Cognition in first-episode bipolar disorder

Why assess cognition in first-episode bipolar disorder?

Cognitive dysfunction is a common feature of bipolar disorder that exists across a number of cognitive domains and usually persists in remission. It is unclear whether cognitive deficits are apparent prior to the onset of bipolar disorder or whether they develop during the course of the illness. Assessing cognitive ability in people with a first-episode of bipolar disorder helps determine whether cognitive deficits were apparent prior to illness onset.

What is the evidence for cognition in first-episode bipolar disorder?

Compared to people without bipolar disorder (controls), high quality evidence shows medium-sized effects of poorer global cognition and processing speed, and small effects of poorer premorbid IQ, working memory, fluency and reasoning in people with first-episode bipolar disorder. Moderate to high quality evidence also suggests a large effect of poorer attention, and medium-sized effects of poorer current IQ, verbal memory, and visual memory in people with first-episode bipolar disorder.

Compared to people with first-episode schizophrenia, moderate to high quality evidence shows medium-sized effects of better verbal memory, verbal fluency, and premorbid IQ in people with first-episode bipolar disorder. Moderate quality evidence also shows small effects of better working memory and processing speed. Moderate to low quality evidence shows a medium-sized effect of better current IQ. There were no differences in attention or reasoning between people with first-episode bipolar disorder and first-episode schizophrenia.

March 2019

Last updated at: 10:15 pm, 30th March 2019
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