Changes of Cognitive Function and the Relationship with Manic Symptoms between Acute Manic and Euthymic States in Patients with Bipolar Disorder

Hur, Ji Won; Kim, Yong Ku

Abstract

OBJECTIVES
The purpose of this study was to investigate 1) whether the change of manic symptoms in bipolar patients would be correlated with cognitive functions and 2) whether there would be significant changes in the cognitive function between acute manic and euthymic states.
METHODS
The thirty-five patients who were diagnosed as manic episode by DSM-IV and SCID-IV interview participated in this study. The memory function, executive function, and sustained attention were measured using Memory Assessment Scale (MAS), Wisconsin Card Sorting Test (WCST), and Vigilance (VIG) and Cognitrone (COG) in the Vienna Test System respectively. The psychopathology was measured using Young Mania Rating Scale (YMRS) and Brief Psychiatric Rating Scale (BPRS) by a trained psychologist. After 6 weeks of drug treatment, the cognitive tests and psychopathology were retested by the same psychologist.
RESULTS
The normal control group (N=76) and bipolar disorder patients group (N=35) showed different neurocognitive performance which were performed at baseline. After 6 weeks of medication, the YMRS and BPRS scores in the patient group decreased significantly. Although the psychiatric symptoms were attenuated, most of the neurocognitive functions including attention, psychomotor speed, memory (N=34), and frontal/executive function (N=35) were still impaired after treatment. Furthermore, the correlations between the variation of psychiatric symptoms and the differences in neurocognitive functions were statistically insignificant.
CONCLUSION
This study provides an evidence for distinct neuropsychological dysfunctions in acute manic state in bipolar disorder patients. Besides, the impairments of neuropsychological functioning remain after medication and remission. These neuropsychological dysfunctions might be one of the trait markers of the disorder, and we suggest that the dysfunctions make the bipolar disorder patients with medication still experience difficult to adjust daily life.