Neurocognitive predictors of functional outcome in patients with bipolar disorder

Abstract

Introduction

Neurocognitive deficits are known as a core feature in bipolar disorder (BPD). Persisting neurocognitive impairment is associated with low self-reported quality of life and low psychosocial functioning. Current findings indicate the importance of adjunctive psychosocial interventions in the treatment of BPD patients to enhance symptomatic and functional outcome.

Objectives

To assess whether functional outcome in patients with BPD is affected by cognitive psychoeducational therapy, clinical parameters and cognitive impairment.

Aims

To identify potential predictors of functional outcome, global clinical impression and early recurrence in patients with BPD.

Methods

Using a neurocognitive test battery 43 patients with BPD in euthymic state were compared to 40 healthy controls. Patients were assigned to two treatment Conditions cognitive psychoeducational therapy over 14 weeks (n = 19, 12 female, age) and treatment-as-usual (n = 24, 14 female). Predictors for functional disability, global clinical impression and early recurrence including clinical and cognitive variables as well as treatment conditions were examined using logistic regression.

Results

Compared to healthy controls patients with BPD showed lower performance in executive function (p < 0.01) and sustained attention (p < 0.001). Cognitive psychoeducation (p < 0.05) and subthreshold depressive symptoms (p < 0.05) were predictors for occupational functioning. Age (p < 0.05), delayed verbal memory (p < 0.05) and word fluency (p < 0.05) predicted global clinical impression. Recurrence in the follow-up period of 12 months was predicted by delayed verbal memory (p < 0.05).

Conclusions

Patients with BPD seem to benefit from cognitive psychoeducational training mainly in areas of working life. The extent of cognitive impairment appears to impact clinical outcome and recurrence rate.