title: Persistence of cognitive impairment and its negative impact on psychosocial functioning in lithium-treated, euthymic bipolar patients: a 6-year follow-up study.
abstract: BACKGROUND
  Previous cross-sectional studies report that cognitive impairment is associated with poor psychosocial functioning in euthymic bipolar patients. There is a lack of long-term studies to determine the course of cognitive impairment and its impact on functional outcome. Method A total of 54 subjects were assessed at baseline and 6 years later; 28 had DSM-IV TR bipolar I or II disorder (recruited, at baseline, from a Lithium Clinic Program) and 26 were healthy matched controls. They were all assessed with a cognitive battery tapping into the main cognitive domains (executive function, attention, processing speed, verbal memory and visual memory) twice over a 6-year follow-up period. All patients were euthymic (Hamilton Rating Scale for Depression score lower than 8 and Young mania rating scale score lower than 6) for at least 3 months before both evaluations. At the end of follow-up, psychosocial functioning was also evaluated by means of the Functioning Assessment Short Test.
  
  
  RESULTS
  Repeated-measures multivariate analysis of covariance showed that there were main effects of group in the executive domain, in the inhibition domain, in the processing speed domain, and in the verbal memory domain (p<0.04). Among the clinical factors, only longer illness duration was significantly related to slow processing (p=0.01), whereas strong relationships were observed between impoverished cognition along time and poorer psychosocial functioning (p<0.05).
  
  
  CONCLUSIONS
  Executive functioning, inhibition, processing speed and verbal memory were impaired in euthymic bipolar out-patients. Although cognitive deficits remained stable on average throughout the follow-up, they had enduring negative effects on psychosocial adaptation of patients.
authors.affiliation: Psychiatric Service, Hospital Santa Maria, University of Lleida, IRBLleida (Biomedicine Research Institute), Lleida, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Mora
authors.forename: M J
authors.initials: MJ
authors.lastname: Portella
authors.forename: I
authors.initials: I
authors.lastname: Forcada
authors.forename: E
authors.initials: E
authors.lastname: Vieta
authors.forename: M
authors.initials: M
authors.lastname: Mur
mesh_terms: D000328:Adult; D018692:Antimanic Agents / Q000627:therapeutic use*; D001288:Attention; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000523:psychology; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000523:psychology*; D004651:Employment; D056344:Executive Function; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007266:Inhibition, Psychological; D007398:Interpersonal Relations; D018020:Lithium Compounds / Q000627:therapeutic use*; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D016896:Treatment Outcome
chemical_list: D018692:Antimanic Agents; D018020:Lithium Compounds