Bipolar disorder patients who have a first affective episode with psychotic symptoms and a history of mania have a semantic verbal fluency deficit that occurs in spite of generally preserved function, say UK scientists.

Bipolar disorder patients have memory, attention, and executive function deficits that persist during euthymia. While such deficits are correlated with the number of prior affective episodes, they have also been demonstrated in first-episode patients.

To examine the extent to which such deficits represent “core” bipolar disorder characteristics, Eugenia Kravariti, from King’s College London, and colleagues administered, among other tests, a neuropsychological battery to 35 bipolar disorder patients with a first affective episode showing psychotic symptoms and a positive history of mania and 274 community controls.

In addition, a subanalysis was performed between the patients and 105 controls matched for current IQ (”good” versus “poor”) and IQ trajectory (”stable,” “declined,” and “improved”).

There were no differences between patients and either groups of controls in terms of gender, education, or National Adult Reading Test IQ, whereas there were significant differences in age and ethnicity.

The results, published in the journal Bipolar Disorders, show that there was evidence of a suggested deficit in patients compared with controls on the Rey Auditory Verbal Learning Test Trial 6, and a significant deficit in patients compared with controls in semantic fluency.

Only the latter deficit was detectable in patents compared with IQ-matched controls. Compared with the overall control group, semantic fluency had a medium effect size, and a small-to-medium effect size compared with IQ-matched controls. There were no other significant deficits.

Further analysis demonstrated that antipsychotic medication had a small and nonsignificant negative correlation with semantic fluency, at average scores of 34.78 in medicated cases versus 45.00 in two non-medicated patients.

The team writes: “In summary, our results point to a moderate, isolated impairment in semantic verbal fluency in patients with a first affective episode with psychotic symptoms and a positive history of mania.

“This pattern contrasts sharply with the widespread neuropsychological dysfunction seen in the early phases of schizophrenia.”

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

Free abstract

• Break-through Preventative Care Program For People Living With Bipolar Disorder
• Pfizer Receives FDA Approval For Geodon(R) (Ziprasidone HCI) Capsules For The Adjunctive Maintenance Treatment Of Bipolar Disorder In Adults
• Optimism For Bipolar Disorder And Schizophrenia If Psychiatrists Abandon 19th Century Dogma, UK