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Bipolar Disorder and Cognitive Dysfunction: A Complex Link

Cipriani, Gabriele MD*; Danti, Sabrina PhD*; Carlesi, Cecilia MD*; Cammisuli, Davide Maria PhD; Di Fiorino, Mario MD

Journal of Nervous & Mental Disease: October 2017 - Volume 205 - Issue 10 - p 743–756
doi: 10.1097/NMD.0000000000000720
Review Article

Abstract: The aim of this article was to describe the current evidence regarding phenomenon of cognitive functioning and dementia in bipolar disorder (BD). Cochrane Library and PubMed searches were conducted for relevant articles, chapters, and books published before 2016. Search terms used included “bipolar disorder,” “cognitive dysfunction,” and “dementia.” At the end of the selection process, 159 studies were included in our qualitative synthesis. As result, cognitive impairments in BD have been previously considered as infrequent and limited to the affective episodes. Nowadays, there is evidence of stable and lasting cognitive dysfunctions in all phases of BD, including remission phase, particularly in the following domains: attention, memory, and executive functions. The cause of cognitive impairment in BD raises the question if it subtends a neurodevelopmental or a neurodegenerative process. Impaired cognitive functioning associated with BD may contribute significantly to functional disability, in addition to the distorted affective component usually emphasized.

*Neurology Unit, Versilia Hospital, Lido di Camaiore (Lu); †Department of Surgical, Medical, Molecular and Critical Area Pathology, Pisa University School of Medicine, Pisa; and ‡Psychiatry Unit, Versilia Hospital, Lido di Camaiore (Lu), Italy.

The authors contributed equally to the planning and drafting of the manuscript.

Send reprint requests to Davide Maria Cammisuli, PhD, Department of Surgical, Medical, Molecular and Critical Area Pathology, Pisa University School of Medicine, 56124 Pisa, Italy. E-mail: d.cammisuli@med.unipi.it.

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