Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-28T19:53:10.708Z Has data issue: false hasContentIssue false

Are bipolar II patients cognitively impaired? A systematic review

Published online by Cambridge University Press:  28 January 2011

B. Solé
Affiliation:
Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
A. Martínez-Arán
Affiliation:
Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
C. Torrent
Affiliation:
Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
C. M. Bonnin
Affiliation:
Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
M. Reinares
Affiliation:
Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
D. Popovic
Affiliation:
Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, Pisa, Italy
J. Sánchez-Moreno
Affiliation:
Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
E. Vieta*
Affiliation:
Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
*
*Address for correspondence: Dr E. Vieta, Bipolar Disorders Program, Clinical Institute of Neuroscience, University Clinic Hospital of Barcelona, CIBERSAM, Villarroel 170, 08036-Barcelona, Spain. (Email: evieta@clinic.ub.es)

Abstract

Background

There is evidence that bipolar disorder (BD) is associated with significant neurocognitive deficits and this occurs in individuals with BD type I (BD I) and with BD type II (BD II). Only a few studies have focused on cognitive impairment in BD II. The aim of this study was to describe the pattern of cognitive impairment in patients with BD II, in order to identify specific cognitive deficits that distinguish BD II from BD I patients as well as from healthy subjects.

Method

We performed a systematic review of the literature of neuropsychological studies of BD II published between 1980 and July 2009. Fourteen articles fulfilled the inclusion criteria and were included in this review.

Results

Main cognitive deficits found in BD II include working memory and some measures of executive functions (inhibitory control) and approximately half of the studies also detected verbal memory impairment.

Conclusions

There are subtle differences between the two subtypes regarding cognition. This may suggest neurobiological differences between the two subgroups which will be helpful in order to determine cognitive endophenotypes in BD subtypes.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2011

