title: Differential executive functioning performance by phase of bipolar disorder.
abstract: OBJECTIVE
  This study examined the influence of illness phase on executive functioning performance using factor-derived cognitive scores in a cross-sectional design.
  
  
  METHODS
  Healthy control (HC) subjects (n = 57), and euthymic (E-BD) (n = 117), depressed (D-BD) (n = 73), and hypomanic/mixed (HM/M-BD) (n = 26) patients with bipolar disorder (BD) were evaluated using executive functioning measures (Wisconsin Card Sorting Test, Trail Making Test-Parts A and B, Verbal Fluency, Parametric Go/No-Go, Stroop, and Digit Symbol) comprising Conceptual Reasoning and Set-Shifting (CRSS), Processing Speed with Interference Resolution (PSIR), Verbal Fluency and Processing Speed (VFPS), and Inhibitory Control (IC) factor scores.
  
  
  RESULTS
  Two of the four executive functioning factors were significantly different between groups based upon phase of illness. The HM/M group was significantly worse than both of the other BD groups and the HC group in IC. The VFPS factor was sensitive to the active phase of BD, with the HM/M-BD and D-BD groups worse than HC. Extending our prior work, the PSIR factor, and now the CRSS factor were significantly worse in BD relative to HC, irrespective of phase of illness.
  
  
  CONCLUSIONS
  Phase of illness had differential cognitive profiles in executive functioning factors, even after considering and excluding the impact of clinical features, illness characteristics, medications, and demographics. Consolidating executive functioning tasks into reliable factor scores provides unique information to measure and define cognitive deficiencies throughout phases of BD, and to measure intermediate phenotypes in BD, and may aid in tracking and clarifying treatment focus.
authors: Department of Psychiatry, University of Michigan, Ann Arbor, MI 48105, USA. karyan@umich.edu
authors: Kelly A
authors: KA
authors: Ryan
authors: Aaron C
authors: AC
authors: Vederman
authors: E Michelle
authors: EM
authors: McFadden
authors: Anne L
authors: AL
authors: Weldon
authors: Masoud
authors: M
authors: Kamali
authors: Scott A
authors: SA
authors: Langenecker
authors: Melvin G
authors: MG
authors: McInnis
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000503:physiopathology*; D016022:Case-Control Studies; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D018450:Disease Progression; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D057190:Stroop Test; D013997:Time Factors; D014145:Trail Making Test