A prospective study of cognitive functioning in bipolar disorders in a tertiary care hospital

Abstract

Introduction: Bipolar disorder (BD) is characterized by episodic pathological mood alterations that can be manic, depressive or mixed [American Psychiatric Association, 1994]. In the last 10 years, there has been increased emphasis on the role of cognition in BD attested by the exponential growth in the number of relevant publications. A significant turning point was the realization that cognitive impairment was a replicable feature of BD with measurable changes being present both during episodes and in remission. Materials and methods: Study Design: A prospective comparative study was conducted at the Department of Psychiatry, Midnapore Medical College and Hospital, Midnapore, West Bengal for 1 year , Institutional ethical clearance was taken. 100 patients suffering from bipolar disorder I currently in remission and 100 healthy controls were included in this study. The clinical state of individuals was assessed by a psychiatrist using a semi-structured proforma for documentation which included socio-demographic data of the patient, history of psychological symptoms, and thorough Physical examination findings. 100 patients were selected for the study, which fulfilled the DSM-IV TR criteria for Bipolar disorder I. Remission was assessed with scores 8 or less on Hamilton Depression Rating Scale (H.D.R.S.) and 6 or less on Young’s Mania Rating Scale (Y.M.R.S.). Results: Patients with bipolar I disorder were found more cognitively impaired in comparison to the control group particularly in attention, working memory, and executive functioning. Factors affecting neurocognitive performances were early-onset, age, duration of illness and number of episodes. Conclusion: Cognitive functioning of an individual is very important as it not only reflects a patient’s socio-occupational functioning and ability to live independently but also about the insight of their illness and compliance to treatment. Adequate cognitive remediation at an early stage of illness might improve the outcome of bipolar illness. Therefore, the development of interventions targeting cognitive impairments is imperative for improving recovery rates and quality of life in patients suffering from bipolar disorder.