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

Akiskal, HS (1996). The prevalent clinical spectrum of bipolar disorders: beyond DSM-IV. Journal of Clinical Psychopharmacology 16, 4S14S.Google Scholar
Andersson, S, Barder, HE, Hellvin, T, Lovdahl, H, Malt, UF (2008). Neuropsychological and electrophysiological indices of neurocognitive dysfunction in bipolar II disorder. Bipolar Disorders 10, 888899.Google Scholar
Angst, J (1998). The emerging epidemiology of hypomania and bipolar II disorder. Journal of Affective Disorders 50, 143151.Google Scholar
APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision (DSM-IV-TR). American Psychiatric Press: Arlington, VA.Google Scholar
Arts, B, Jabben, N, Krabbendam, L, van Os, J (2008). Meta-analyses of cognitive functioning in euthymic bipolar patients and their first-degree relatives. Psychological Medicine 38, 771785.CrossRefGoogle ScholarPubMed
Balanzá-Martínez, V, Rubio, C, Selva-Vera, G, Martinez-Arán, A, Sánchez-Moreno, J, Salazar-Fraile, J, Vieta, E, Tabarés-Seisdedos, R (2008). Neurocognitive endophenotypes (endophenocognitypes) from studies of relatives of bipolar disorder subjects: a systematic review. Neuroscience and Biobehavioral Reviews 32, 14261438.CrossRefGoogle ScholarPubMed
Balanzá-Martínez, V, Selva, G, Martínez-Arán, A, Prickaerts, J, Salazar, J, González-Pinto, A, Vieta, E, Tabarés-Seisdedos, R (2010). Neurocognition in bipolar disorders – a closer look at comorbidities and medications. European Journal of Pharmacology 626, 8796.Google Scholar
Benazzi, F (1999). Prevalence of bipolar II disorder in atypical depression. European Archives of Psychiatry and Clinical Neuroscience 249, 6265.CrossRefGoogle ScholarPubMed
Benazzi, F (2001). Prevalence and clinical correlates of residual depressive symptoms in bipolar II disorder. Psychotherapy and Psychosomatics 70, 232238.CrossRefGoogle ScholarPubMed
Berk, M, Dodd, S (2005). Bipolar II disorder: a review. Bipolar Disorders 7, 1121.CrossRefGoogle ScholarPubMed
Berns, GS, Martin, M, Proper, SM (2002). Limbic hyperreactivity in bipolar II disorder. American Journal of Psychiatry 159, 304306.CrossRefGoogle ScholarPubMed
Bora, E, Yucel, M, Pantelis, C (2009). Cognitive endophenotypes of bipolar disorder: a meta-analysis of neuropsychological deficits in euthymic patients and their first-degree relatives. Journal of Affective Disorders 113, 120.Google Scholar
Bruno, SD, Papadopoulou, K, Cercignani, M, Cipolotti, L, Ron, MA (2006). Structural brain correlates of IQ changes in bipolar disorder. Psychological Medicine 36, 609618.CrossRefGoogle ScholarPubMed
Daban, C, Martínez-Arán, A, Torrent, C, Tabarés-Seisdedos, R, Balanzá-Martínez, V, Salazar-Fraile, J, Selva-Vera, G, Vieta, E (2006). Specificity of cognitive deficits in bipolar disorder versus schizophrenia. A systematic review. Psychotherapy and Psychosomatics 75, 7284.Google Scholar
Derntl, B, Seidel, EM, Kryspin-Exner, I, Hasmann, A, Dobmeier, M (2009). Facial emotion recognition in patients with bipolar I and bipolar II disorder. British Journal of Clinical Psychology 48, 363375.Google Scholar
Dittmann, S, Hennig-Fast, K, Gerber, S, Seemuller, F, Riedel, M, Emanuel, SW, Langosch, J, Engel, RR, Moller, HJ, Grunze, HC (2008). Cognitive functioning in euthymic bipolar I and bipolar II patients. Bipolar Disorders 10, 877887.Google Scholar
Engstrom, C, Brandstrom, S, Sigvardsson, S, Cloninger, R, Nylander, PO (2003). Bipolar disorder. II: personality and age of onset. Bipolar Disorders 5, 340348.Google Scholar
Glahn, DC, Bearden, CE, Niendam, TA, Escamilla, MA (2004). The feasibility of neuropsychological endophenotypes in the search for genes associated with bipolar affective disorder. Bipolar Disorders 6, 171182.CrossRefGoogle ScholarPubMed
