Vikash Dixit, Pradeep Kumar Yadav
BACKGROUND Patients with bipolar disorder, cycle through episodes of mania, depression and euthymia, leading to dramatic fluctuations in energy, mood, social behaviour and cognitive functioning. It presents with dysfunctioning in cognition, particularly executive functioning, attention, processing speed, verbal learning and declarative memory. Cognitive dysfunctioning not only occurs in acute phase but also in remission phase. We compared the frequency and types of neurocognitive deficits and factors influencing them in individuals with Bipolar I disorder in euthymic state with healthy control. METHODS The study included 50 euthymic patients with bipolar I disorder and were compared with 50 healthy controls on cognitive functions. Diagnosis of bipolar disorder I was made following DSM IV TR criteria and current euthymic state was established by applying YMRS and HDRS scale. Neurocognitive performance was assessed on MMSE, Frontal Assessment Battery, Trail Making Test A and B. Statistical tests used were chi square test, ANOVA and Pearson’s correlation using SPSS 20 software. RESULTS Patients with bipolar I disorder were found cognitively impaired in comparison to control group particularly in attention, working memory, and executive functioning. Factors affecting neurocognitive performance were early onset, age, duration of illness and number of episodes. CONCLUSIONS Our study suggests that Euthymic Bipolar I patients had significant frontal dysfunction and impairment in psychomotor speed, visual conceptualization and visuomotor tracking. Neuropsychological deficits in remission period impair sociooccupational functions which lead to poor compliance and more relapses. This highlights the need of routine assessment and early interventions even in euthymic stage.
