Published online by Cambridge University Press: 08 May 2018
Cognitive deficits are a well-established feature of bipolar disorders (BD), even during periods of euthymia, but risk factors associated with cognitive deficits in euthymic BD are still poorly understood. We aimed to validate classification criteria for the identification of clinically significant cognitive impairment, based on psychometric properties, to estimate the prevalence of neuropsychological deficits in euthymic BD, and identify risk factors for cognitive deficits using a multivariate approach.
We investigated neuropsychological performance in 476 euthymic patients with BD recruited via the French network of BD expert centres. We used a battery of tests, assessing five domains of cognition. Five criteria for the identification of neuropsychological impairment were tested based on their convergent and concurrent validity. Uni- and multivariate logistic regressions between cognitive impairment and several clinical and demographic variables were performed to identify risk factors for neuropsychological impairment in BD.
One cut-off had satisfactory psychometric properties and yielded a prevalence of 12.4% for cognitive deficits in euthymic BD. Antipsychotics use were associated with the presence of a cognitive deficit.
This is the first study to validate a criterion for clinically significant cognitive impairment in BD. We report a lower prevalence of cognitive impairment than previous studies, which may have overestimated its prevalence. Patients with euthymic BD and cognitive impairment may benefit from cognitive remediation.
List of FondaMental Advanced Center of Expertise (FACE-BD): FACE-BD Clinical Coordinating Center (Fondation FondaMental); B. Etain, C. Henry, E. Olié, and M. Leboyer; FACE-BD Data Coordinating Center (Fondation FondaMental); V. Barteau, O. Godin, H. Laouamri, and Karmene Souryis; FACE-BD Clinical Sites and Principal Collaborators in France;AP-HP, DHU PePSY, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires H Mondor, Créteil; S. Hotier, A. Pelletier, and A. Raust; AP-HP, GH Saint-Louis–Lariboisière–Fernand Widal, Pôle Neurosciences, Paris; F. Bellivier, M. Carminati, B. Etain, and P. Seguin; Hôpital C. Perrens, Centre Expert Trouble Bipolaire, Service de Psychiatrie Adulte, Pôle 3-4-7, Bordeaux; B. Antoniol, A. Desage, S. Gard, A. Jutant, K. Mbailara, I. Minois, and L. Zanouy; Département d'Urgence et Post Urgence Psychiatrique, CHRU Montpellier, Montpellier; S. Bonnet, F. Coppola, P. Courtet, D. Ducasse, M. Gachet, L. Matos, F. Molière, B. Noisette, E. Olié and G. Tarquini; Département de Psychiatrie, Hôpital Sainte Marguerite, Marseille; J. M. Azorin, R. Belzeaux, N. Corréard, J. L. Consoloni, F. Groppi, L. Lescalier. J. Montant and N. Viglianese; Service de Psychiatrie et Psychologie Clinique, CHU de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy; R. Cohen, J.P. Kahn, P. Kieffer, and O. Wajsbrot-Elgrabli; Clinique Universitaire de Psychiatrie, CHU de Grenoble et des Alpes, Grenoble; T. Bougerol, B. Fredembach, S. Garçon, P. Grignon, A. Perrin, and M. Polosan; Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie d'adultes, Le Chesnay; A.M. Galliot, I. Grévin, A.S. Cannavo, N. Kayser, C. Passerieux, and P. Roux; Service de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco; V. Aubin, I. Cussac, M.A Dupont, J. Loftus, and I. Medecin.