Long-term poor functional outcome among bipolar disorder patients may be linked to both cognitive impairment and the time spent with subsyndromal depressive symptomatology, Argentinean study findings indicate.

Cognitive impairment has been shown to be negatively associated with measures of disability and social and occupational functioning, but there is a lack of data examining the ability of cognitive impairments to predict long-term functional outcome.

Sergio Strehilevich and colleagues from the Favaloro Foundation in Buenos Aires therefore administered a neurocognitive battery assessing verbal memory, attention, and executive function to 35 patients with euthymic bipolar disorder and 30 mentally healthy controls matched for age and years in education.

The patients were assessed every 1??”4 weeks for ?1 year, with the course of illness documented using a modified life charting technique. The General Assessment to Functioning (GAF) and the Functioning Assessment Short Test (FAST) were used to determine psychosocial functioning at the end of the follow-up period.

Patients had lower performance than healthy controls on measures of verbal memory, attention, and executive function. There were no significant differences between patients and controls in terms of age, gender, years in education, and baseline scores on the Young Mania Rating Scale (YMRS) and the Hamilton Depression Rating Scale (HDRS).

The team found significant association between GAF scores at the end of follow-up and subsyndromal depressive symptomatology, along with impairments in verbal memory, attention, and executive function. Further analysis revealed that around 43% of the variance in GAF scores was accounted for by subsyndromal depressive symptomatology, and impairments in attention and verbal memory.

Similar results were seen for FAST scores, the researchers note in the Journal of Affective Disorders, with 28% of the variance of scores at the end of follow-up accounted for by impairments in attention and executive function. The results for both functioning assessments were unmodified by YMRS and HDRS scores.

“In summary, our findings bring further evidence that both cognitive impairments as well as subsyndromal depressive symptomatology are illness features associated with long-term functional outcome,” the team says.

“These results point out the importance of in which way developing strategies to improve cognitive impairments and subsyndromal symptomatology may lead to more comprehensive treatments and contribute to enhance the long-term functional outcome in patients with bipolar disorder.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

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