Cognitive deficits have been reported in people with bipolar disorder that are present early in the course of the disorder and may be stable over time. Relatives of people with bipolar disorder may show attenuated signs of cognitive deficits. If cognitive deficits found in people with bipolar disorder are also found in their relatives, this may be suggestive of an underlying genetic basis.

What is the evidence on cognition in relatives of people with bipolar disorder?

High quality evidence shows small to medium-sized effects of poorer processing speed, verbal fluency, executive functioning (on speed tasks) and social cognition in first-degree relatives of any age compared to controls without a first-degree relative with the disorder. There were no differences in executive functioning (accuracy), IQ, verbal memory, visual memory, working memory or sustained attention. In young first-degree relatives (10 to 25 years), there were small effects of poorer performance on IQ, verbal memory, visual memory, processing speed, sustained attention, and executive functioning, with no differences in working memory.

Moderate to high quality evidence suggests small to medium-sized effects of better IQ, verbal memory, working memory, processing speed, verbal fluency and accuracy of executive functioning in first-degree relatives of people with bipolar disorder compared to first-degree relatives of people with schizophrenia. There were no differences in executive functioning (on speed tasks), visual memory or sustained attention.

September 2021

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