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What is learning in bipolar disorder?

Learning is the ability to acquire, or change, existing knowledge, behaviours or skills. There are two distinct forms of learning. Explicit (or declarative) learning occurs during a high level of consciousness regarding specific learnt content, for example, memorising information for an exam. Implicit (or procedural) learning is less conscious and refers to learning that is gained from task performance, for example, juggling. Explicit verbal learning can be measured with the Hopkins Verbal Learning test, the California Verbal Learning test and verbal list-learning, for example. The Brief Visuospatial memory test, the Rey design learning test, the Rey complex figure test, and visual reproduction all measure explicit visual learning. Implicit learning can be measured using the Serial Reaction Time task where learning is inferred from reduced reaction time to stimuli.

What is the evidence on learning in people with bipolar disorder?

High quality evidence finds medium-sized effects of poorer verbal and visual learning in people with the disorder (including first-episode) compared to controls without the disorder. Moderate quality evidence finds a large effect of poorer verbal and visual learning and memory in euthymic youth (aged 13 years) with bipolar disorder compared to age and IQ-matched controls. Moderate to low quality evidence finds a medium-sized effect of poorer serial learning in elderly people with bipolar disorder compared to age and education-matched controls. There was also a small trend effect in first-degree relatives of people with bipolar disorder aged 10-25 years. There were no changes in list learning over time (~5 years).

High quality evidence finds a medium-sized effect of poorer list learning in people with bipolar disorder and a history of psychotic symptoms compared to people with bipolar disorder without a history of psychotic symptoms. There was a small effect of poorer list learning in people with bipolar I disorder compared to people with bipolar II disorder.

Moderate to high quality evidence suggests a medium-sized effect of better list learning in people with first-episode bipolar disorder compared to people with first-episode schizophrenia, but poorer list learning during euthymia when people with bipolar disorder were compared to people with depression.

High quality evidence suggests a small association between poorer visual and verbal learning and memory and poorer general functioning.

October 2021

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Last updated at: 3:23 pm, 28th July 2022
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