Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-28T06:25:04.211Z Has data issue: false hasContentIssue false

Longitudinal Study of Sustained Attention in Outpatients with Bipolar Disorder

Published online by Cambridge University Press:  27 January 2014

Alexandrea L. Harmell
Affiliation:
University of California, San Diego, Department of Psychiatry, La Jolla, California San Diego State University, Department of Psychology, San Diego, California
Brent T. Mausbach
Affiliation:
University of California, San Diego, Department of Psychiatry, La Jolla, California
Raeanne C. Moore
Affiliation:
University of California, San Diego, Department of Psychiatry, La Jolla, California The Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California
Colin A. Depp
Affiliation:
University of California, San Diego, Department of Psychiatry, La Jolla, California The Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California
Dilip V. Jeste
Affiliation:
University of California, San Diego, Department of Psychiatry, La Jolla, California The Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California
Barton W. Palmer*
Affiliation:
University of California, San Diego, Department of Psychiatry, La Jolla, California The Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California Veterans Medical Research Foundation, VASDHS, San Diego, California
*
Correspondence and reprint requests to: Barton W. Palmer, Division of Geriatric Psychiatry 116A-1, University of California, San Diego, 8950 Villa La Jolla Drive Suite B101, La Jolla, CA 92037. E-mail: bpalmer@ucsd.edu

