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Acta Psychiatr Scand ; 128(3): 149-62, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23617548

RESUMEN

OBJECTIVE: An association between bipolar disorder and cognitive impairment has repeatedly been described, even for euthymic patients. Findings are inconsistent both across primary studies and previous meta-analyses. This study reanalysed 31 primary data sets as a single large sample (N = 2876) to provide a more definitive view. METHOD: Individual patient and control data were obtained from original authors for 11 measures from four common neuropsychological tests: California or Rey Verbal Learning Task (VLT), Trail Making Test (TMT), Digit Span and/or Wisconsin Card Sorting Task. RESULTS: Impairments were found for all 11 test-measures in the bipolar group after controlling for age, IQ and gender (Ps ≤ 0.001, E.S. = 0.26-0.63). Residual mood symptoms confound this result but cannot account for the effect sizes found. Impairments also seem unrelated to drug treatment. Some test-measures were weakly correlated with illness severity measures suggesting that some impairments may track illness progression. CONCLUSION: This reanalysis supports VLT, Digit Span and TMT as robust measures of cognitive impairments in bipolar disorder patients. The heterogeneity of some test results explains previous differences in meta-analyses. Better controlling for confounds suggests deficits may be smaller than previously reported but should be tracked longitudinally across illness progression and treatment.


Asunto(s)
Síntomas Afectivos , Trastorno Bipolar , Trastornos del Conocimiento , Competencia Mental , Pruebas Neuropsicológicas , Psicotrópicos/efectos adversos , Adulto , Afecto , Síntomas Afectivos/psicología , Edad de Inicio , Trastorno Bipolar/complicaciones , Trastorno Bipolar/diagnóstico , Trastorno Bipolar/tratamiento farmacológico , Trastorno Bipolar/epidemiología , Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/tratamiento farmacológico , Trastornos del Conocimiento/epidemiología , Trastornos del Conocimiento/etiología , Factores de Confusión Epidemiológicos , Femenino , Humanos , Masculino , Procesos Mentales/efectos de los fármacos , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Psicotrópicos/administración & dosificación , Factores de Riesgo
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