Abstract
ObjectiveTo examine which subgroups of DSM-IV bipolar disorder (BD) [BD type I (BD-I) or BD type II (BD-II), and subgroups based on history of psychosis, presenting polarity, and age at onset] differentiate best regarding neurocognitive measures.MethodsA total of 199 patients with BD were characterized by clinical and neurocognitive features. The distribution of subgroups in this sample was: BD-I, 64% and BD-II, 36%; 60% had a history of psychosis; 57% had depression as the presenting polarity; 61% had an early onset of BD, 25% had a mid onset, and 14% had a late onset. We used multivariate regression analyses to assess relationships between neurocognitive variables and clinical subgroups.ResultsBoth BD-I diagnosis and elevated presenting polarity were related to impairments in verbal memory, with elevated presenting polarity explaining more of the variance in this cognitive domain (22.5%). History of psychosis and BD-I diagnosis were both related to impairment in semantic fluency, with history of psychosis explaining more of the variance (11.6%).ConclusionPoor performance in verbal memory appears to be associated with an elevated presenting polarity, and poor performance in semantic fluency appears to be associated with a lifetime history of psychosis.
Highlights
Both Bipolar disorder (BD)-I diagnosis and elevated presenting polarity were related to impairments in verbal memory, with elevated presenting polarity explaining more of the variance in this cognitive domain (22.5%)
History of psychosis and BD type I (BD-I) diagnosis were both related to impairment in semantic fluency, with history of psychosis explaining more of the variance (11.6%)
The characteristics of the disorder may vary with the age at onset (29), and those with an early onset appear as a separate subgroup with specific clinical manifestations including higher recurrence rates of mood episodes, more elevated episodes at least in BD-I (36), more often depressive onsets (35), more suicide attempts (32, 35), higher risk for comorbid borderline personality disorder (37), higher rates of psychotic symptoms (38, 39), more frequent neurocognitive impairment (40), more BD-I than BD type II (BD-II) (35), and more often a family history of BD (32, 41 –44) compared to patients with later onsets
Summary
A total of 199 patients with BD were characterized by clinical and neurocognitive features. The distribution of subgroups in this sample was: BD-I, 64% and BD-II, 36%; 60% had a history of psychosis; 57% had depression as the presenting polarity; 61% had an early onset of BD, 25% had a mid onset, and 14% had a late onset. We used multivariate regression analyses to assess relationships between neurocognitive variables and clinical subgroups
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