Abstract

Individuals with bipolar disorder (BD) may exhibit attentional deficits, however, the extent of impairment and long-term fluctuations in performance in attention are relatively unknown. We investigated the relationship between sustained attention and affective symptoms over time among BD patients. We also examined whether global differences in attentional capacity differed among BD versus normal comparison (NC) subjects. Participants included 106 outpatients with BD and 66 NC subjects who were administered symptom rating scales and a measure of sustained attention (Continuous Performance Test- Identical Pairs). Measures were repeated 6, 12, and 26 weeks post-baseline. Compared to NC subjects, participants with BD showed impairment in sustained attention across time. Within patient increases in manic symptoms were associated with increased false alarms; both manic and depressive symptoms were associated with worse discrimination. Neither manic nor depressive symptoms were related to hit rates. Our results indicate that the ability to inhibit a response to near miss stimuli (i.e., those that are close to but not identical to the target) is globally impaired among BD patients relative to NC subjects, as well as state-dependent, covarying with affective symptoms. Psychosocial interventions requiring high levels of attentional capacity may need to be adapted according to patients’ current symptomatology. (JINS, 2014, 20, 1–8)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ancín, I., Santos, J.L., Teijeira, C., Sánchez-Morla, E.M., Bescós, M.J., Argudo, I., Cabranes-Díaz, J.A. (2010). Sustained attention as a potential endophenotype for bipolar disorder. Acta Psychiatrica Scandinavica, 122(3), 235245.CrossRefGoogle ScholarPubMed
Backs, R.W., Seljos, K.A. (1994). Metabolic and cardiorespiratory measures of mental effort: The effects of level of difficulty in a working memory task. International Journal of Psychophysiology, 16(1), 5768.Google Scholar
Borkowska, A., Rybakowski, J.K. (2001). Neuropsychological frontal lobe tests indicate that bipolar depressed patients are more impaired than unipolar. Bipolar Disorders, 3, 8894.Google Scholar
Clark, L., Goodwin, G.M. (2004). State- and trait-related deficits in sustained attention in bipolar disorder. European Archives of Psychiatry and Clinical Neuroscience, 254(2), 6168.Google Scholar
Clark, L., Kempton, M.J., Scarnà, A., Grasby, P.M., Goodwin, G.M. (2005). Sustained attention-deficit confirmed in euthymic bipolar disorder but not in first-degree relatives of bipolar patients or euthymic unipolar depression. Biological Psychiatry, 15, 57(2), 183187.Google Scholar
Clark, L., Iversen, S.D., Goodwin, G.M. (2001). A neuropsychological investigation of prefrontal cortex involvement in acute mania. American Journal of Psychiatry, 158, 16051611.Google Scholar
Corwin, J., Peselow, E., Feenan, K., Rotrosen, J., Fieve, R. (1990). Disorders of decision in affective disease: An effect of b-Adrenergic Dysfunction? Biological Psychiatry, 27, 813833.Google Scholar
Depp, C.A., Mausbach, B.T., Harmell, A.L., Savla, G.N., Bowie, C.R., Harvey, P.D., Patterson, T.L. (2012). Meta-analysis of the association between cognitive abilities and everyday functioning in bipolar disorder. Bipolar Disorders, 14(3), 217226.Google Scholar
Depp, C.A., Savla, G.N., Moore, D.J., Palmer, B.W., Stricker, J.L., Lebowitz, B.D., Jeste, D.V. (2008). Short-term course of neuropsychological abilities in middle-aged and older adults with bipolar disorder. Bipolar Disorders, 10(6), 684690.Google Scholar
Depp, C.A., Savla, G.N., Vergel de Dios, L.A., Mausbach, B.T., Palmer, B.W. (2012). Affective symptoms and intra-individual variability in the short-term course of cognitive functioning in bipolar disorder. Psychological Medicine, 42, 14091416.Google Scholar
First, M.B., Spitzer, R.L., Gibbon, M., Williams, J.B.W. (2002). Structured clinical interview for DSM-IV-TR Axis I disorders, research version, patient edition. (SCID-I/P) New York: Biometrics Research, New York State Psychiatric Institute.Google Scholar
Glisky, E.L. (2007). Changes in cognitive function in human aging. In: D. R. Riddle, (Ed.), Brain aging: Models, methods, and mechanisms. Boca Raton, FL: CRC Press. Chapter 1. Retrieved from: http://www.ncbi.nlm.nih.gov/books/NBK3885/ Google Scholar
Glosser, G., Deutsch, G.K., Cole, L.C., Corwin, J., Saykin, A.J. (1998). Differential lateralization of memory discrimination and response bias in temporal lobe epilepsy patients. Journal International Neuropsychology Society, 4(5), 502511.Google Scholar
Goodwin, F.K., Jamison, K.R. (1990). Manic-depressive illness. New York: Oxford University Press.Google Scholar
Goswami, U., Sharma, A., Varma, A., Gulrajani, C., Ferrier, I.N., Young, A.H., Moore, P.B. (2009). The neurocognitive performance of drug-free and medicated euthymic bipolar patients do not differ. Acta Psychiatrica Scandinavica, 120, 456463.Google Scholar
