Attention impairment in bipolar disorder: A systematic review.

Evelyn V M Camelo,Tania Netto,Pedro Ribeiro,Bruna Velasques,Elie Cheniaux

doi:10.3922/j.psns.2013.3.08

Abstract

disorder (BD) has been associated with marked cognitive impairment, including euthymic periods. Attention is among the most compromised functions in BD. Changes related to learning, memory, and visuospatial abilities can be derived from these attention impairments. The objective of this article is to review the scientific literature on the performance of BD patients in attention tests. A systematic review was performed of controlled studies that assessed attention in patients diagnosed with BD aged between 18 and 65 years. The databases included Medline, LILACS, Cochrane Library, Institute for Scientific Information Web of Knowledge, and Scientific Electronic Library Online (SciELO), and the search encompassed the period from 2008 to 2013. Only studies that had a minimum sample of 10 patients were included. A total of 110 articles fulfilled the inclusion criteria. Compared with healthy control subjects, bipolar patients showed poorer attention performance. Compared with other mental disorders, BD was associated with poorer performance than unipolar depression but better performance than schizophrenia. When bipolar patients in different phases of the disease were compared with one another, the performance of euthymic patients was similar to or better than patients in a depressive state; moreover, manic patients performed worse than depressive patients. Attention is significantly impaired in BD. Attention impairment in BD is milder than in schizophrenia but greater than in unipolar depression. Attention impairment is possibly more severe in manic and depressed episodes than in euthymic periods.Keywords: attention, cognition, neuropsychological tests, bipolar disorder.

Highlights

Cognitive deficits were first studied in brain injury and dementia and later in schizophrenia
Our aim was to provide an update on the body of knowledge about attention impairment in patients with bipolar disorder (BD) based on studies published over the past five years
Our results on attention impairment in BD were very similar to those found in these reviews

Summary

Introduction

Cognitive deficits were first studied in brain injury and dementia and later in schizophrenia. The literature has provided evidence of stable and persistent cognitive impairments across the phases of BD, including euthymia, in the following domains: sustained attention, learning, memory, visuospatial ability, and executive function (Caligiuri, & Ellwanger, 2000; Latalova, Jan, Tomas, Dana, & Hana, 2011). In BD, attentional changes are very relevant and can affect other cognitive functions, such as memory, learning, and executive function (Goodwin, Jaminson, & Ghaemi, 2007). Numerous review articles have been published on cognitive impairments in BD, but these studies did not address attention impairments (Sachs, Schaffer, & Winklbaur, 2007; Latalova et al, 2011; Kałwa, 2010; Quaishi & Frangou, 2002). Only one review article published 9 years ago (Clark, & Goodwin, 2004) focused on attentional changes in bipolar patients. The present study provides an update on the knowledge of attention impairments in patients with BD by systematically reviewing controlled studies published in the past 5 years

Objectives

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Conclusion