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. 2020 Nov;10(11):e01813.
doi: 10.1002/brb3.1813. Epub 2020 Aug 30.

Effects of mood episodes and comorbid anxiety on neuropsychological impairment in patients with bipolar spectrum disorder

Chih-Chun Huang  1 , Yun-Hsuan Chang  2   3   4 , Tzu-Yun Wang  4 , Sheng-Yu Lee  4   5   6 , Shiou-Lan Chen  4   7   8 , Po See Chen  4   9 , Hsien-Yuan Lane  2   10   11 , Yen Kuang Yang  1   4   12 , Ru-Band Lu  4   13
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Effects of mood episodes and comorbid anxiety on neuropsychological impairment in patients with bipolar spectrum disorder

Chih-Chun Huang et al. Brain Behav. 2020 Nov.

Abstract

Objectives: Cases of patients with bipolar disorder (BD) having neuropsychological impairment have been reported, although inconsistently. The possibility of comorbidity with anxiety disorder (AD) has been suggested. The association between mood episodes and AD comorbidity on neuropsychological performance is unclear and thus was investigated in the current study.

Methods: All participants were informed about and agreed to participate in this study. Patients with BD were recruited from outpatient and inpatient settings, and healthy controls (HCs) were recruited as a comparison group. Six hundred and twenty-eight participants (175 HCs and 453 BD-56 BDI and 397 BDII) were studied based on their current mood episode, namely, depressive (BDd ), manic/hypomanic (BDm), mixed (BDmix), and euthymic (BDeu), compared with/without AD comorbidity (164 with AD).

Results: Compared to HCs, all BD groups had significantly more impaired neuropsychological profiles, but the BDeu group was found to have less impairment in memory and executive function than the episodic BD groups. The percentage of AD comorbidity in BDd, BDm, BDmix, and BDeu was 33.9%, 40.3%, 33.0%, and 35.6%, respectively (χ2 = 1.61, p > .05). The results show that AD plays a different role in neuropsychological impairment across various mood episodes in BD.

Conclusion: Memory impairment and executive dysfunction may be state-like cognitive phenotypes and are affected by AD comorbidity during mixed and depressive episodes in BD, while sustained attention deficiencies are more like trait markers, regardless of mood episodes, and persist beyond the course of the illness. The AD comorbidity effect on attentional deficit is greater when suffering from a manic episode.

Keywords: anxiety disorder; bipolar disorder; comorbidity; neuropsychological impairment.

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Conflict of interest statement

The authors declare no conflicts of interests.

Figures

Figure 1
Figure 1
The influence of anxiety disorder (AD) comorbidity on various subscales of neuropsychological function in bipolar disorder (BD) (a‐1~c‐1)
See this image and copyright information in PMC

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References

    1. Allen, M. H. , Chessick, C. A. , Miklowitz, D. J. , Goldberg, J. F. , Wisniewski, S. R. , Miyahara, S. , … Sachs, G. S. (2005). Contributors to suicidal ideation among bipolar patients with and without a history of suicide attempts. Suicide and Lifethreatening Behavior, 35(6), 671–680. 10.1521/suli.2005.35.6.671 - DOI - PubMed
    1. Altinay, M. I. , Hulvershorn, L. A. , Karne, H. , Beall, E. B. , & Anand, A. (2016). Differential resting‐state functional connectivity of striatal subregions in bipolar depression and hypomania. Brain Connect, 6(3), 255–265. 10.1089/brain.2015.0396 - DOI - PMC - PubMed
    1. American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th ed.
    1. Basso, M. R. , Lowery, N. , Ghormley, C. , Combs, D. , Purdie, R. , Neel, J. , … Bornstein, R. (2007). Comorbid anxiety corresponds with neuropsychological dysfunction in unipolar depression. Cognitive Neuropsychiatry, 12(5), 437–456. 10.1080/13546800701446517 - DOI - PubMed
    1. Bauer, M. S. , Altshuler, L. , Evans, D. R. , Beresford, T. , Williford, W. O. , Hauger, R. , & Team, V. A. C. S. (2005). Prevalence and distinct correlates of anxiety, substance, and combined comorbidity in a multi‐site public sector sample with bipolar disorder. Journal of Affective Disorders, 85(3), 301–315. 10.1016/j.jad.2004.11.009 - DOI - PubMed

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