert-Pacific Mental Illness Research, Education and Clinical Center, VA San Diego Healthcare System, San Diego, California, USA
| | - Brent P Forester
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jennifer R Gatchel
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Ariel Gildengers
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Lars V Kessing
- Copenhagen Affective Disorder research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen, Denmark
| | - Kamilla W Miskowiak
- Copenhagen Affective Disorder research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Regan E Patrick
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sigfried Schouws
- GGZ inGeest, Department of Psychiatry, Amsterdam UMC, location VU Medical Center, Amsterdam Neuroscience, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Joaquim Radua
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- CIBERSAM, Madrid, Spain
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Clinical Neuroscience, Stockholm Health Care Services, Stockholm County Council, Karolinska Institutet, Stockholm, Sweden
| | - Caterina Del M Bonnín
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
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Zazula R, Mohebbi M, Dodd S, Dean OM, Berk M, Vargas HO, Nunes SOV. Cognitive Profile and Relationship with Quality of Life and Psychosocial Functioning in Mood Disorders. Arch Clin Neuropsychol 2021; 37:376-389. [PMID: 34259318 DOI: 10.1093/arclin/acab054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/14/2021] [Accepted: 06/21/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Comparisons between healthy controls (HCs) and individuals with mood disorders have shown more cognitive dysfunction among the latter group, in particular in bipolar disorder (BD). This study aimed to characterize the pattern of cognitive function of BD and major depressive disorder (MDD) and compare them to HC using the (CogState Research Battery) CSRB™. METHOD Participants were tested, comprising the following domains: processing speed, attention, working memory, visual memory, executive functions, and verbal memory. Quality of life and functionality were also assessed. Multiple linear regression models were performed to examine the effect of demographic characteristics and functionality on cognitive outcomes separately for BD and MDD. RESULTS Ninety individuals participated in the study, of which 32 had BD, 30 had MDD, and 28 were HC. Differences were found between both BD and MDD and HC for the composite cognitive score, with significant differences between BD and HC (Diff = -5.5, 95% CI = [-9.5, -1.5], p = 0.005), and MDD and HC (Diff = -4.6, 95% CI = [-8.6, -0.5], p = 0.025). There were overall significant differences in five cognitive domains: processing speed (p = 0.001 and p = 0.004), attention (p = 0.002), working memory (p = 0.02), visual memory (p = 0.021), and verbal memory (p = 0.007). BD also presented worse performance than both MDD and HC, and MDD presented better performance than BD but worse than HC in quality of life and functionality. Multiple linear regression models were significative for education (p < 0.001) and age (p = 0.004) for BD and education (p < 0.001) for MDD. CONCLUSION In general, cognition is more affected in BD than MDD, which could be associated with functional and quality of life impairment.
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Affiliation(s)
- Robson Zazula
- Federal University for Latin American Integration, Foz do Iguacu, Brazil.,Londrina State University, Health Sciences Graduate Program, Londrina, Brazil
| | - Mohammadreza Mohebbi
- Deakin University, iMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, Australia.,Biostatistics Unit, Faculty of Health, Deakin University, Melbourne, Australia
| | - Seetal Dodd
- Deakin University, iMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Olivia M Dean
- Deakin University, iMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, Australia.,Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Michael Berk
- Deakin University, iMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia.,Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.,Orygen, the National Centre of Excellence in Youth Mental Health and the Centre of Youth Mental Health, University of Melbourne, Parkville, Australia
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Omer E, Braw Y, Amiaz R, Ravona-Springer R. Executive functioning of older adults with bipolar disorder. Int J Geriatr Psychiatry 2021; 36:106-115. [PMID: 33411378 DOI: 10.1002/gps.5402] [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: 04/03/2019] [Revised: 05/18/2020] [Accepted: 08/08/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Despite their impact on daily functioning, we have limited understanding of the executive functioning of older adults with bipolar disorder (OABD). Even less is known about the possible differences in the executive functioning of OABD and older adults with unipolar depression (OADEP). METHODS After excluding acutely ill patients, the executive functioning of OABD was compared to that of OADEP and healthy controls (n = 22, n = 20, n = 22; respectively). Cognitive insight, a sub-domain of executive functioning, was operationalized as the discrepancy between the participants' self-reported cognitive functioning and appraisals that were made by their care partners. To complement the cognitive profiling, the groups were compared in information processing speed, verbal memory, and visual-spatial memory. RESULTS OABD were impaired in several cognitive domains compared to healthy controls, most prominently in executive functioning and memory. OABD had poorer executive functioning and visual-spatial memory than OADEP. The findings also tentatively point toward intact cognitive insight among OABD, while OADEP seem to have a heightened level of awareness of their cognitive impairment. CONCLUSIONS OABD have a unique profile of cognitive impairment compared to OADEP. It is characterized by a more severe cognitive impairment, accompanied by relatively intact cognitive insight. The findings may help clarify the cognitive profile of OABD and assist in the development of cognitive rehabilitation programs tailored to their needs. They should, however, be considered preliminary and await further research.