Latalova, K., Prasko, J., Diveky, T., Velartova, H. (2011). Cognitive impairment in bipolar disorder. Biomedical papers of the medical faculty at the University Palacky Olomouc, Czech Republic, 155(1), 1926.Google Scholar
Montgomery, S.A., Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382389.Google Scholar
Najt, P., Glahn, D., Bearden, C.E., Hatch, J.P., Monkul, E.S., Kaur, S., Soares, J.C. (2005). Attention deficits in bipolar disorder: A comparison based on the Continuous Performance Test. Neuroscience Letters, 379, 122126.Google Scholar
Nuechterlein, K.H., Green, M.F. (2006). MCCB: MATRICS consensus cognitive battery manual. Los Angeles, CA: MATRICS Assessment, Inc.Google Scholar
Pattanayak, R.D., Sagar, R., Mehta, M. (2012). Neuropsychological performance in euthymic Indian patients with bipolar disorder type I: Correlation between quality of life and global functioning. Psychiatry Clinical Neuroscience, 66(7), 553563.Google Scholar
Phillips, M.L., Travis, M.J., Fagiolini, A., Kupfer, D.J. (2008). Medication effects in neuroimaging studies of bipolar disorder. The American Journal of Psychiatry, 165(3), 313.Google Scholar
Pompei, F., Jogia, J., Tatarelli, R., Girardi, P., Rubia, K., Kumari, V., Frangou, S. (2011). Familial and disease specific abnormalities in the neural correlates of the Stroop Task in Bipolar Disorder. Neuroimage, 56(3), 16771684.Google Scholar
Quraishi, S., Frangou, S. (2002). Neuropsychology of bipolar disorder: A review Journal of Affective Disorders, 72(3), 209, 226.Google Scholar
Riccio, C.A., Reynolds, C.R., Lowe, P., Moore, J.J. (2002). The Continuous Performance Test: A window on the neural substrates for attention? Archives of Clinical Neuropsychology, 17, 235272.Google Scholar
Sarter, M., Givens, B., Bruno, J.P. (2001). The cognitive neuroscience of sustained attention: Where top-down meets bottom-up. Brain Research Reviews, 35, 146160.Google Scholar
Sepede, G., De Berardis, D., Campanella, D., Perrucci, M.G., Ferretti, A., Serroni, N., Gambi, F. (2012). Impaired sustained attention in euthymic bipolar disorder patients and non-affected relatives: An fMRI study. Bipolar Disorders, 4(7), 764779.Google Scholar
Shi, T., Li, X., Song, J., Zhao, N., Sun, C., Xia, W., Tomoda, A. (2012). EEG characteristics and visual cognitive function of children with attention deficit hyperactivity disorder (ADHD). Brain & Development, 34(10), 806811.Google Scholar
Silverstein, S.M., Schenkel, L.S., Valone, C., Nuernberger, S.W. (1998). Cognitive deficits and psychiatric rehabilitation outcomes in schizophrenia. Psychiatric Quarterly, 69(3), 169191.Google Scholar
Singer, J.D., Willet, J.B. (2003). Applied longitudinal data analysis modeling change and event occurrence. New York: Oxford University Press.Google Scholar
Snyder, P.J., Nussbaum, P.D., Robins, D.L. (2006). Clinical neuropsychology: A pocket handbook for assessment (2nd ed., pp. 572606). Washington, DC: American Psychological Association.Google Scholar
Stefanopoulou, E., Manoharan, A., Landau, S., Geddes, J.R., Goodwin, G., Frangou, S. (2009). Cognitive functioning in patients with affective disorders and schizophrenia: A meta-analysis. International Review of Psychiatry, 21, 336356.Google Scholar
Swann, A.C., Anderson, J.C., Dougherty, D.M., Moeller, F.G. (2001). Measurement of inter-episode impulsivity in bipolar disorder. Psychiatry Research, 101(2), 195197.Google Scholar
Tucha, O., Mecklinger, L., Laufkötter, R., Klein, H.E., Walitza, S., Lange, K.W. (2006). Methylphenidate-induced improvements of various measures of attention in adults with attention-deficit hyperactivity disorder. Journal Neural Transmission, 113, 15751592.Google Scholar
Ucok, A., Cakir, S., Duman, Z.C., Dişcigil, A., Kandemir, P., Atli, H. (2006). Cognitive predictors of skill acquisition on social problem solving in patients with schizophrenia. European Archives of Psychiatry and Clinical Neuroscience, 256(6), 388394.Google Scholar
Van Merrienboer, J.J., Sweller, J. (2005). Cognitive load theory and complex learning: Recent developments and future directions. Educational Psychology Review, 17(2), 147177.Google Scholar
Walshe, M., Schulze, K.K., Stahl, D., Hall, M.H., Chaddock, C., Morris, R., Kravariti, E. (2012). Sustained attention in bipolar I disorder patients with familial psychosis and their first degree relatives. Psychiatry Research, 199(1), 7073.Google Scholar
Wilkinson, G.S., Robertson, G.J. (2006). Wide Range Achievement Test 4 (WRAT4). Odessa, FL: Psychological Assessment Resources, Inc.Google Scholar
Wingen, M., Kuypers, K.P., van de Ven, V., Formisano, E., Ramaekers, J.G. (2008). Sustained attention and serotonin: A pharmaco-fMRI study. Human Psychopharmacology, 23(3), 221230.Google Scholar
Young, R.C., Biggs, J.T., Ziegler, V.E., Meyer, D.A. (1978). A rating scale for mania: Reliability, validity and sensitivity. British Journal Psychiatry, 133, 429435.Google Scholar
Youngstrom, E.A., Arnold, L.E., Frazier, T.W. (2010). Bipolar and ADHD comorbidity: Both artifact and outgrowth of shared mechanisms. Clinical Psychology (New York), 17(4), 350359.Google Scholar