Do cognitive complaints in euthymic bipolar patients reflect objective cognitive impairment?

Psychotherapy and Psychosomatics

PubMedID: 16088267

Martínez-Arán A, Vieta E, Colom F, Torrent C, Reinares M, Goikolea JM, Benabarre A, Comes M, Sánchez-Moreno J. Do cognitive complaints in euthymic bipolar patients reflect objective cognitive impairment?. Psychother Psychosom. 2005;74(5):295-302.
BACKGROUND
In clinical practice, bipolar patients complain of cognitive deficits such as attentional or memory disturbances. The main aim of this study was to determine whether subjective cognitive complaints were associated with objective neuropsychological impairments.

METHOD
Sixty euthymic bipolar patients were assessed through a neuropsychological battery. A structured clinical interview was used to determine subjective cognitive complaints in patients. Thirty healthy controls were also included in the study in order to compare the neuropsychological performance among groups.

RESULTS
Bipolar patients with a higher number of episodes, especially the number of mixed episodes, longer duration of the illness and the onset of the illness at an earlier age showed more subjective complaints. Furthermore, bipolar patients with subjective complaints showed lower scores in several cognitive measures related to attention, memory and executive function compared with the control group. Nevertheless, patients without complaints also performed less well than controls in some neuropsychological measures.

CONCLUSION
Bipolar patients who were aware of cognitive deficits were more chronic, had presented more previous episodes, especially mixed type, and their illness had started at an earlier age compared with patients who did not complain about cognitive problems. Moreover, patients with good cognitive insight also had a poorer social and occupational functioning as well as a poorer neuropsychological performance. However, the bipolar group without complaints also obtained lower scores in several tests compared with healthy controls. Cognitive status of bipolar patients should be routinely assessed, regardless of the patients awareness about their cognitive deficits.