Neuropsychological impairment in bipolar disorder: the relationship with glucocorticoid receptor function.
OBJECTIVE
Basal levels of glucocorticoids, such as cortisol, are generally unaltered in bipolar disorder. However, neuroendocrine tests of glucocorticoid receptor (GR) function such as the dexamethasone suppression test (DST) are frequently abnormal. Neuropsychological impairment is well documented in healthy volunteers after administration of glucocorticoids and in patients with bipolar affective disorder. This suggests a potential link between neuropsychological and hypothalamic-pituitary-adrenal axis function. We examined the hypothesis that neuropsychological impairment in bipolar disorder is associated with abnormal GR function.


METHODS
Seventeen euthymic bipolar patients and 16 controls completed tests of verbal declarative and working memory (WM) tests and the DST. The correlation between neuroendocrine and neuropsychological function was examined.


RESULTS
Bipolar patients made significantly more errors of omission and commission on the WM paradigm and demonstrated impaired verbal recognition memory. Patients' post-dexamethasone cortisol correlated with WM commission errors (r(s) = 0.64, p = 0.0006). No such relationship was evident in controls.


CONCLUSIONS
Deficits in declarative memory and WM are evident in patients with bipolar disorder. The deficit in retrieval accuracy from WM appears to be correlated with abnormal GR function.
Watson
Stuart
S
The Stanley Research Centre, School of Neurology, Neurobiology, and Psychiatry, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
Thompson
Jill M
JM
Ritchie
James C
JC
Nicol Ferrier
I
I
Young
Allan H
AH
D000293:Adolescent; D000328:Adult; D000339:Affect / Q000502:physiology; D000367:Age Factors; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D003907:Dexamethasone; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics / Q000706:statistics & numerical data; D011965:Receptors, Glucocorticoid / Q000502:physiology*; D013223:Statistics as Topic
D011965:Receptors, Glucocorticoid; D003907:Dexamethasone; D006854:Hydrocortisone