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Affiliation(s)
- Elad Omer
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel.,Department of Psychology, Ariel University, Ariel, Israel
| | - Yoram Braw
- Department of Psychology, Ariel University, Ariel, Israel.,Memory Clinic, Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel
| | - Revital Amiaz
- Psychiatry Division, Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Ramit Ravona-Springer
- Memory Clinic, Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Robin A, Sauvaget A, Deschamps T, Bulteau S, Thomas-Ollivier V. Combined Measures of Psychomotor and Cognitive Alterations as a Potential Hallmark for Bipolar Depression. Psychiatry Investig 2019; 16:954-957. [PMID: 31870090 PMCID: PMC6933132 DOI: 10.30773/pi.2019.0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/03/2019] [Accepted: 11/07/2019] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The current study aimed to examine whether specific features of psychomotor retardation (PMR) and cognitive functioning established different profiles in unipolar (UD) and bipolar depression (BD). METHODS Two groups of age-matched patients with UD (n=54) and BD (n=20) completed the Montgomery-Asberg Depression Rating Scale (MADRS/60), the Montreal Cognitive Assessment (MoCA/30), and the Salpêtrière Retardation Rating Scale (SRRS/60). We analyzed the group effect and then performed intra-group analyses. RESULTS The BD patients have higher SRRS score, and lower MoCA score than UD despite no difference on the level of depression between UD and BD. Our results show that PMR can be predicted by the level of depression in UD and by the cognitive alteration and onset of disease in BD. CONCLUSION PMR is a relevant marker of depression. Our results highlight the importance of concomitant evaluation of psychomotor and cognitive functions in the distinction of UD and BD symptoms.
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Affiliation(s)
- Alison Robin
- Laboratory “Movement, Interactions, Performance” (E.A. 4334), Faculty of Sport Sciences, University of Nantes, Nantes, France
- Addictology and Liaison Psychiatry Department, University Hospital Nantes, Nantes, France
| | - Anne Sauvaget
- Laboratory “Movement, Interactions, Performance” (E.A. 4334), Faculty of Sport Sciences, University of Nantes, Nantes, France
- Addictology and Liaison Psychiatry Department, University Hospital Nantes, Nantes, France
| | - Thibault Deschamps
- Laboratory “Movement, Interactions, Performance” (E.A. 4334), Faculty of Sport Sciences, University of Nantes, Nantes, France
| | - Samuel Bulteau
- Addictology and Liaison Psychiatry Department, University Hospital Nantes, Nantes, France
| | - Véronique Thomas-Ollivier
- Laboratory “Movement, Interactions, Performance” (E.A. 4334), Faculty of Sport Sciences, University of Nantes, Nantes, France
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Seelye A, Thuras P, Doane B, Clason C, VanVoorst W, Urošević S. Steeper aging-related declines in cognitive control processes among adults with bipolar disorders. J Affect Disord 2019; 246:595-602. [PMID: 30605878 DOI: 10.1016/j.jad.2018.12.076] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/20/2018] [Accepted: 12/23/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Little is known about the specificity of executive functioning (EF) decline in older adults with bipolar disorders (OABD), or the impact of bipolar disorders (BD) on the timing and slope of age-related declines in EF processes implicated in both BD etiology and normative aging-cognitive control (CC). This cross-sectional study investigated age-related CC decline in BD. METHODS Participants were 43 adults with BD (M age = 61.5, SD = 15.8; 86% male) and 45 Controls (M age = 65.2, SD = 12.2; 98% male). Two-way ANOVAs examined the effects of median-age-split and diagnostic groups on cognitive processes with established BD deficits-CC processes (mental flexibility and response inhibition), verbal learning, and verbal fluency. RESULTS The median-split-age-by-diagnostic-group interaction was significant for mental flexibility; OABD performed significantly worse than younger adults with BD and younger and older Controls. Exploratory multivariate adaptive regression spline characterized non-linear nature of aging-slope changes in mental flexibility for each diagnostic group, yielding an inflection point at older age and steeper subsequent decline in OABD versus Controls. LIMITATIONS This study is limited by a small sample (particularly for select neuropsychological measures) of mostly Caucasian men and BD diagnoses based on clinical interview and medical records review. CONCLUSIONS Compared to healthy older adults, OABD showed steeper age-related decline in mental flexibility-select EF processes that depend on the integrity of the CC system. Preliminary evidence links CC integrity to daily functioning in OABD; accelerated aging decline in CC may pose a mechanism for high risk of functional impairment and dementia in OABD.
