title: Low compliance to pharmacological treatment is linked to cognitive impairment in euthymic phase of bipolar disorder.
abstract: BACKGROUND
  Cognitive impairment and low compliance to pharmacological treatment are frequent complications in bipolar disorder. Moreover, low compliance in patients with bipolar disorder is one of the main reasons for relapse. This in turn, is associated with an increase in neurocognitive symptoms. The current study aimed to determine whether attention, memory, and executive function are related to the level of compliance to pharmacological treatment in individuals with bipolar disorder in euthymic phase.
  
  
  METHODS
  We examined 34 patients with bipolar disorder (12 with low compliance to the treatment and 22 with high compliance to the treatment) according to the DSM-IV criteria, in the range of 18-55 years. All patients were assessed through a neuropsychological battery in one single session. Analysis of covariance (ANCOVA) was used to compare neuropsychological test scores between low and high compliance patients. Clinical and sociodemographic characteristics were included as covariates in the study.
  
  
  RESULTS
  Patients with low level of compliance performed significantly worse than high treatment compliance on verbal memory immediate free recall (F (1)=12.14, p=.002), verbal memory immediate cued recall (F (1)=10.45, p=.003), verbal memory delayed free recall (F (1)=5.52, p=.027), and verbal memory delayed cued recall (F (1)=6.11, p=.021). Covariates such as number of manic episodes, history of psychosis and years of education were found significant for executive functions and processing speed.
  
  
  CONCLUSIONS
  We found that low compliance to pharmacological treatment is consistently linked to immediate and delayed verbal memory. In addition, executive function and processing speed were associated with clinical and demographic characteristics. Limitations of this study include the small sample size, a cross-sectional design that cannot address causality, and inability to account for pharmacologic effects.
authors.affiliation: University of Guadalajara, Guadalajara, Mexico. Electronic address: fuentes.ile@gmail.com.
authors.forename: Ileana
authors.initials: I
authors.lastname: Fuentes
authors.affiliation: Especialidades e Investigación para la Salud, Guadalajara, Mexico.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Rizo-Méndez
authors.affiliation: University of Guadalajara, Guadalajara, Mexico; University of Barcelona, Barcelona, Spain.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Jarne-Esparcia
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy* / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D003463:Cues; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology / Q000523:psychology; D011939:Mental Recall; D008875:Middle Aged; D009483:Neuropsychological Tests; D010349:Patient Compliance; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014706:Verbal Learning; D055815:Young Adult
keywords: Bipolar disorder; Cognitive impairment; Neuropsychological tests; Treatment compliance