Brief cognitive assessment instruments in schizophrenia and bipolar patients, and healthy control subjects: A comparison study between the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS) and the Screen for Cognitive Impairment in Psychiatry (SCIP)

Cognitive impairment in schizophrenia and psychosis is ubiquitous and acknowledged as a core feature of clinical expression, pathophysiology, and prediction of functioning. However, assessment of cognitive functioning is excessively time-consuming in routine practice, and brief cognitive instruments specific to psychosis would be of value. Two screening tools have recently been created to address this issue, i.e., the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS) and the Screen for Cognitive Impairment in Psychiatry (SCIP). The aim of this research was to examine the comparative validity of these two brief instruments in relation to a global cognitive score. 161 patients with p…

The switch from conventional to atypical antipsychotic treatment should not be based exclusively on the presence of cognitive deficits. A pilot study in individuals with schizophrenia

Abstract Background Atypical antipsychotics provide better control of the negative and affective symptoms of schizophrenia when compared with conventional neuroleptics; nevertheless, their heightened ability to improve cognitive dysfunction remains a matter of debate. This study aimed to examine the changes in cognition associated with long-term antipsychotic treatment and to evaluate the effect of the type of antipsychotic (conventional versus novel antipsychotic drugs) on cognitive performance over time. Methods In this naturalistic study, we used a comprehensive neuropsychological battery of tests to assess a sample of schizophrenia patients taking either conventional (n = 13) or novel a…

Neurocognitive impairment and psychosocial functioning in bipolar II disorder

Sole B, Bonnin CM, Torrent C, Balanza-Martinez V, Tabares-Seisdedos R, Popovic D, Martinez-Aran A, Vieta E. Neurocognitive impairment and psychosocial functioning in bipolar II disorder. Objective:  There is a growing body of evidence on neurocognitive impairment in euthymic bipolar patients, but this issue has been studied mostly in bipolar I disorder, data on bipolar II (BD-II) are scant and discrepant. The two aims of this study were to ascertain whether strictly defined euthymic BD-II patients would present neurocognitive disturbances and to evaluate their impact on functional outcome. Method:  Forty-three BD-II patients and 42 demographically and educationally matched healthy subjects …

Functional outcome in bipolar disorder: the role of clinical and cognitive factors.

Introduction:  Few studies have examined the clinical, neuropsychological and pharmacological factors involved in the functional outcome of bipolar disorder despite the gap between clinical and functional recovery. Methods:  A sample of 77 euthymic bipolar patients were included in the study. Using an a priori definition of low versus good functional outcome, based on the psychosocial items of the Global Assessment of Functioning (GAF, DSM-IV), and taking also into account their occupational adaptation, the patients were divided into two groups: good or low occupational functioning. Patients with high (n = 46) and low (n = 31) functioning were compared on several clinical, neuropsychologica…

Long-Term Outcome of Cognitive Impairment in Bipolar Disorder

OBJECTIVE: To evaluate the longitudinal course and outcome of cognitive deficits and their clinical correlates in bipolar disorder. METHOD: One hundred thirteen participants (68 patients and 45 healthy controls) were assessed by the means of a neuropsychological battery targeting attention, psychomotor speed, verbal memory, and executive functions at baseline: 68 euthymic outpatients with a DSM-IV diagnosis of bipolar disorder (53 bipolar I and 15 bipolar II) were enrolled at the Bipolar Disorder Unit of the Hospital Clinic of Barcelona. Forty-five patients completed the follow-up. The assessments started in February 1999 and finished in July 2010. The primary outcome of the study was the c…

Bipolar I patients with and without a history of psychotic symptoms: do they differ in their cognitive functioning?

Abstract Recently, many reports have consistently demonstrated cognitive deficits in patients with bipolar disorder (BD), but their relationship with symptomatology, specifically psychotic symptoms, remains unclear. Our main hypothesis was that a history of hallucinations and/or delusions in the course of BD-I is associated with severe cognitive deficits. We investigated several cognitive functions (memory, attention, verbal fluency and executive functions) in 18 BD-I patients with a history of psychotic symptoms (HPS+), 17 BD-I patients without a history of psychotic symptoms (HPS−), 33 schizophrenic patients and 26 healthy control subjects. Both groups of BD-I patients were more impaired …

High cognitive reserve in bipolar disorders as a moderator of neurocognitive impairment

