The authors of this paper do not have any commercial associations that might pose a conflict of interest in connection with this manuscript.
Neuropsychological task performance in bipolar spectrum illness: genetics, alcohol abuse, medication and childhood trauma
Article first published online: 30 APR 2008
Copyright © Blackwell Munksgaard 2008
Volume 10, Issue 4, pages 479–494, June 2008
How to Cite
Savitz, J. B., Van Der Merwe, L., Stein, D. J., Solms, M. and Ramesar, R. S. (2008), Neuropsychological task performance in bipolar spectrum illness: genetics, alcohol abuse, medication and childhood trauma. Bipolar Disorders, 10: 479–494. doi: 10.1111/j.1399-5618.2008.00591.x
- Issue published online: 30 APR 2008
- Article first published online: 30 APR 2008
- Received 29 November 2006, revised and accepted for publication 14 June 2007
- alcohol abuse;
- bipolar disorder;
- childhood trauma;
- major depression;
Introduction: Impaired executive and memory function is a putative genetic trait marker of bipolar I disorder (BPD I). Although executive/memory function has been posited to be an endophenotype of BPD I, it is unclear whether this extends to bipolar spectrum illness. It is also unclear to what extent non-genetic factors such as childhood abuse, alcoholism and medication influence neurocognitive function. We assessed the neuropsychological performance of a large cohort of bipolar disorder probands and their affectively ill and healthy family members, while controlling for self-reported childhood sexual and emotional abuse, emotional neglect, alcohol abuse and medication.
Methods: A total of 230 largely euthymic participants from 47 families, comprising 49 subjects with BPD I, 19 with bipolar II disorder (BPD II), 44 with recurrent major depression (MDE-R), 33 with a single lifetime episode of depression (MDE-S), 20 with other DSM-IV diagnoses and 65 unaffected relatives, were assessed with a battery of neuropsychological tasks.
Results: Sexual abuse, emotional abuse and emotional neglect scores were associated with poorer cognitive performance. After controlling for childhood trauma, the BPD I group performed worse than unaffected relatives on tests of visual recall memory as well as verbal recall and recognition memory. In contrast, individuals with BPD II and bipolar spectrum illness did not differ significantly from unaffected relatives. Treatment with lithium and antipsychotic medication was associated with reduced executive and verbal recognition memory function. After controlling for medication and other covariates, only verbal recall memory was significantly impaired in the BPD I cohort.
Conclusions: Verbal recall deficits may be one manifestation of a genetically driven dysfunction of frontal-striatal cortical networks in BPD I.