[Neuropsychological disturbances in bipolar disorder].
OBJECTIVE
Systematic literature review of the controlled studies published in the last 15 years on neuropsychological deficits in Bipolar Disorder.


METHODS
Bibliographical research was completed through Medline, Lilacs, PubMed and ISI, specifically for 1990 to 2005 period. Selected studies were organized beginning with the comparison among the selected sample (bipolar versus other pathology versus control healthy). We included only controlled studies with a patient sample larger than 10, and 73 papers were found, being that 53 selected for this systematic review.


RESULTS
Patients with Bipolar Disorder present difficulties in several cognitive domains which partially persist even after acute episodes acute episodes. The deficits impaired basically the executive functions. When compared to schizophrenia, bipolar patients present milder deficits in the neuropsychological tests, which may explain differences in terms of disease outcome and specific circuitry abnormalities. There was a positive correlation between cognitive deficits and number of episodes or hospitalizations. The medications used for mood stabilization can produce a negative impact on cognition.


CONCLUSIONS
The abnormalities suggest a dysfunction in specific frontostriatal circuits, and may partially explain the difficulties in the psychosocial adaptation of these patients. Future studies should evaluate the effectiveness of neuropsychological rehabilitation programs, which seek through cognitive training to minimize the impact of these deficits in the every day life.
Rocca
Cristiana C A
CC
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos 785, São Paulo 05403-010, SP, Brazil. crisrocca@uol.com.br
Lafer
Beny
B
D001714:Bipolar Disorder / Q000523:psychology*; D003072:Cognition Disorders / Q000523:psychology*; D006801:Humans; D009483:Neuropsychological Tests; D011596:Psychomotor Disorders / Q000523:psychology*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index