BackgroundCognitive reserve (CR) reflects the capacity of the brain to endure neuropathology, minimize clinical manifestations and successfully complete cognitive tasks. The present study aims to determine whether high CR may constitute a moderator of cognitive functioning in bipolar disorder (BD).MethodsOne hundred and two patients with BD and 32 healthy controls were enrolled. All patients met DSM-IV criteria for I or II BD and were euthymic (YMRS ≤ 6 and HDRS ≤ 8) during a 6-month period. All participants were tested with a comprehensive neuropsychological battery, and a Cerebral Reserve Score (CRS) was estimated. Subjects with a CRS below the group median were classified as having low C…

Neurocognitive Impairment in Bipolar Patients With and Without History of Psychosis

Objective: Little is known regarding the impact of psychotic symptoms on the cognitive functioning of bipolar patients. Findings from previous reports are controversial and mainly focused on current psychotic symptoms. The main aim of this study was to ascertain whether the history of psychotic symptoms was associated with greater cognitive impairment in euthymic bipolar patients. Method: Sixty-five euthymic bipolar disorder patients (DSM-IV criteria; 35 with a history of psychotic symptoms and 30 without such a history) were assessed through a neuropsychological battery targeting attention, psychomotor speed, verbal memory, and executive functions. Thirty-five healthy controls were also in…

Neuropsychological testing of cognitive impairment in euthymic bipolar disorder: an individual patient data meta-analysis

© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Neurocognitive endophenotypes (endophenocognitypes) from studies of relatives of bipolar disorder subjects: a systematic review.

Abstract Background There is growing interest to research neurocognition as a putative endophenotype for subjects with bipolar disorders (BD). The authors sought to review the available literature focused on relatives of subjects with bipolar disorder (BD-Rels) and identify suitable cognitive candidates to endophenotypes or endophenocognitypes. Method A systematic review was conducted in Medline, EMBASE and PsycINFO databases (1980–July 2007), supplemented with a manual search of reference lists. Results Twenty-three cross-sectional papers of discordant twins (4 studies), genetic high-risk subjects (7), and different BD-Rel groups (12) met the inclusion criteria and evaluated 532 BD-Rels. I…

The clinical implications of cognitive impairment and allostatic load in bipolar disorder.

AbstractBackgroundAllostatic load (AL) relates to the neural and bodily “wear and tear” that emerge in the context of chronic stress. This paper aims to provide clinicians with a comprehensive overview of the role of AL in patophysiology of bipolar disorder (BD) and its practical implications.MethodsPubMed searches were conducted on English-language articles published from 1970 to June 2011 using the search terms allostatic load, oxidative stress, staging, and bipolar disorder cross-referenced with cognitive impairment, comorbidity, mediators, prevention.ResultsProgressive neural and physical dysfunction consequent to mood episodes in BD can be construed as a cumulative state of AL. The con…

Evidence for association between structural variants in lissencephaly-related genes and executive deficits in schizophrenia or bipolar patients from a Spanish isolate population.

There is evidence for an association between structural variants in genes for lissencephaly, which are involved in neuronal migration, and prefrontal cognitive deficits in schizophrenia and bipolar patients. On the basis of these intriguing findings, we analyzed 16 markers located in the lissencephaly critical region (LCR in chromosome 17p13.3) in 124 schizophrenic, 56 bipolar, and 141 healthy individuals. All recruits were from a Spanish population isolate of Basque origin that is characterized by low genetic heterogeneity. In addition, we examined whether structural genomic variations in the LCR were associated with executive cognition. Twenty-three patients (12.8%), but none of the contr…

Treatment nonadherence and neurocognitive impairment in bipolar disorder.

OBJECTIVE: Little is known regarding the relationship between treatment adherence and residual cognitive dysfunction in euthymic bipolar disorder patients. This study aimed to investigate whether poor treatment adherence is associated with cognitive impairment in euthymic bipolar patients and whether other factors may be associated with both adherence and cognitive functioning. METHOD: Euthymic DSM-IV bipolar I or II disorder patients (N = 103: 61 with high levels of treatment adherence and 42 with poor treatment adherence) were assessed using a neuropsychological battery targeting attention, psychomotor speed, verbal memory, and executive functions and compared with 35 healthy controls of …

NORMATIVE DATA OF THE SCIP-S IN SCHIZOPHRENIA AND TYPE I BIPOLAR DISORDER

Utility of the World Health Organization Disability Assessment Schedule II in schizophrenia.