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Affiliation(s)
- Adriana Seelye
- Minneapolis VA Health Care System, Minneapolis, MN, United States; University of Minnesota, Department of Psychiatry, Minneapolis, MN, United States; Oregon Health & Science University, Department of Neurology, Portland, OR, United States; Oregon Center for Aging & Technology, Portland, OR, United States.
| | - Paul Thuras
- Minneapolis VA Health Care System, Minneapolis, MN, United States; University of Minnesota, Department of Psychiatry, Minneapolis, MN, United States
| | - Bridget Doane
- Minneapolis VA Health Care System, Minneapolis, MN, United States
| | - Christie Clason
- Minneapolis VA Health Care System, Minneapolis, MN, United States
| | - Wendy VanVoorst
- Minneapolis VA Health Care System, Minneapolis, MN, United States
| | - Snežana Urošević
- Minneapolis VA Health Care System, Minneapolis, MN, United States; University of Minnesota, Department of Psychiatry, Minneapolis, MN, United States
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Lee CY, Wang LJ, Lee Y, Hung CF, Huang YC, Lee MI, Lee SY. Differentiating bipolar disorders from unipolar depression by applying the Brief Assessment of Cognition in Affective Disorders. Psychol Med 2018; 48:929-938. [PMID: 28826415 DOI: 10.1017/s003329171700229x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Scholars continue to argue about whether bipolar disorders (BD) and unipolar depression (UD) are distinguishable with regard to neurocognitive function. This study aims to explore the cognitive profiles of UD and BD by applying the Brief Assessment of Cognition in Affective Disorders (BAC-A) for neuropsychological assessment. METHOD This cross-sectional study included 68 patients with UD, 67 patients with BD, and 135 healthy control subjects. We evaluated the participants' cognitive functions at euthymic status using the BAC-A, which is made up of six traditional cognitive subtests and the Affective Processing Test. We then used a discriminant function analysis (DFA) to determine whether cognitive performance can be used to distinguish these participant groups. RESULTS Healthy controls demonstrated better performance in all subtests of the BAC-A than both the UD and BD patients, with the exception of delayed recognition of affective interference. Compared with the BD group, the UD group exhibited better performance in working memory and emotion inhibition. Furthermore, using all BAC-A indexes, a total of 70% of participants could be correctly classified using a DFA model, and the discriminating validity between UD and BD was superior to using either the traditional cognitive domains or the Affective Processing Test alone. CONCLUSIONS We have found that UD patients may exhibit an intermediate performance between healthy subjects and BD patients in working memory and emotional inhibition tests. The BAC-A can potentially assist in differentiating BD patients from UD patients at euthymic status in clinical settings.
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Affiliation(s)
- C-Y Lee
- Department of Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan
| | - L-J Wang
- Department of Child and Adolescent Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan
| | - Y Lee
- Department of Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan
| | - C-F Hung
- Department of Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan
| | - Y-C Huang
- Department of Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan
| | - M-I Lee
- Department of Child and Adolescent Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan
| | - S-Y Lee
- Department of Psychiatry,School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University,Kaohsiung,Taiwan
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Terachi S, Yamada T, Pu S, Yokoyama K, Matsumura H, Kaneko K. Comparison of neurocognitive function in major depressive disorder, bipolar disorder, and schizophrenia in later life: A cross-sectional study of euthymic or remitted, non-demented patients using the Japanese version of the Brief Assessment of Cognition in Schizophrenia (BACS-J). Psychiatry Res 2017; 254:205-210. [PMID: 28476012 DOI: 10.1016/j.psychres.2017.04.058] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 03/29/2017] [Accepted: 04/23/2017] [Indexed: 12/11/2022]
Abstract
Major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ) are associated with cognitive dysfunction both in adulthood and in later life. In this study, we directly compared neurocognitive function between these three conditions in later life, employing stringent definitions of euthymia and symptomatic remission. Cognitive function in 60 elderly outpatients with MDD, BD, or SZ (20 patients per group) was assessed using the Japanese version of the Brief Assessment of Cognition in Schizophrenia. Patients with MDD had significantly higher z scores than both the other groups with large or moderately large effect sizes, for verbal fluency, attention and speed of information processing, and composite scores. In contrast, there were no significant differences in the degree of neurocognitive impairment between patients with BD and SZ. In later life, patients with BD and SZ showed a similar degree of neurocognitive impairment, while patients with MDD showed smaller impairments in several neurocognitive domains compared to patients with either of the other two disorders.
