Hot and cold cognition in unmedicated depressed subjects with bipolar disorder.
OBJECTIVE
Neuropsychological studies in subjects with bipolar disorder (BD) have reported deficits on a variety of cognitive measures. However, because the majority of subjects were medicated at the time of testing in previous studies, it is currently unclear whether the pattern of deficits reported is related to BD itself or to psychotropic medication. We addressed this issue by examining cognitive performance in a group of unmedicated, currently depressed subjects with BD.


METHODS
Forty-nine unmedicated subjects who met DSM-IV criteria for BD, depressed phase, and 55 control subjects participated in this study. Most patients were diagnosed with bipolar II disorder. Performance on emotion-dependent, or 'hot', and emotion-independent, or 'cold', cognitive tasks was assessed using tests from the Cambridge Neuropsychological Test Automated Battery.


RESULTS
The groups were well matched with respect to general intelligence and demographic variables. Deficits in the unmedicated depressed BD group were apparent on tests tapping 'hot' cognitive processing, for example the Cambridge Gamble task and the Probabilistic Reversal Learning task. However, other than a deficit on the Spatial Span test in the depressed BD subjects, the groups performed equivalently on most measures of 'cold' cognitive processing, for example visual memory, attention, and working memory.


CONCLUSIONS
These data suggest that deficits on tests involving reward processing, short-term spatial memory storage, and sensitivity to negative feedback in depressed BD subjects represent an effect of the illness itself and not mood-stabilizing medication.
Roiser
Jonathan P
JP
Institute of Cognitive Neuroscience, University College London, London, UK.
Cannon
Dara M
DM
Gandhi
Shilpa K
SK
Taylor Tavares
Joana
J
Erickson
Kristine
K
Wood
Suzanne
S
Klaver
Jacqueline M
JM
Clark
Luke
L
Zarate
Carlos A
CA
Sahakian
Barbara J
BJ
Drevets
Wayne C
WC
D000328:Adult; D000704:Analysis of Variance; D001288:Attention / Q000502:physiology; D001714:Bipolar Disorder / Q000150:complications*; D016022:Case-Control Studies; D002755:Choice Behavior / Q000502:physiology; D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology*; D001330:Electronic Data Processing; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D009483:Neuropsychological Tests; D011340:Problem Solving / Q000502:physiology; D013811:Psychotherapeutic Processes; D012193:Reversal Learning / Q000502:physiology