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Neurocognitive heterogeneity in patients with bipolar disorder and their unaffected relatives: associations with emotional cognition

Published online by Cambridge University Press:  26 December 2019

Hanne Lie Kjærstad Open the ORCID record for Hanne Lie Kjærstad [Opens in a new window] ,
Fillip Ferreira Eikeseth Open the ORCID record for Fillip Ferreira Eikeseth [Opens in a new window] ,
Maj Vinberg Open the ORCID record for Maj Vinberg [Opens in a new window] ,
Lars Vedel Kessing Open the ORCID record for Lars Vedel Kessing [Opens in a new window]  and
Kamilla Miskowiak Open the ORCID record for Kamilla Miskowiak [Opens in a new window]
Hanne Lie Kjærstad*
Affiliation:
Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
Fillip Ferreira Eikeseth
Affiliation:
Department of Psychology, University of Copenhagen, Copenhagen, Denmark
Maj Vinberg
Affiliation:
Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
Lars Vedel Kessing
Affiliation:
Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
Kamilla Miskowiak
Affiliation:
Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark Department of Psychology, University of Copenhagen, Copenhagen, Denmark
*
Author for correspondence: Hanne Lie Kjærstad, E-mail: [email protected]
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Abstract

Background

Recent evidence suggests that neurocognitive impairments in remitted patients with bipolar disorder (BD) are heterogeneous. Our study aims to replicate recent findings of neurocognitive subgroups, and further explore whether these are related to impairments in affective cognition, in a large sample of remitted patients recently diagnosed with BD and their unaffected relatives compared to healthy controls (HCs).

Methods

Hierarchal cluster analysis was conducted using neurocognitive data from remitted patients with BD (n = 158). Relatives of patients with BD (n = 52) were categorised into groups consistent with their affected relative's cluster assignment. The neurocognitive clusters of patients with BD and relatives, respectively, were compared with HCs (n = 110) in neurocognition and affective cognition (i.e. emotion processing and regulation).

Results

Three discrete neurocognitive clusters were identified in patients with BD: a globally impaired (23.4%), a selectively impaired (31.0%) and a cognitively intact cluster (45.6%). The neurocognitive subgroups differed in affective cognition, with patients categorised as globally impaired exhibited most impairments in facial expression recognition and emotion regulation in social scenarios. First-degree relatives of cognitively impaired patients displayed impaired facial expression recognition but no impairments in non-emotional cognition.

Conclusions

In a clinical sample of remitted patients recently diagnosed with BD 54.4% had either global or selective cognitive impairment, replicating results of previous studies in patients with longer illness duration. The results suggest that patterns of neurocognition are associated with differential impairments in affective cognition. Aberrant affective cognition in relatives of patients categorised as neurocognitively impaired indicates an inherited risk for BD.

Keywords

Bipolar disordercognitioncognitive heterogeneitycognitive impairmentendophenotypenewly diagnosedrelatives
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 4 , March 2021 , pp. 668 - 679
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Copyright
Copyright © Cambridge University Press 2019

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