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Affiliation(s)
- Sayaka Terachi
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan; Kurayoshi Hospital, Kurayoshi, Tottori, Japan.
| | | | - Shenghong Pu
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
| | - Katsutoshi Yokoyama
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
| | - Hiroshi Matsumura
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
| | - Koichi Kaneko
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
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Szmulewicz AG, Valerio MP, Smith JM, Samamé C, Martino DJ, Strejilevich SA. Neuropsychological profiles of major depressive disorder and bipolar disorder during euthymia. A systematic literature review of comparative studies. Psychiatry Res 2017; 248:127-133. [PMID: 28040657 DOI: 10.1016/j.psychres.2016.12.031] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 11/09/2016] [Accepted: 12/23/2016] [Indexed: 11/16/2022]
Abstract
Bipolar disorder and major depressive disorder have been shown to be associated with neurocognitive abnormalities during periods of clinical remission. However, at present, there is no consensus on whether these disorders have distinctive cognitive profiles. The aim of this study was to provide an updated systematic review of studies comparing neuropsychological functioning between bipolar disorder and major depressive disorder during remission. Main findings included the following: 1) no differences regarding performances in measures of attention and processing speed, executive functions and theory of mind were found between both patient groups and 2) regarding verbal memory, preliminary evidence points towards a more defective performance in patients with bipolar disorder than those with major depressive disorder. However, several variables with negative impact on cognition (medication status, age at onset, premorbid IQ, bipolar subtype, among others) were not adequately controlled in most studies. In conclusion, evidence from studies exploring neuropsychological profiles in bipolar disorder and major depressive disorder could not provide clues to differentiate these mood disorders. Larger studies with adequate control of confounding variables would be necessary to elucidate if the finding of more defective verbal memory performance in bipolar disorder is truly explained by distinct underlying mechanisms.
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Affiliation(s)
- Alejandro G Szmulewicz
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; Hospital de Emergencias Psiquiátricas Torcuato de Alvear, Buenos Aires, Argentina; Department of Pharmacology, University of Buenos Aires, Buenos Aires, Argentina.
| | - Marina P Valerio
- Hospital de Emergencias Psiquiátricas Torcuato de Alvear, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - José M Smith
- Hospital de Emergencias Psiquiátricas Torcuato de Alvear, Buenos Aires, Argentina
| | - Cecilia Samamé
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; School of Psychology, University of Buenos Aires, Buenos Aires, Argentina
| | - Diego J Martino
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Sergio A Strejilevich
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina
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12
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Samamé C, Szmulewicz AG, Valerio MP, Martino DJ, Strejilevich SA. Are major depression and bipolar disorder neuropsychologically distinct? A meta-analysis of comparative studies. Eur Psychiatry 2016; 39:17-26. [PMID: 27810614 DOI: 10.1016/j.eurpsy.2016.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 06/18/2016] [Accepted: 06/20/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Neuropsychological deficits are present in both major depression and bipolar disorder. So far, however, reports directly comparing these mood disorders with regard to cognitive outcomes have been scant and yielded inconsistent results. This work aims to combine the findings of comparative studies of cognition in major depression and bipolar disorder in order to explore whether these neuropsychiatric conditions present with distinct cognitive features. METHODS The main online databases were extensively searched to retrieve reports assessing neurocognitive functioning in two groups of mood disorder patients, one with major depressive disorder and another with bipolar disorder, both in the same phase of illness. Between-group effect sizes for cognitive variables were obtained from selected studies and pooled by means of meta-analytic procedures. RESULTS During euthymia, a significant overall effect size (Hedges'g=0.64, P<0.001) favoring major depressive disorder was found for verbal memory as assessed with list learning tests, whereas no significant between-group differences were found for the remaining variables analyzed. During depressive episodes, similar cognitive outcomes were observed between groups. CONCLUSION At present, it is not possible to postulate specific neuropsychological profiles for major depression and bipolar disorder in light of available evidence. It remains to be ascertained whether the differences found for verbal memory constitute an expression of distinct underlying mechanisms or whether they are best explained by sample characteristics or differential exposure to variables with a negative impact on cognition.
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Affiliation(s)
- C Samamé
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; School of Psychology, University of Buenos Aires, Buenos Aires, Argentina
| | - A G Szmulewicz
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; Psychiatric Emergencies Hospital Torcuato de Alvear, Buenos Aires, Argentina
| | - M P Valerio
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Psychiatric Emergencies Hospital Torcuato de Alvear, Buenos Aires, Argentina
| | - D J Martino
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - S A Strejilevich
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina.