Goldberg, JF, Chengappa, KN (2009). Identifying and treating cognitive impairment in bipolar disorder. Bipolar Disorders 11 (Suppl. 2), 123137.Google Scholar
Harkavy-Friedman, JM, Keilp, JG, Grunebaum, MF, Sher, L, Printz, D, Burke, AK, Mann, JJ, Oquendo, M (2006). Are BPI and BPII suicide attempters distinct neuropsychologically? Journal of Affective Disorders 94, 255259.Google Scholar
Henin, A, Mick, E, Biederman, J, Fried, R, Wozniak, J, Faraone, SV, Harrington, K, Davis, S, Doyle, AE (2007). Can bipolar disorder-specific neuropsychological impairments in children be identified? Journal of Consulting and Clinical Psychology 75, 210–20.CrossRefGoogle ScholarPubMed
Holmes, MK, Erickson, K, Luckenbaugh, DA, Drevets, WC, Bain, EE, Cannon, DM, Snow, J, Sahakian, BJ, Manji, HK, Zarate, CA Jr. (2008). A comparison of cognitive functioning in medicated and unmedicated subjects with bipolar depression. Bipolar Disorders 10, 806815.Google Scholar
Hsiao, YL, Wu, YS, Wu, JY, Hsu, MH, Chen, HC, Lee, SY, Lee, IH, Yeh, TL, Yang, YK, Ko, HC, Lu, RB (2009). Neuropsychological functions in patients with bipolar I and bipolar II disorder. Bipolar Disorders 11, 547554.Google Scholar
Kapczinski, F, Vieta, E, Andreazza, AC, Frey, BN, Gomes, FA, Tramontina, J, Kauer-Sant'anna, M, Grassi-Oliveira, R, Post, RM (2008). Allostatic load in bipolar disorder: implications for pathophysiology and treatment. Neuroscience and Biobehavioral Reviews 32, 675692.CrossRefGoogle Scholar
Martínez-Arán, A, Penades, R, Vieta, E, Colom, F, Reinares, M, Benabarre, A, Salamero, M, Gasto, C (2002). Executive function in patients with remitted bipolar disorder and schizophrenia and its relationship with functional outcome. Psychotherapy and Psychosomatics 71, 3946.CrossRefGoogle ScholarPubMed
Martínez-Arán, A, Torrent, C, Tabarés-Seisdedos, R, Salamero, M, Daban, C, Balanzá-Martínez, V, Sánchez-Moreno, J, Manuel, GJ, Benabarre, A, Colom, F, Vieta, E (2008). Neurocognitive impairment in bipolar patients with and without history of psychosis. Journal of Clinical Psychiatry 69, 233239.Google Scholar
Martínez-Arán, A, Vieta, E, Colom, F, Reinares, M, Benabarre, A, Gastó, C, Salamero, M (2000). Cognitive dysfunctions in bipolar disorder: evidence of neuropsychological disturbances. Psychotherapy and Psychosomatics 69, 218.Google Scholar
Martínez-Arán, A, Vieta, E, Colom, F, Torrent, C, Sánchez-Moreno, J, Reinares, M, Benabarre, A, Goikolea, JM, Brugue, E, Daban, C, Salamero, M (2004 a). Cognitive impairment in euthymic bipolar patients: implications for clinical and functional outcome. Bipolar Disorders 6, 224232.CrossRefGoogle ScholarPubMed
Martínez-Arán, A, Vieta, E, Reinares, M, Colom, F, Torrent, C, Sánchez-Moreno, J, Benabarre, A, Goikolea, JM, Comes, M, Salamero, M (2004 b). Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. American Journal of Psychiatry 161, 262270.Google Scholar
Martino, DJ, Marengo, E, Igoa, A, Scapola, M, Ais, ED, Perinot, L, Strejilevich, SA (2009). Neurocognitive and symptomatic predictors of functional outcome in bipolar disorders: a prospective 1 year follow-up study. Journal of Affective Disorders 116, 3742.Google Scholar
Pallanti, S, Quercioli, L, Pazzagli, A, Rossi, A, Dell'Osso, L, Pini, S, Cassano, GB (1999). Awareness of illness and subjective experience of cognitive complaints in patients with bipolar I and bipolar II disorder. American Journal of Psychiatry 156, 10941096.CrossRefGoogle ScholarPubMed
Pavuluri, MN, Schenkel, LS, Aryal, S, Harral, EM, Hill, SK, Herbener, ES, Sweeney, JA (2006). Neurocognitive function in unmedicated manic and medicated euthymic pediatric bipolar patients. American Journal of Psychiatry 163, 286293.CrossRefGoogle ScholarPubMed
Robinson, LJ, Thompson, JM, Gallagher, P, Goswami, U, Young, AH, Ferrier, IN, Moore, PB (2006). A meta-analysis of cognitive deficits in euthymic patients with bipolar disorder. Journal of Affective Disorders 93, 105115.CrossRefGoogle ScholarPubMed
