Increased sensitivity to error during decision-making in bipolar disorder patients with acute mania.
BACKGROUND
Decision-making is a complex and important function for daily life that can be assessed quantitatively using a simple two-choice prediction task. Bipolar disorder (BD) patients are thought to show altered responsivity to positive and negative feedback. In this study we examined whether BD patients with psychotic mania show altered patterns of decision-making as a function of the frequency of incorrect predictions or error rate.


METHODS
Fourteen adult DSM-IV-diagnosed BD patients with psychotic mania and 14 normal comparison subjects (NC) were tested with a two-choice prediction task using three error rate conditions (20%, 50%, or 80%).


RESULTS
BD patients showed an increased sensitivity to error rate changes and switched more frequently at high error rates than NC subjects. In comparison, there were no differences between BD and NC subjects on the degree to which the response or stimulus during a previous trial predicts the current response.


CONCLUSIONS
Decision-making in BD patients with psychotic mania appears to be highly sensitive to high error rates. Moreover, the patterns of responses appear distinct from what has been previously observed in acutely and chronically ill schizophrenia patients. The results of this study are informative as to the effects of errors on decision-making strategies in psychotic BD manic patients.
Department of Psychiatry, University of California San Diego, 200 West Arbor Drive, Mailcode 8620, San Diego, CA 92103-8620, USA. aminassian@ucsd.edu
Arpi
A
Minassian
Martin P
MP
Paulus
William
W
Perry
D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology*; D002755:Choice Behavior; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D009949:Orientation; D010364:Pattern Recognition, Visual; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance; D012054:Reinforcement, Psychology; D035501:Uncertainty