Financial Capacity Assessment in Female Euthymic Bipolar Patients: Catching Up on a Long Neglected Vulnerable Group

Abstract

Background: Patients with bipolar disorder (BD) face many challenges as many basic cognitive and non-cognitive domains can be affected by their disease. Financial capacity requires complex cognitive functioning and is little investigated in BD, especially in the Greek cultural context. Objectives: This study, for the first time, is focusing on whether financial capacity shows deficits in female euthymic BD patients compared to controls and what the self-estimations of the patients for their performance are. Materials and Methods: Patients and a sample of one-to-one matched healthy controls were examined with a detailed neuropsychological battery and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). Before their neuropsychological assessment, participants responded to a single-item five-point Likert scale about their financial capacity. Results: Findings extend earlier work in other groups of older patients and indicate that euthymic BD patients' performance is lower than that of the control group in various subdomains and total score of LCPLTAS (p < 0.001), resembling the performance of patients with a diagnosis of Mild Cognitive Impairment (MCI). However, euthymic BD patients are not aware of their cognitive deficits compared to healthy controls and overestimate their financial capacities as they have more positive estimations regarding their financial capacity than controls (χ²(1) = 8.315, p = 0.004) despite their lower real performance. In addition, from a number of classic neuropsychological tests administered, only Trail Making Part B correlates with LCPLTAS scores for the group of euthymic BD patients (rho = -0.561, p = 0.005). Conclusions: The results support that special care must be provided for euthymic BD individuals, so we can prevent financial exploitation.

Keywords: bipolar disorder; euthymic; financial capacity; financial decision-making; financial exploitation; self-estimations.