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13
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Schouws SNTM, Paans NPG, Comijs HC, Dols A, Stek ML. Coping and personality in older patients with bipolar disorder. J Affect Disord 2015; 184:67-71. [PMID: 26072315 DOI: 10.1016/j.jad.2015.05.045] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 05/22/2015] [Accepted: 05/22/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Little is known about coping styles and personality traits in older bipolar patients. Adult bipolar patients show a passive coping style and higher neuroticism scores compared to the general population. Our aim is to investigate personality traits and coping in older bipolar patients and the relationship between coping and personality. METHOD 75 Older patients (age > 60) with bipolar I or II disorder in a euthymic mood completed the Utrecht Coping List and the NEO Personality Inventory FFI and were compared to normative data. RESULTS Older bipolar patients show more passive coping styles compared to healthy elderly. Their personality traits are predominated by openness, in contrast conscientiousness and altruism are relatively sparse. Neuroticism was related to passive coping styles, whereas conscientiousness was related to an active coping style. CONCLUSIONS Older bipolar patients have more passive coping styles. Their personality is characterized by openness and relatively low conscientiousness and altruism. Our sample represents a survival cohort; this may explain the differences in personality traits between older patients in this study and in adult bipolar patients in other studies. The association between coping styles and personality traits is comparable to reports of younger adult patients with bipolar disorder. Longitudinal studies are warranted to explore if coping and personality change with ageing in bipolar patients and to determine which coping style is most effective in preventing mood episodes.
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Affiliation(s)
| | - Nadine P G Paans
- GGZ inGeest, Mental Health Institute, Amsterdam, The Netherlands
| | - Hannie C Comijs
- GGZ inGeest, Mental Health Institute, Amsterdam, The Netherlands; Department of Psychiatry, EMGO Institute of Care and Health Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Annemiek Dols
- GGZ inGeest, Mental Health Institute, Amsterdam, The Netherlands
| | - Max L Stek
- GGZ inGeest, Mental Health Institute, Amsterdam, The Netherlands
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14
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Chen MH, Li CT, Tsai CF, Lin WC, Chang WH, Chen TJ, Pan TL, Su TP, Bai YM. Risk of Subsequent Dementia Among Patients With Bipolar Disorder or Major Depression: A Nationwide Longitudinal Study in Taiwan. J Am Med Dir Assoc 2015; 16:504-8. [DOI: 10.1016/j.jamda.2015.01.084] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 01/14/2015] [Indexed: 10/23/2022]
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15
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Bai YM, Su TP, Li CT, Tsai SJ, Chen MH, Tu PC, Chiou WF. Comparison of pro-inflammatory cytokines among patients with bipolar disorder and unipolar depression and normal controls. Bipolar Disord 2015; 17:269-77. [PMID: 25257835 DOI: 10.1111/bdi.12259] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 06/27/2014] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Research evidence has shown that bipolar disorder (BD) and unipolar depression (UD) are both related to inflammatory dysregulation, but few studies have compared the levels of cytokines between these two disorders. METHODS Study subjects were age- and gender-matched outpatients with BD or UD and normal controls (NC). Severities of depression and mania symptoms were assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Young Mania Rating Scale (YMRS). Pro-inflammatory cytokines, including soluble interleukin-6 receptor (sIL-6R), soluble interleukin-2 receptor (sIL-2R), C-reactive protein (CRP), soluble tumor necrosis factor receptor type 1 (sTNF-R1), soluble p-selectin receptor (sP-selectin), and monocyte chemotactic protein-1 (MCP-1), were assessed in all subjects by enzyme-linked immunosorbent assays. RESULTS In all, 130 patients with BD, 149 patients with UD, and 130 NC were enrolled in the study; 67.6% were female and the average age was mean ± standard deviation (SD) 43.5 ± 11.8 years. The BD group had a significantly higher smoking rate, more medical comorbidity, higher body mass index (BMI), and higher levels of sIL-2R, sIL-6R, CRP, sTNF-R1, and MCP-1 (all p < 0.01) than the UD and NC groups. When the remitted patients with BD (YMRS scores ≤ 12) were compared with the patients with UD, controlling for age, MADRS score, smoking, medical comorbidity, and BMI in the regression model, the results showed that the BD group had significantly higher levels of sIL-6R (p < 0.001), CRP (p = 0.045), sTNF-R1 (p = 0.036), and MCP-1 (p = 0.001) than the UD group. CONCLUSIONS Higher levels of sIL-6R, CRP, sTNF-R1, and MCP-1 were noted in BD than in UD. These results may suggest a more severe inflammatory dysregulation in BD. Further studies are required to investigate whether these cytokines could be biomarkers for affective disorders.