Rucklidge, JJ (2006). Impact of ADHD on the neurocognitive functioning of adolescents with bipolar disorder. Biological Psychiatry 60, 921928.CrossRefGoogle ScholarPubMed
Salazar-Fraile, J, Balanzá-Martínez, V, Selva-Vera, G, Martínez-Arán, A, Sánchez-Moreno, J, Vieta, E, Gómez-Beneyto, M, Tabarés-Seisdedos, R (2009). Motor speed predicts stability of cognitive deficits in both schizophrenic and bipolar I patients at one-year follow-up. European Journal of Psychiatry 23, 184197.CrossRefGoogle Scholar
Sanchez-Moreno, J, Martinez-Aran, A, Colom, F, Scott, J, Tabares-Seisdedos, R, Sugranyes, G, Torrent, C, Daban, C, Benabarre, A, Goikolea, JM, Franco, C, González-Pinto, A, Ayuso-Mateos, JL, Vieta, E (2009). Neurocognitive dysfunctions in euthymic bipolar patients with and without prior history of alcohol use. Journal of Clinical Psychiatry 70, 11201127.Google Scholar
Savitz, JB, Solms, M, Ramesar, RS (2005). Neurocognitive function as an endophenotype for genetic studies of bipolar affective disorder. NeuroMolecular Medicine 7, 275286.Google Scholar
Savitz, JB, van der Merwe, L, Stein, DJ, Solms, M, Ramesar, RS (2008). Neuropsychological task performance in bipolar spectrum illness: genetics, alcohol abuse, medication and childhood trauma. Bipolar Disorders 10, 479494.Google Scholar
Simonsen, C, Sundet, K, Vaskinn, A, Birkenaes, AB, Engh, JA, Færden, A, Jónsdóttir, H, Ringen, PA, Opjordsmoen, S, Melle, I, Friis, S, Andreassen, OA (2011). Neurocognitive dysfunction in bipolar and schizophrenia spectrum disorders depends on history of psychosis rather than diagnostic group. Schizophrenia Bulletin 37, 7383.CrossRefGoogle ScholarPubMed
Simonsen, C, Sundet, K, Vaskinn, A, Birkenaes, AB, Engh, JA, Hansen, CF, Jónsdóttir, H, Ringen, PA, Opjordsmoen, S, Friis, S, Andreassen, OA (2008). Neurocognitive profiles in bipolar I and bipolar II disorder: differences in pattern and magnitude of dysfunction. Bipolar Disorders 10, 245255.CrossRefGoogle ScholarPubMed
Summers, M, Papadopoulou, K, Bruno, S, Cipolotti, L, Ron, MA (2006). Bipolar I and bipolar II disorder: cognition and emotion processing. Psychological Medicine 17991809.Google Scholar
Taylor Tavares, JV, Clark, L, Cannon, DM, Erickson, K, Drevets, WC, Sahakian, BJ (2007). Distinct profiles of neurocognitive function in unmedicated unipolar depression and bipolar II depression. Biological Psychiatry 62, 917924.CrossRefGoogle ScholarPubMed
Torrent, C, Martínez-Arán, A, Daban, C, Sánchez-Moreno, J, Comes, M, Goikolea, JM, Salamero, M, Vieta, E (2006). Cognitive impairment in bipolar II disorder. British Journal of Psychiatry 189, 254259.Google Scholar
Torres, IJ, Boudreau, VG, Yatham, LN (2007). Neuropsychological functioning in euthymic bipolar disorder: a meta-analysis. Acta Psychiatrica Scandinavica 116 (Suppl. 434), 1726.Google Scholar
Vieta, E (2009). The influence of medications on neurocognition in bipolar disorder. Acta Psychiatrica Scandinavica 120, 414415.Google Scholar
Vieta, E, Colom, F, Martínez-Arán, A, Benabarre, A, Gasto, C (1999). Personality disorders in bipolar II patients. Journal of Nervous and Mental Disease 187, 245248.Google Scholar
Vieta, E, Gasto, C, Otero, A, Nieto, E, Vallejo, J (1997). Differential features between bipolar I and bipolar II disorder. Comprehensive Psychiatry 38, 98101.Google Scholar
Vieta, E, Suppes, T (2008). Bipolar II disorder: arguments for and against a distinct diagnostic entity. Bipolar Disorders 10, 163178.Google Scholar
Warrington, EK (1996). The Camden Memory Tests. Psychology Press: Hove, East Sussex.Google Scholar
Zarate, Jr. CA, Tohen, M, Land, M, Cavanagh, S (2000). Functional impairment and cognition in bipolar disorder. Psychiatric Quarterly 71, 309329.Google Scholar