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Cognitive Deficits in Euthymic Patients With Bipolar Disorder

State or Trait Marker?

Srivastava, Chhitij, MD, MRCPsych*†‡; Bhardwaj, Anupam, MD, MRCPsych§; Sharma, Mukul, MD; Kumar, Sanjay, MPhil, PhD

The Journal of Nervous and Mental Disease: February 2019 - Volume 207 - Issue 2 - p 100–105
doi: 10.1097/NMD.0000000000000920
Original Articles

Cognitive deficits have been demonstrated in people in the euthymic phase of bipolar disorder. This cross-sectional study compared euthymic bipolar disorder patients (n = 30) with never psychiatrically ill controls (n = 30) on a neuropsychological test battery containing tasks of executive function, the Wisconsin Card Sorting Test (WCST), attention and working memory, digits forward and backward, and speed of information processing digit symbol. Scores on the Mini-Mental State Examination (MMSE) and vocabulary test did not differ between the groups. The bipolar group was significantly impaired compared with controls on various indices of executive function on the WCST and on the digit tests. The impaired performance on the digit tests, but not the WCST, was significantly associated with medication status, notably prescribed benzodiazepines. There was no significant effect of severity or course of illness on performance. The findings support the hypothesis that impairments in executive function are present between illness episodes in bipolar disorder, and so they are not simply state markers.

*Psychiatry Unit, Moti Lal Nehru Medical College, Allahabad, India;

Institute of Psychiatry, King's College London, London, United Kingdom;

Centre of Behavioral and Cognitive Sciences, University of Allahabad, Allahabad, India;

§Department of Child and Adolescent Psychiatry, Cambridge and Peterborough Foundation Trust, Cambridge;

Woodlands Resource Centre–Fylde Adult Community Mental Health Team, Lancashire Care NHS Trust, Lytham St Annes; and

Department of Psychology, Oxford Brookes University, Oxford, United Kingdom.

Send reprint requests to Sanjay Kumar, MPhil, PhD, Department of Psychology, Oxford Brookes University, Oxford, OX3 0BP, United Kingdom. E-mail:

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