Sustained attention deficit in bipolar disorder.
BACKGROUND
Recovery in bipolar disorder is central to its definition but is rarely complete. Previous work has suggested that neuropsychological impairment persists during the euthymic state but has been confounded partly by mild affective symptoms in remitted patients.


OBJECTIVE
To characterise neuropsychological functioning in the euthymic phase of bipolar disorder with an emphasis on tasks of executive functioning.


METHODS
Thirty euthymic patients with bipolar disorder were compared with thirty healthy controls on neuropsychological tasks differentially sensitive to damage within prefrontal cortex.


RESULTS
Bipolar I patients were impaired on tasks of attentional set shifting, verbal memory and sustained attention. Only sustained attention deficit survived controlling for mild affective symptoms. This deficit was related to progression of illness, but was none the less present in a subgroup of patients near illness onset.


CONCLUSIONS
Sustained attention deficit may represent a neuropsychological vulnerability marker for bipolar disorder, providing a focus for further understanding of the phenotype and analysis of the neuronal networks involved.
Clark
Luke
L
University Department of Psychiatry, Warneford Hospital, Oxford.
Iversen
Susan D
SD
Goodwin
Guy M
GM
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001288:Attention; D001714:Bipolar Disorder / Q000503:physiopathology / Q000523:psychology*; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D017397:Prefrontal Cortex / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales; D018709:Statistics, Nonparametric