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Affiliation(s)
- Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital; Department of Psychiatry, College of Medicine, National Yang-Ming University
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16
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Wang M, Saudino KJ. Genetic and environmental influences on individual differences in emotion regulation and its relation to working memory in toddlerhood. Emotion 2013; 13:1055-67. [PMID: 24098922 PMCID: PMC4108294 DOI: 10.1037/a0033784] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This is the first study to explore genetic and environmental contributions to individual differences in emotion regulation in toddlers, and the first to examine the genetic and environmental etiology underlying the association between emotion regulation and working memory. In a sample of 304 same-sex twin pairs (140 MZ, 164 DZ) at age 3, emotion regulation was assessed using the Behavior Rating Scale of the Bayley Scales of Infant Development (BRS; Bayley, 1993), and working memory was measured by the visually cued recall (VCR) task (Zelazo, Jacques, Burack, & Frye, 2002) and several memory tasks from the Mental Scale of the BSID. Based on model-fitting analyses, both emotion regulation and working memory were significantly influenced by genetic and nonshared environmental factors. Shared environmental effects were significant for working memory, but not for emotion regulation. Only genetic factors significantly contributed to the covariation between emotion regulation and working memory.
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17
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Koorevaar AML, Comijs HC, Dhondt ADF, van Marwijk HWJ, van der Mast RC, Naarding P, Oude Voshaar RC, Stek ML. Big Five personality and depression diagnosis, severity and age of onset in older adults. J Affect Disord 2013; 151:178-85. [PMID: 23820093 DOI: 10.1016/j.jad.2013.05.075] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 04/09/2013] [Accepted: 05/25/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Personality may play an important role in late-life depression. The aim of this study is to examine the association between the Big Five personality domains and the diagnosis, severity and age of onset of late-life depression. METHODS The NEO-Five Factor Inventory (NEO-FFI) was cross-sectionally used in 352 depressed and 125 non-depressed older adults participating in the Netherlands Study of Depression in Older Persons (NESDO). Depression diagnosis was determined by the Composite International Diagnostic Interview (CIDI). Severity of depression was assessed by the Inventory of Depressive Symptomatology (IDS). Logistic and linear regression analyses were applied. Adjustments were made for sociodemographic, cognitive, health and psychosocial variables. RESULTS Both the presence of a depression diagnosis and severity of depression were significantly associated with higher Neuroticism (OR=1.35, 95% CI=1.28-1.43 and B=1.06, p<.001, respectively) and lower Extraversion (OR=.79, 95% CI=.75-.83; B=-.85, p<.001) and Conscientiousness (OR=.86, 95% CI=.81.-.90; B=-.86, p<.001). Earlier onset of depression was significantly associated with higher Openness (B=-.49, p=.026). LIMITATIONS Due to the cross-sectional design, no causal inferences can be drawn. Further, current depression may have influenced personality measures. CONCLUSIONS This study confirms an association between personality and late-life depression. Remarkable is the association found between high Openness and earlier age of depression onset.
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Affiliation(s)
- A M L Koorevaar
- Department of Old-age and Hospital Psychiatry, GGZ Noord Holland Noord, Oude Hoeverweg 10, 1816 BT Alkmaar, The Netherlands.
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18
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Samamé C, Martino DJ, Strejilevich SA. A quantitative review of neurocognition in euthymic late-life bipolar disorder. Bipolar Disord 2013; 15:633-44. [PMID: 23651122 DOI: 10.1111/bdi.12077] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Accepted: 01/13/2013] [Indexed: 01/27/2023]
Abstract
OBJECTIVES A sizeable body of work has consistently documented that a number of euthymic mixed-age bipolar disorder subjects exhibit prominent impairments in a variety of cognitive domains. By contrast, knowledge about neuropsychological functioning in elderly patients is scant, despite being necessary for the adequate treatment of this population and the understanding of illness evolution. The aim of this study was to combine findings from the available literature in order to examine the pattern and extent of cognitive deficits in euthymic late-life bipolar disorder subjects. METHODS A literature search was conducted through the online databases PubMed, ScienceDirect, EBSCO, and Wiley-Blackwell, covering the period between January 1990 and April 2012. Effect sizes reflecting patient-control differences for 10 cognitive variables were extracted from selected investigations and combined by means of meta-analytical procedures. RESULTS No significant patient-control differences were found for global cognitive status as assessed with the Mini-Mental State Examination and the Clock Drawing Test. Significant overall effect sizes (Hedges' g) of between 0.61 and 0.88 were noted for sustained attention, digit span (forwards and backwards), delayed recall, serial learning, cognitive flexibility, and verbal fluency (phonemic and categorical). CONCLUSIONS The extent of cognitive dysfunction in euthymic late-life bipolar disorder subjects may be, on average, similar to that reported for remitted young adult patients. Larger effect sizes of impairment may be associated with late illness onset. Implications and future directions for research are proposed.
