title: Optimising screening for cognitive dysfunction in bipolar disorder: Validation and evaluation of objective and subjective tools.
abstract: BACKGROUND
  Cognitive impairment is common in bipolar disorder and contributes to socio-occupational difficulties. The objective was to validate and evaluate instruments to screen for and monitor cognitive impairments, and improve the understanding of the association between cognitive measures and socio-occupational capacity.
  
  
  METHODS
  Patients with bipolar disorder in partial or full remission (n=84) and healthy controls (n=68) were assessed with the Screen for Cognitive Impairment in Psychiatry (SCIP), Cognitive Complaints in Bipolar Disorder Rating Scale (COBRA), and established neuropsychological tests and subjective rating scales. Socio-occupational function and affective symptoms were evaluated with the Functional Assessment Short Test, and the Hamilton Depression Rating Scale 17-items and Young Mania Rating Scale, respectively. Concurrent validity of the SCIP and COBRA were assessed by correlation with established objective and subjective cognitive measures, and decision validity was determined with Receiver-Operating-Characteristic analyses. Correlations and linear regression analyses were conducted to determine the associations between objective and subjective cognitive impairment, and socio-occupational difficulties.
  
  
  RESULTS
  The SCIP and COBRA correlated strongly with established objective and subjective cognitive measures, respectively. The SCIP yielded higher sensitivity and specificity for detection of cognitive dysfunction than the COBRA or a combined SCIP-COBRA measure. Correlations between objective and subjective cognitive impairment were weak but both were associated with socio-occupational difficulties.
  
  
  CONCLUSIONS
  Influence of ageing was not investigated.
  
  
  CONCLUSIONS
  The SCIP and COBRA are valid for detection of objective and subjective cognitive impairment in bipolar disorder. Screening for cognitive dysfunction should be conducted with an objective measure like the SCIP.
authors: Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet Dep. 6233, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
authors: Johan Høy
authors: JH
authors: Jensen
authors: Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet Dep. 6233, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
authors: Mette Marie
authors: MM
authors: Støttrup
authors: Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet Dep. 6233, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
authors: Emilie
authors: E
authors: Nayberg
authors: Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet Dep. 6233, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
authors: Ulla
authors: U
authors: Knorr
authors: Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet Dep. 2031, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
authors: Henrik
authors: H
authors: Ullum
authors: Alberta Hospital Edmonton Neuropsychology, and the University of Alberta Faculty of Medicine & Dentistry, Box 307 (17480 Fort Road), Edmonton, Alta., Canada.
authors: Scot E
authors: SE
authors: Purdon
authors: Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet Dep. 6233, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
authors: Lars V
authors: LV
authors: Kessing
authors: Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet Dep. 6233, Blegdamsvej 9, DK-2100, Copenhagen, Denmark. Electronic address: Kamilla@miskowiak.dk.
authors: Kamilla W
authors: KW
authors: Miskowiak
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000150:complications* / Q000523:psychology; D003072:Cognition Disorders / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000592:standards* / Q000706:statistics & numerical data; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Bipolar disorder; Cognitive complaints; Cognitive impairment; Screening