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The long-term course of cognition in bipolar disorder: a systematic review and meta-analysis of patient-control differences in test-score changes

Published online by Cambridge University Press:  12 November 2021

Cecilia Samamé Open the ORCID record for Cecilia Samamé [Opens in a new window] ,
Brenda Lucía Cattaneo ,
María Cristina Richaud ,
Sergio Strejilevich  and
Ivan Aprahamian
Cecilia Samamé*
Affiliation:
National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina Favaloro University, Buenos Aires, Argentina
Brenda Lucía Cattaneo
Affiliation:
Favaloro University, Buenos Aires, Argentina
María Cristina Richaud
Affiliation:
National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
Sergio Strejilevich
Affiliation:
Favaloro University, Buenos Aires, Argentina AREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina
Ivan Aprahamian
Affiliation:
Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Geriatrics Division, Internal Medicine Department, Jundiaí Medical School, Jundiaí, Brazil Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
*
Author for correspondence: Cecilia Samamé, E-mail: ceciliasamame@gmail.com
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Abstract

Neuropsychological impairment represents a key aspect of bipolar disorder (BD) that is evident even in early-course patients and is a strong predictor of functional outcomes among those affected. Previous meta-analyses of longitudinal studies suggest that BD-related cognitive deficits may not progress along the course of the disorder. However, short test-retest periods were used in most primary studies and comparisons with healthy controls were limited. The aim of this review was to synthesize the findings of research reports comparing long-term neurocognitive trajectories between BD patients and healthy individuals. PubMed, PsycINFO, and Scopus databases were searched from inception through July 2021. Publications were considered for inclusion if they reported cognitive test scores of BD patients and healthy controls at two different time points, with a minimum test-retest interval of 5 years. Fifteen studies compared the long-term course of cognition in BD patients with that of healthy controls. Ten of these were included in the quantitative analysis and involved 540 BD patients and 644 healthy individuals (mean follow-up period: 8.9 years). Patient-control effect sizes (standardized mean differences) were calculated for test-score changes in 24 neuropsychological variables and combined by means of meta-analytic procedures. No significant differences were found between patients and controls regarding long-term cognitive outcomes. These findings are consistent with previous shorter-term longitudinal meta-analyses and do not provide evidence for progressive cognitive deterioration in most bipolar individuals. Future studies should address the longitudinal course of cognition in different subgroups of BD patients and its prognostic and therapeutic value.

Keywords

Bipolar disordercognitionlong-termmeta-analysis

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Type
Review Article
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Psychological Medicine , Volume 52 , Issue 2 , January 2022 , pp. 217 - 228
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Copyright © The Author(s), 2021. Published by Cambridge University Press

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