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Affiliation(s)
- Cecilia Samamé
- Bipolar Disorders Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina
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Quilty LC, Pelletier M, Deyoung CG, Michael Bagby R. Hierarchical personality traits and the distinction between unipolar and bipolar disorders. J Affect Disord 2013; 147:247-54. [PMID: 23261133 DOI: 10.1016/j.jad.2012.11.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 11/06/2012] [Indexed: 02/03/2023]
Abstract
BACKGROUND The association between personality and psychopathology can provide an insight into the structure of mental disorders and the shared etiology and pathophysiology underlying diagnoses with overlapping symptomatology. The majority of personality-psychopathology research pertinent to the mood disorders has focused upon traits at the higher-order levels of the personality hierarchy, rather than those at intermediate or lower levels. The purpose of the current investigation was to investigate whether unipolar and bipolar mood disorders, and the severity of depressive and manic symptoms, show differential associations with traits at multiple levels of the personality hierarchy. METHODS Participants (N=275; 63% women; mean age 42.95 years) with depressive disorders (n=139) and bipolar disorders (n=136), as assessed by the Structured Clinical Interview for DSM-IV, Axis I Disorders, Patient Version (SCID-I/P; First et al., 1995), completed the Hamilton Depression Rating Scale, Young Mania Scale, Revised NEO Personality Inventory and Big Five Aspect Scales. RESULTS Results support the hypothesis that lower levels of the personality hierarchy provide additional differentiation of affective pathology. As compared to the widespread association of depressive symptoms with traits across the personality hierarchy, manic symptoms demonstrated more specific associations with traits at lower levels of the personality hierarchy. LIMITATIONS Patients with severe mania were excluded, thus the full range of mania is not represented in the current sample. CONCLUSIONS These results support the use of lower-order personality traits to discriminate between unipolar versus bipolar mood disorder, and are consistent with changes proposed to the psychiatric nosology to increase diagnostic precision.
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Affiliation(s)
- Lena C Quilty
- Clinical Research Department, Centre for Addiction and Mental Health, Canada.
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20
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Coulston CM, Bargh DM, Tanious M, Cashman EL, Tufrey K, Curran G, Kuiper S, Morgan H, Lampe L, Malhi GS. Is coping well a matter of personality? A study of euthymic unipolar and bipolar patients. J Affect Disord 2013; 145:54-61. [PMID: 22921480 DOI: 10.1016/j.jad.2012.07.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 07/16/2012] [Accepted: 07/16/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Euthymic bipolar disorder (BD) patients often demonstrate better clinical outcomes than remitted patients with unipolar illness (UP). Reasons for this are uncertain, however, personality and coping styles are each likely to play a key role. This study examined differences between euthymic BD and UP patients with respect to the inter-relationship between personality, coping style, and clinical outcomes. METHODS A total of 96 UP and 77 BD euthymic patients were recruited through the CADE Clinic, Royal North Shore Hospital in Sydney, and assessed by a team comprising Psychiatrists and Psychologists. They underwent a structured clinical diagnostic interview, and completed self-report measures of depression, anxiety, stress, personality, coping, social adjustment, self-esteem, dysfunctional attitudes, and fear of negative evaluation. RESULTS Compared to UP, BD patients reported significantly higher scores on levels of extraversion, adaptive coping, self-esteem, and lower scores on trait anxiety and fear of negative evaluation. Extraversion correlated positively with self-esteem, adaptive coping styles, and negatively with trait anxiety and fear of negative evaluation. Trait anxiety and fear of negative evaluation correlated positively with eachother, and both correlated negatively with self-esteem and adaptive coping styles. Finally, self-esteem correlated positively with adaptive coping styles. LIMITATIONS The results cannot be generalised to depressive states of BD and UP, as differences in the course of illness and types of depression are likely to impact on coping and clinical outcomes, particularly for BD. CONCLUSIONS During remission, functioning is perhaps better 'preserved' in BD than in UP, possibly because of the protective role of extraversion which drives healthier coping styles.
