Cognition and disability in bipolar disorder: lessons from schizophrenia research


  • Philip D Harvey,

    1. Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA
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  • Aliza P Wingo,

    1. Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA
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  • Katherine E Burdick,

    1. Department of Psychiatry, Division of Psychiatry Research, The Zucker Hillside Hospital-North Shore Long Island Jewish Health System, Glen Oaks
    2. The Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset
    3. Department of Psychiatry, Albert Einstein College of Medicine, Bronx, NY
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  • Ross J Baldessarini

    1. Department of Psychiatry and Neuroscience Program, Harvard Medical School, Boston
    2. Psychopharmacology Program and International Consortium for Bipolar Disorder Research, Mailman Research Center, McLean Division of Massachusetts General Hospital, Belmont, MA, USA
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  • PDH has received current research support from AstraZeneca and has served as an advisor or consultant in the past year to Eli Lilly & Co., Dainippon Sumitomo America, Solvay Pharma, Abbott, and Shire. KEB is a member of the Merck speakers bureau. RJB has been a consultant or investigator-initiated research collaborator with Auritec, Biotrofix, IFI, Janssen, JDS, Eli Lilly & Co., Luitpold, Merck, NeuroHealing, Novartis, and SK-BioPharmaceuticals. APW has no relevant potential conflicts of interest to report. The authors and their family members do not hold equity positions in any pharmaceutical or biomedical companies.

Corresponding author:
Philip D. Harvey, Ph.D.
Department of Psychiatry and Behavioral Sciences
Emory University School of Medicine
101 Woodruff Circle, N.E., Suite 4000
Atlanta, GA 30322, USA
Fax: 404-727-3233


Harvey PD, Wingo AP, Burdick KE, Baldessarini RJ. Cognition and disability in bipolar disorder: lessons from schizophrenia research.
Bipolar Disord 2010: 12: 364–375. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S.

Background:  Cognitive and functional impairments occur in patients diagnosed with bipolar disorder (BPD), although they are usually less severe and far less studied than in schizophrenia. There may be value in applying approaches developed in schizophrenia research to study cognitive functioning among BPD patients in areas including performance-based disability assessment, cognitive remediation treatments, enhancement of the accuracy of real-world functioning, and studying cognition and disability in relatives.

Methods:  We reviewed current research on cognitive and functional disability in BPD, noted areas of similarity and discrepancy to research on schizophrenia, and highlighted methods and approaches used to study schizophrenia that can be applied to study unmet needs of BPD patients.

Results:  Research in schizophrenia increasingly separates potential functional capacity from real-world outcome status, and has assessed contributions of cognitive impairment and other illness factors to functional outcomes. For schizophrenia, various behavioral and pharmacological treatments aimed at cognitive enhancement have been attempted, with moderate success, compared to rare studies of treatment effects on cognitive impairment in BPD. Very little research has been performed in the occurrence of cognitive impairments in first-degree relatives of people with BPD, despite evidence that cognitive impairments may be stable traits across symptomatic status in people with BPD.

Conclusions:  Research and treatment approaches developed for schizophrenia can productively be applied to the study and treatment of patients diagnosed with BPD, notably including studies of the characteristics of and treatments for functional impairment related to cognitive deficits.