Neuropsychological functions in Han Chinese patients in Taiwan with bipolar II disorder comorbid and not comorbid with alcohol abuse/alcohol dependence disorder.
OBJECTIVE
Studies exploring neuropsychological functions of bipolar disorder (BP) specifically include patients comorbid with alcohol abuse (AB), alcohol dependence (AD), or both (AB/AD). Contradictory assessments of neuropsychological impairment may be caused by not excluding the confounding effects of comorbid AB/AD. Most of the literature discusses BP without subtyping, which overlooks that BP-II may be a valid diagnosis different from BP-I. Because neuropsychological functions are involved in overall BP-II outcomes, we hypothesized that the neuropsychological functions of patients with BP-II comorbid with AD (BP(+AD)) are significantly different from and more impaired than those of patients with BP-II not comorbid with AD (BP(-AD)).


METHODS
Using DSM-IV criteria, the study included 69 patients with BP-II (19 with BP(+AD); 28 with BP(-AD)) and 22 healthy controls compared using a battery of neuropsychological tests that assessed memory, psychomotor speed, and certain aspects of frontal executive function. All BP-II patients were in an inter-episode period (a period of remission between states of mania, hypomania, and depression).


RESULTS
BP(+AD) patients had lower scores than did BP(-AD) patients and controls in verbal memory, visual memory, attention, psychomotor speed, and executive function. Working memory was poorer for BP(+AD) than BP(-AD) patients and for both BP groups than for controls.


CONCLUSIONS
BP(+AD) patients manifested wide neuropsychological dysfunctions, and BP(-AD) patients showed a reduction in working memory, which suggested that working memory might be related to a history of BP-II. Neuropsychological dysfunctions seemed more strongly associated with AB/AD than with BP-II in inter-episode periods.
Institute of Behavioral Medicine, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Taiwan.
Cindy
C
Shan
Sheng-Yu
SY
Lee
Yun-Hsuan
YH
Chang
Jo Yung-Wei
JY
Wu
Shiou-Lan
SL
Chen
Shih-Heng
SH
Chen
Yih-Lynn
YL
Hsiao
Hsin-Fen
HF
Yang
I Hui
IH
Lee
Po See
PS
Chen
Tzung Lieh
TL
Yeh
Yen Kuang
YK
Yang
Ru-Band
RB
Lu
D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology*; D044466:Asian People / Q000208:ethnology; D001288:Attention / Q000502:physiology; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance; D018709:Statistics, Nonparametric; D013624:Taiwan / Q000453:epidemiology / Q000208:ethnology; D055815:Young Adult