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Affiliation(s)
- Carissa M Coulston
- CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, Sydney, Australia
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Snyder HR. Major depressive disorder is associated with broad impairments on neuropsychological measures of executive function: a meta-analysis and review. Psychol Bull 2013; 139:81-132. [PMID: 22642228 PMCID: PMC3436964 DOI: 10.1037/a0028727] [Citation(s) in RCA: 1032] [Impact Index Per Article: 93.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cognitive impairments are now widely acknowledged as an important aspect of major depressive disorder (MDD), and it has been proposed that executive function (EF) may be particularly impaired in patients with MDD. However, the existence and nature of EF impairments associated with depression remain strongly debated. Although many studies have found significant deficits associated with MDD on neuropsychological measures of EF, others have not, potentially due to low statistical power, task impurity, and diverse patient samples, and there have been no recent, comprehensive, meta-analyses investigating EF in patients with MDD. The current meta-analysis uses random-effects models to synthesize 113 previous research studies that compared participants with MDD to healthy control participants on at least one neuropsychological measure of EF. Results of the meta-analysis demonstrate that MDD is reliably associated with impaired performance on neuropsychological measures of EF, with effect sizes ranging from 0.32 to 0.97. Although patients with MDD also have slower processing speed, motor slowing alone cannot account for these results. In addition, some evidence suggests that deficits on neuropsychological measures of EF are greater in patients with more severe current depression symptoms, and those taking psychotropic medications, whereas evidence for effects of age was weaker. The results are consistent with the theory that MDD is associated with broad impairment in multiple aspects of EF. Implications for treatment of MDD and theories of EF are discussed. Future research is needed to establish the specificity and causal link between MDD and EF impairments.
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Affiliation(s)
- Hannah R Snyder
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO 80309, USA.
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Neuropathological substrates and structural changes in late-life depression: the impact of vascular burden. Acta Neuropathol 2012; 124:453-64. [PMID: 22836715 DOI: 10.1007/s00401-012-1021-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 07/13/2012] [Accepted: 07/17/2012] [Indexed: 01/01/2023]
Abstract
A first episode of depression after 65 years of age has long been associated with both severe macrovascular and small microvascular pathology. Among the three more frequent forms of depression in old age, post-stroke depression has been associated with an abrupt damage of cortical circuits involved in monoamine production and mood regulation. Late-onset depression (LOD) in the absence of stroke has been related to lacunes and white matter lesions that invade both the neocortex and subcortical nuclei. Recurrent late-life depression is thought to induce neuronal loss in the hippocampal formation and white matter lesions that affect limbic pathways. Despite an impressive number of magnetic resonance imaging (MRI) studies in this field, the presence of a causal relationship between structural changes in the human brain and LOD is still controversial. The present article provides a critical overview of the contribution of neuropathology in post-stroke, late-onset, and late-life recurrent depression. Recent autopsy findings challenge the role of stroke location in the occurrence of post-stroke depression by pointing to the deleterious effect of subcortical lacunes. Despite the lines of evidences supporting the association between MRI-assessed white matter changes and mood dysregulation, lacunes, periventricular and deep white matter demyelination are all unrelated to the occurrence of LOD. In the same line, neuropathological data show that early-onset depression is not associated with an acceleration of aging-related neurodegenerative changes in the human brain. However, they also provide data in favor of the neurotoxic theory of depression by showing that neuronal loss occurs in the hippocampus of chronically depressed patients. These three paradigms are discussed in the light of the complex relationships between psychosocial determinants and biological vulnerability in affective disorders.
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Weber K, Giannakopoulos P, Bacchetta JP, Quast S, Herrmann FR, Delaloye C, Ghisletta P, De Ribaupierre A, Canuto A. Personality traits are associated with acute major depression across the age spectrum. Aging Ment Health 2012; 16:472-80. [PMID: 22128822 DOI: 10.1080/13607863.2011.630375] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVES Psychological predictors, such as personality traits, have aroused growing interest as possible predictors of late-life depression outcome in old age. It remains, however, unclear whether the cross-sectional relationship between personality traits and depression occurrence reported in younger samples is also present in the elderly. METHODS Comparisons amongst 79 outpatients with DSM-IV major depression and 102 healthy controls included assessment of the five-factor model of personality (NEO PI-R), socio-demographic variables, physical health status, as well as depression features. Two sub-groups were considered, defined as young (25-50 years) and old (60-85 years) patients. RESULTS Depressed patients showed significantly higher levels of Neuroticism and lower levels of Extraversion, Openness to Experience and Conscientiousness compared to controls. Sequential logistic regression models confirmed that the combination of increased physical burden, levels of dependency, and increased Neuroticism strongly predicts the occurrence of acute depressive symptoms. In contrast, the levels of Neuroticism did not allow for differentiating late-life from young age depression. Increased physical burden and decreased depression severity were the main predictors for this distinction. CONCLUSION Our data indicate that personality factors and depression are related, independently of patients' age. Differences in this relationship are mainly due to the intensity of depressive symptoms rather than the patients' life period. They also stress the need to consider physical health, level of dependency and severity of symptoms when studying the relationship between personality traits and mood disorders.
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Affiliation(s)
- Kerstin Weber
- Division of Liaison Psychiatry and Crisis Intervention, University Hospitals of Geneva, Switzerland.
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