JPR, LC and BJS have performed consultancy work for Cambridge Cognition, owners of the CANTAB. DMC, SKG, JTT, KE, SW, JMK, CAZ and WCD have no competing interests to declare.
Hot and cold cognition in unmedicated depressed subjects with bipolar disorder
Article first published online: 25 FEB 2009
© 2009 The Authors. Journal compilation © 2009 Blackwell Munksgaard
Volume 11, Issue 2, pages 178–189, March 2009
How to Cite
Roiser, J. P., Cannon, D. M., Gandhi, S. K., Tavares, J. T., Erickson, K., Wood, S., Klaver, J. M., Clark, L., Zarate Jr, C. A., Sahakian, B. J. and Drevets, W. C. (2009), Hot and cold cognition in unmedicated depressed subjects with bipolar disorder. Bipolar Disorders, 11: 178–189. doi: 10.1111/j.1399-5618.2009.00669.x
- Issue published online: 25 FEB 2009
- Article first published online: 25 FEB 2009
- Received 17 January 2008, revised and accepted for publication 20 June 2008
- bipolar disorder;
- hot cognition;
Objectives: Neuropsychological studies in subjects with bipolar disorder (BD) have reported deficits on a variety of cognitive measures. However, because the majority of subjects were medicated at the time of testing in previous studies, it is currently unclear whether the pattern of deficits reported is related to BD itself or to psychotropic medication. We addressed this issue by examining cognitive performance in a group of unmedicated, currently depressed subjects with BD.
Methods: Forty-nine unmedicated subjects who met DSM-IV criteria for BD, depressed phase, and 55 control subjects participated in this study. Most patients were diagnosed with bipolar II disorder. Performance on emotion-dependent, or ‘hot’, and emotion-independent, or ‘cold’, cognitive tasks was assessed using tests from the Cambridge Neuropsychological Test Automated Battery.
Results: The groups were well matched with respect to general intelligence and demographic variables. Deficits in the unmedicated depressed BD group were apparent on tests tapping ‘hot’ cognitive processing, for example the Cambridge Gamble task and the Probabilistic Reversal Learning task. However, other than a deficit on the Spatial Span test in the depressed BD subjects, the groups performed equivalently on most measures of ‘cold’ cognitive processing, for example visual memory, attention, and working memory.
Conclusions: These data suggest that deficits on tests involving reward processing, short-term spatial memory storage, and sensitivity to negative feedback in depressed BD subjects represent an effect of the illness itself and not mood-stabilizing medication.