The World Health Organization Disability Assessment Schedule II (WHODAS II) was developed for assessing disability. This study provides data on the validity and utility of the Spanish version of the WHODAS II in a large sample of patients with schizophrenia.The sample included 352 patients with a schizophrenia spectrum disorder. They completed a comprehensive assessment battery including measures of psychopathology, functionality and quality-of-life. A sub-sample of 36 patients was retested after six months to assess its temporal stability.Participation in society (6.3%) and Life activities (4.0%) were the domains with the highest percentage of missing data. The internal consistency (Cronba…

Spanish version of the Screen for Cognitive Impairment in Psychiatry (SCIP-S): psychometric properties of a brief scale for cognitive evaluation in schizophrenia.

The Screen for Cognitive Impairment in Psychiatry (SCIP) is a brief scale designed for detecting cognitive deficits in several psychotic and affective disorders. This study examined the psychometric properties of the Spanish version of the SCIP in a sample of outpatients suffering schizophrenia-spectrum disorders.Psychometric properties were evaluated in a sample of 126 stable patients with schizophrenia. Men and women 18 to 55 years of age were recruited from consecutive admissions to 40 psychiatric outpatient clinics in Spain and asked to complete a series of cognitive measures at baseline, as well as three versions of the SCIP separated by one week intervals. A matched sample of 39 healt…

Comparing neurocognitive impairment in schizophrenia and bipolar I disorder using the Screen for Cognitive Impairment in Psychiatry Scale

AbstractThe purpose of this study was to compare the psychometric properties of the Screen for Cognitive Impairment in Psychiatry (SCIP) when applied to patients diagnosed with schizophrenia (n=126) or bipolar I disorder (n=76), and also to compare the cognitive impairment in both samples of patients and a control group (n=83) using the SCIP and a complete neuropsychological battery. The SCIP is a scale intended to quickly and easily assess cognitive impairment in patients with severe psychiatric disorders. The results showed firstly that, in terms of internal consistency, temporal stability, dimensional structure, and criterion-referenced validity, the SCIP provides reliable and valid scor…

Effects of atypical antipsychotics on neurocognition in euthymic bipolar patients

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P-1294 - Utility of the world health organization disability assessment schedule II in schizophrenia

Aim The World Health Organization Disability Assessment Schedule II (WHODAS II) was developed for assessing disability. This study provides data on the validity and utility of the Spanish version of the WHODAS II in a large sample of patients with schizophrenia. Methods The sample included 352 patients with a schizophrenia spectrum disorder. They completed a comprehensive assessment battery including measures of psychopathology, functionality and quality-of-life. A sub-sample of 36 patients was retested after six months to assess its temporal stability. Results Participation in society (6.3%) and Life activities (4.0%) were the domains with the highest percentage of missing data. The intern…

Neurocognitive and clinical predictors of functional outcome in patients with schizophrenia and bipolar I disorder at one-year follow-up

Abstract Objective Many studies have reported that cognitive ability may be predictive of the functional outcome for patients with schizophrenia. However, no study has prospectively examined these aspects in schizophrenia and bipolar disorders simultaneously. The present study attempted to analyze if neurocognition and clinical status predicts the real-life functioning for patients with schizophrenia or bipolar I disorder, using a longitudinal design. Method Forty-seven schizophrenic and 43 bipolar I outpatients were assessed twice with a neurocognitive battery (Executive Functions, Working Memory, Verbal Memory, Visual Memory, Visual-Motor Processing, Vigilance, Vocabulary and Motor Speed …

Disability in bipolar I disorder: the 36-item World Health Organization Disability Assessment Schedule 2.0.

Abstract Background The WHODAS 2.0 is an ICF-based multidimensional instrument developed for measuring disability. The present study analyzes the utility of the 36-item interviewer-administered version in a sample of patients with bipolar disorder. There is no study to date that analyses how the scale works in a sample that only comprises such patients. Methods A total of 291 patients with bipolar disorder (42.6% males) according to DSM-IV-TR criteria from a cross-sectional study conducted in outpatient psychiatric clinics were enrolled. In addition to the WHODAS 2.0, patients completed a comprehensive assessment battery including measures on psychopathology, functionality and quality of li…

Smoking does not impact social and non-social cognition in patients with first episode psychosis.

