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What is language ability in bipolar disorder?

Language may be altered in people with bipolar disorder and may present in the form of disorganised speech. Tasks designed to assess language ability include; letter fluency tasks that assess the ability to generate words starting with a particular letter; and category fluency tasks that assess the ability to name words within a specified category. Working memory is needed for both letter and category fluency as participants must organise and retrieve relevant information.

Other tests designed to assess language include: Boston Naming task; Wechsler Adult Intelligence Scale (WAIS) comprehension (including the subtest information, similarities and vocabulary), WAIS verbal memory, verbal fluency, National Adult Reading Test (NART)/ Wide Range Achievement Test (WRAT), Controlled Oral Word Association Test (COWA), Category Instance Generation Test (CIGT), Multiple Choice Vocabulary Test (MWT-B), Hopkins Verbal Learning test (HVLT), California Verbal Learning Test (CVLT), Rey Auditory Verbal Learning Test (AVLT), semantic priming tasks and Lexical Decision Task and the Peabody Individual Achievement reading comprehension (PIAT).

What is the evidence on language fluency in people with bipolar disorder?

Moderate to high quality evidence shows a medium-sized effect of poorer language fluency in people with bipolar I disorder than controls. There was also a medium-sized effect of poorer language fluency in people with bipolar II disorder compared to controls. In direct comparison between bipolar I disorder and bipolar II disorder, those with bipolar I disorder showed a small effect of poorer language fluency.

High quality evidence shows a small effect of poorer language fluency in people with first-episode bipolar disorder compared to controls. Moderate to high quality evidence suggests a medium-sized effect of better fluency in people with first-episode bipolar disorder compared to people with first-episode schizophrenia.

High quality evidence suggests a medium to large effect of poorer language fluency in elderly people with bipolar disorder compared to controls matched for age and education.

High quality evidence suggests a small to medium-sized effect of poorer language fluency in first-degree relatives of people with bipolar disorder compared to controls. There was better fluency in first-degree relatives of people with bipolar disorder than first-degree relatives of people with schizophrenia.

High quality evidence suggests a small association between poor verbal ability/fluency and poor general functioning.

Moderate quality evidence suggests no changes in performance on fluency tasks over time (~3-4 years) in people with bipolar disorder.

October 2021

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Last updated at: 1:27 am, 18th October 2021
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