Neurocognitive function in pediatric bipolar disorder: 3-year follow-up shows cognitive development lagging behind healthy youths.
OBJECTIVE
Longitudinal follow-up of neurocognitive functioning in people with pediatric bipolar disorder (PBD) was conducted to characterize the developmental trajectory of cognitive disabilities in this disorder.


METHODS
Patients with PBD (n = 26) and controls (HC; n = 17; mean age 11.66 +/- 2.70 years) completed cognitive testing at baseline and then again at a 3-year follow-up. Groups were matched at baseline on age, sex, race, parental socioeconomic status, general intelligence, and single-word reading ability. The PBD group received treatment guided by a standardized medication algorithm during the 3-year period. A battery of neuropsychological tests was administered to assess attention, executive function, working memory, verbal memory, visual memory, and visuospatial perception at baseline and follow-up.


RESULTS
At baseline and follow-up, the patients showed deficits in all of the examined domains. At 3-year follow-up, developmental progress in executive functions and verbal memory was significantly less in the patients with PBD than in the HC. Improvement on attention, working memory, visual memory, and visuospatial perception tasks in the patients with PBD was comparable to that of the HC, but the patients with PBD remained impaired in all domains relative to the HC.


CONCLUSIONS
The developmental delay in some neurocognitive functioning in PBD suggests that the illness disrupts cognitive development with potential lifelong implications for reduced functional ability. Treating bipolar symptoms does not seem to prevent the lag in cognitive development. This dysmaturation may be a direct effect of the illness on brain function, or it may represent indirect consequences of psychopathology or medications on cognitive development.
Pavuluri
Mani N
MN
Drs. Pavuluri and West and Mr. Jindal are with the Institute for Juvenile Research at the University of Illinois at Chicago; Drs. Pavuluri, Hill, and Sweeney are affiliated with the Center for Cognitive Medicine at the University of Illinois at Chicago. Electronic address: mpavuluri@psych.uic.edu.
West
Amy
A
Drs. Pavuluri and West and Mr. Jindal are with the Institute for Juvenile Research at the University of Illinois at Chicago; Drs. Pavuluri, Hill, and Sweeney are affiliated with the Center for Cognitive Medicine at the University of Illinois at Chicago.
Hill
S Kristian
SK
Drs. Pavuluri and West and Mr. Jindal are with the Institute for Juvenile Research at the University of Illinois at Chicago; Drs. Pavuluri, Hill, and Sweeney are affiliated with the Center for Cognitive Medicine at the University of Illinois at Chicago.
Jindal
Kittu
K
Drs. Pavuluri and West and Mr. Jindal are with the Institute for Juvenile Research at the University of Illinois at Chicago; Drs. Pavuluri, Hill, and Sweeney are affiliated with the Center for Cognitive Medicine at the University of Illinois at Chicago.
Sweeney
John A
JA
Drs. Pavuluri and West and Mr. Jindal are with the Institute for Juvenile Research at the University of Illinois at Chicago; Drs. Pavuluri, Hill, and Sweeney are affiliated with the Center for Cognitive Medicine at the University of Illinois at Chicago.
D000124:Achievement; D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D018692:Antimanic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004351:Drug Resistance; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007859:Learning Disabilities / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D008297:Male; D008433:Mathematics; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011594:Psychometrics; D012307:Risk Factors
D000927:Anticonvulsants; D018692:Antimanic Agents