Abstract Background Many studies having shown significant improvements in non-social and social cognitive performance in smoking FEP patients compared to non-smoking FEP patients. The findings are controversial. This study analyzed the effects of tobacco use on non-social and social cognitive function in a large group of FEP patients and a matched healthy control group. Methods A sample of 335 patients with FEP and 253 healthy controls was divided into four subgroups: control tobacco users (CTU), control non-tobacco users (CNTU), patient tobacco users (PTU) and patient non-tobacco users (PNTU). Demographic variables, tobacco use variables (presence or absence, frequency and duration of toba…

EPA-0492 - Functional remediation in bipolar II patients: improvement of functioning and subsyndromal symptoms

Introduction Recently, Functional Remediation (FR) has proven to be effective in improving the functional outcome of euthymic bipolar patients. Objective Our objective was to test the efficacy of FR programme in a subsample of euthymic bipolar II patients (BPII). Aims The main aim was improve the functional outcome in these patients. Method Post-hoc analyses were undertaken using data of 53 DSM-IV diagnosed BPII outpatients who had participated in a multicentre, rater blind, randomized, controlled trial (RCT) exploring the efficacy of FR (n=17) as compared with a Psychoeducation (PSY) (n=19) and a control (n=17) groups which only treatment as usual (TAU). The primary outcome variable was a …

Motor speed predicts stability of cognitive deficits in both schizophrenic and bipolar I patients at one-year follow-up

Background We examined whether motor speed assessed by the finger tapping test predicts generalized and specific stable deficits because of a common patho-genic process in bipolar and schizophrenic patients. Methods: One hundred and two patients underwent a battery of neuropsychological tests. Patients with a score of less than one standard deviation from their siblings' sample in two assessments with an interval of one year were defined as suffering from stable deficits because of a common pathogenic process. In addition to univariate analyses, factor analyses, ordinal logistic regression, and multiple linear regressions were used. A general score was also calculated. Results: No differenc…

Neurocognition in bipolar disorders—A closer look at comorbidities and medications

The last decade has witnessed a growing interest in the neuropsychological study of bipolar disorder (BD). This chronic mood disorder is associated with persistent neurocognitive impairments even during periods of euthymia, particularly in the broad domains of attention, verbal memory and executive functions. More interestingly, cognitive dysfunction seems to predict a poorer functional outcome among BD patients and thus represents an important target for future therapies. The aetiology of cognitive dysfunction is probably multifactorial, including gene-environment interactions with potentially confounding variables as well. Drug-induced cognitive adverse effects represent an important and …

Variations in genes regulating neuronal migration predict reduced prefrontal cognition in schizophrenia and bipolar subjects from mediterranean Spain: A preliminary study

Both neural development and prefrontal cortex function are known to be abnormal in schizophrenia and bipolar disorder. In order to test the hypothesis that these features may be related with genes that regulate neuronal migration, we analyzed two genomic regions: the lissencephaly critical region (chromosome 17p) encompassing the LIS1 gene and which is involved in human lissencephaly; and the genes related to the platelet-activating-factor, functionally related to LIS1, in 52 schizophrenic patients, 36 bipolar I patients and 65 normal control subjects. In addition, all patients and the 25 control subjects completed a neuropsychological battery. Thirteen (14.8%) patients showed genetic varia…

Effects of atypical antipsychotics on neurocognition in euthymic bipolar patients.

Abstract Background Different factors may influence cognitive functioning in bipolar disorder such as the effect of subsyndromal symptoms, the history of psychotic symptomatology or substance abuse, negative symptomatology, chronicity, sleep disturbances, and hormonal factors. The effect of pharmacologic treatment on cognition is still uncertain because of an insufficient number of studies examining this issue. Objective The aims of this study were to compare neuropsychologic performance of treated bipolar patients with that of controls, including unmedicated patients and healthy subjects, as well as to evaluate possible neurocognitive differences among 3 different atypical antipsychotics. …

Mutations in genes regulating neuronal migration predict reduced prefrontal cognition in schizophrenia and bipolar disorder: a preliminary study

El artículo se basa en la presentación de un póster en International Society on Brain and Behaviour: 2nd International Congress on Brain and Behaviour Thessaloniki, Greece. 17–20 November 2005

Cognitive impairment in schizoaffective disorder: a comparison with non-psychotic bipolar and healthy subjects.

Objective:  Only a few studies have examined specifically the neuropsychological performance of schizoaffective patients. Method:  The sample consisted of 34 euthymic DSM-IV schizoaffective patients, who were compared with 41 euthymic bipolar patients without history of psychotic symptoms and 35 healthy controls. Euthymia was defined by a score of 6 or less at the Young Mania Rating Scale and a score of 8 or less at the Hamilton Depression Rating Scale for at least 6 months. Patients were compared with several clinical, occupational, and neuropsychological variables such as executive function, attention, verbal and visual memory and the two groups were contrasted with 35 healthy controls on…