Cognition and bipolar type

How is bipolar disorder type and cognition related?

Bipolar disorder is characterised by episodes of depression and mania. A major depressive episode is a period of at least two weeks in which a person has at least five of the following symptoms (including one of the first two): intense sadness or despair; feelings of helplessness, hopelessness or worthlessness; loss of interest in activities once enjoyed; feelings of guilt, restlessness or agitation; sleeping too little or too much; slowed speech or movements; changes in appetite; loss of energy; difficulty concentrating, remembering or making decisions; and/or thoughts of death or suicide. A manic episode is a period of at least one week when a person is high spirited or irritable in an extreme way most of the day for most days. A manic episode involves changes in normal behaviour such as showing exaggerated self-esteem or grandiosity, less need for sleep, talking more than usual, talking more loudly and quickly, being easily distracted, doing many activities at once, scheduling more events in a day than can be accomplished, embarking on risky behaviour, uncontrollable racing thoughts, and/or quickly changing ideas or topics. These changes in behaviour are significant and clear to friends and family and are severe enough to cause major dysfunction.

The difference between bipolar I disorder and bipolar II disorder is determined by the existence of mania in bipolar I and hypomania in bipolar II, which is a less severe form of mania. People with bipolar I disorder are also more likely to have psychotic symptoms. As people with psychotic disorders show cognitive deficits, they may be more apparent in people with bipolar I disorder.

What is the evidence for cognition in different types of bipolar disorder?

High quality evidence suggests small significant effects of greater cognitive impairment in global cognition, verbal memory, processing speed, and executive functioning in people with bipolar I disorder compared to bipolar II disorder, with no differences in working or visual memory, attention or social cognition.

March 2019

Last updated at: 9:59 pm, 30th March 2019
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