Cognitive functioning following stabilisation from first episode mania

Rothanthi Daglas,Kelly Allott,Lisa P. Henry,Michael Berk,Sue M. Cotton,Melissa K. Hasty,Murat Yücel,Craig A. Macneil

doi:10.1186/s40345-017-0108-2

Abstract

BackgroundThe purpose of this study was to examine cognitive functioning in people following first-episode mania relative to a demographically similar healthy control group.MethodsForty-one patients, who had recently stabilised from a first manic episode, and twenty-one healthy controls, were compared in an extensive cognitive assessment.ResultsFirst-episode mania participants had significantly lower Full-Scale IQ (FSIQ) relative to healthy controls; however, this finding could be driven by premorbid differences in intellectual functioning. There were no significant differences between groups in Verbal IQ (VIQ) and Performance IQ (PIQ). First-episode mania participants performed significantly poorer than healthy controls in processing speed, verbal learning and memory, working memory, and cognitive flexibility with medium-to-large effects. There were no group differences in other measures of cognition.ConclusionsParticipants following first-episode mania have poorer global intelligence than healthy controls, and have cognitive difficulties in some, but not all areas of cognitive functioning. This highlights the importance of early intervention and cognitive assessment in the early course of the disorder.

Highlights

The purpose of this study was to examine cognitive functioning in people following first-episode mania relative to a demographically similar healthy control group
41 first episode mania (FEM) participants and 21 healthy control (HC) were included in the study
While the groups were statistically matched in estimated premorbid intelligence, the difference in premorbid IQ was of medium effect and so the difference in current Full-Scale IQ (FSIQ) may be driven by true pre-existing group differences or the inherent difficulties encountered matching FEM and HC on premorbid intelligence

Summary

Introduction

The purpose of this study was to examine cognitive functioning in people following first-episode mania relative to a demographically similar healthy control group. Cognitive impairments during euthymia in people in all stages of bipolar disorder have been reported by several meta-analyses, with findings of medium to large effect in processing speed, verbal learning and memory, non-verbal memory, working memory, verbal fluency, sustained attention and executive functions (Arts et al 2008; Bora et al 2009; Bourne et al 2013; Mann-Wrobel et al 2011). Two meta-analyses on adults with first episode bipolar disorder (including any polarity of illness) have identified impairments in most cognitive domains relative to healthy control (HC) participants (Bora and Pantelis 2015; Lee et al 2014). Daglas et al Int J Bipolar Disord (2017) 5:39 develop bipolar disorder Those with the highest school grades displayed a nearly fourfold increased risk of developing the disorder by age 31, whilst those with the lowest school performance were found to have close to a twofold increased risk (MacCabe et al 2010). Predictors of lower intellectual functioning in individuals with bipolar disorder include an earlier age of onset, greater number of prior episodes and hospitalisations (Denicoff et al 1999)

Objectives

Methods

Results

Discussion

Conclusion