title: Executive function impairments in depression and bipolar disorder: association with functional impairment and quality of life.
abstract: BACKGROUND
  The neuropsychological correlates of major depressive (MDD) and bipolar disorder (BD), and their association with quality of life (QOL) and functioning, have not been sufficiently studied in the literature. The present study aimed to compare executive functions, attention, processing speed, QOL and disability between patients with BD type I, BD type II, MDD and healthy controls.
  
  
  METHODS
  205 participants (n=37 BDI, 81% female; n=35 BDII, 80% female; n=45 MDD, 69% female; n=89C, 46% female) aged between 18 and 67 years were administered an extensive neurocognitive battery consisting of widely used standardized measures such as the Trail Making Test, the Stroop Color-Word Test and a modified version of the Wisconsin Card Sorting Task. Z-scores were compared between groups by ANCOVA. The prevalence of impairments on each measure (Z-score<1.5) was compared between groups using chi-square tests. The associations between cognition, quality of life and functioning were evaluated through correlational analysis.
  
  
  RESULTS
  Patients with MDD showed poor selective and sustained attention, and exhibited impairments in timed tasks, suggesting low efficiency of executive processing. Patients with BDI displayed more widespread cognitive impairment than the remaining groups, and performed worse than subjects with MDD on measures of sustained attention and inhibitory control. Decision-making ability and attentional control were able to distinguish between patients with BDI and BDII. QOL and disability were most impaired in patients with BDI, and more closely associated with cognitive impairment than in the remaining groups.
  
  
  CONCLUSIONS
  No control of pharmacological variables, clinical or demographic characteristics.
  
  
  CONCLUSIONS
  Our results provide important information regarding the nature and severity of the cognitive alterations associated with different mood disorders, and may contribute to the diagnosis, rehabilitation and treatment of these conditions.
authors.affiliation: Department of Psychology, Pontifical Catholic University of Rio Grande do Sul, Avenue Ipiranga, 6681 Prédio 11, Sala 932, Porto Alegre, RS Postal code: 90619-900, Brazil. Electronic address: c.cotrena@gmail.com.
authors.forename: Charles
authors.initials: C
authors.lastname: Cotrena
authors.affiliation: Department of Psychology, Pontifical Catholic University of Rio Grande do Sul, Avenue Ipiranga, 6681 Prédio 11, Sala 932, Porto Alegre, RS Postal code: 90619-900, Brazil.
authors.forename: Laura Damiani
authors.initials: LD
authors.lastname: Branco
authors.affiliation: São Pedro Psychiatric Hospital, Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Flávio Milman
authors.initials: FM
authors.lastname: Shansis
authors.affiliation: Department of Psychology, Pontifical Catholic University of Rio Grande do Sul, Avenue Ipiranga, 6681 Prédio 11, Sala 932, Porto Alegre, RS Postal code: 90619-900, Brazil.
authors.forename: Rochele Paz
authors.initials: RP
authors.lastname: Fonseca
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001288:Attention / Q000502:physiology; D001714:Bipolar Disorder / Q000523:psychology*; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000523:psychology*; D006233:Persons with Disabilities / Q000523:psychology / Q000706:statistics & numerical data; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011788:Quality of Life / Q000523:psychology; D055815:Young Adult
keywords: Bipolar disorder; Executive functions; Functioning; Major depressive disorder; Quality of life