title: Greater executive and visual memory dysfunction in comorbid bipolar disorder and substance use disorder.
abstract: Measures of cognitive dysfunction in Bipolar Disorder (BD) have identified state and trait dependent metrics. An influence of substance abuse (SUD) on BD has been suggested. This study investigates potential differential, additive, or interactive cognitive dysfunction in bipolar patients with or without a history of SUD. Two hundred fifty-six individuals with BD, 98 without SUD and 158 with SUD, and 97 Healthy Controls (HC) completed diagnostic interviews, neuropsychological testing, and symptom severity scales. The BD groups exhibited poorer performance than the HC group on most cognitive factors. The BD with SUD exhibited significantly poorer performance than BD without SUD in visual memory and conceptual reasoning/set-shifting. In addition, a significant interaction effect between substance use and depressive symptoms was found for auditory memory and emotion processing. BD patients with a history of SUD demonstrated worse visual memory and conceptual reasoning skills above and beyond the dysfunction observed in these domains among individuals with BD without SUD, suggesting greater impact on integrative, gestalt-driven processing domains. Future research might address longitudinal outcome as a function of BD, SUD, and combined BD/SUD to evaluate neural systems involved in risk for, and effects of, these illnesses.
authors: Department of Psychiatry, University of Michigan, 2101 Commonwealth Blvd, Suite C, Ann Arbor, MI 48105, USA. davimars@med.umich.edu
authors: David F
authors: DF
authors: Marshall
authors: Sara J
authors: SJ
authors: Walker
authors: Kelly A
authors: KA
authors: Ryan
authors: Masoud
authors: M
authors: Kamali
authors: Erika F H
authors: EF
authors: Saunders
authors: Anne L
authors: AL
authors: Weldon
authors: Kenneth M
authors: KM
authors: Adams
authors: Melvin G
authors: MG
authors: McInnis
authors: Scott A
authors: SA
authors: Langenecker
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000523:psychology*; D017831:Diagnosis, Dual (Psychiatry); D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology*; D008569:Memory Disorders / Q000150:complications / Q000523:psychology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology*