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Longitudinal relationships between cognition and functioning over 2 years in euthymic patients with bipolar disorder: a cross-lagged panel model approach with the FACE-BD cohort

Published online by Cambridge University Press:  13 August 2019

Mickael Ehrminger
Affiliation:
Doctoral Researcher, Department of Adult Psychiatry, Versailles Hospital; HandiRESP Laboratory, EA4047, Department of Health Sciences, University of Versailles Saint-Quentin-En-Yvelines; and Centers of Expertise, Fondamental Foundation, France
Eric Brunet-Gouet
Affiliation:
Psychiatrist, Researcher, Department of Adult Psychiatry, Versailles Hospital; HandiRESP Laboratory, EA4047, Department of Health Sciences, University of Versailles Saint-Quentin-En-Yvelines; and Centers of Expertise, Fondamental Foundation, France
Anne-Sophie Cannavo
Affiliation:
Psychologist, Researcher, Department of Adult Psychiatry, Versailles Hospital; HandiRESP Laboratory, EA4047, Department of Health Sciences, University of Versailles Saint-Quentin-En-Yvelines; and Centers of Expertise, Fondamental Foundation, France
Bruno Aouizerate
Affiliation:
Psychiatrist, Researcher, Centers of Expertise, Fondamental Foundation; and Department of General Psychiatry (3/4/7), Charles Perrens Hospital, France
Irena Cussac
Affiliation:
Psychiatrist, Researcher, Centers of Expertise, Fondamental Foundation; and Department of Psychiatry, Princesse Grace Hospital, France
Jean-Michel Azorin
Affiliation:
Psychiatrist, Researcher, Centers of Expertise, Fondamental Foundation; and Department of Psychiatry, Sainte-Marguerite Hospital, AP-HM, France
Frank Bellivier
Affiliation:
Psychiatrist, Researcher, Centers of Expertise, Fondamental Foundation; Department of Psychiatry and Addictology, Neuroscience Pole, Saint-Louis Lariboisière–Fernand Widal Hospital, AP-HP; and UMR-S 1144, Paris Diderot University, France
Thierry Bougerol
Affiliation:
Psychiatrist, Researcher, Centers of Expertise, Fondamental Foundation; Psychology and Neurocognition Laboratory, Grenoble-Alpes University; Department of Psychiatry, Grenoble and Alpes Hospital; and INSERM U836, Grenoble Institute of Neuroscience (GIN), France
Philippe Courtet
Affiliation:
Psychiatrist, Researcher, Centers of Expertise, Fondamental Foundation; Department of Emergency Psychiatry & Post-Acute Care, Academic Hospital of Montpellier; and INSERM U1061, Montpellier University, France
Caroline Dubertret
Affiliation:
Psychiatrist, Researcher, Centers of Expertise, Fondamental Foundation; and Department of Psychiatry, Louis Mourier Hospital, AP-HP; INSERM U894, School of Medicine, Paris Diderot University, Sorbonne Paris Cité, France
Bruno Etain
Affiliation:
Psychiatrist, Researcher, Centers of Expertise, Fondamental Foundation; Department of Psychiatry and Addictology, Neuroscience Pole, Saint-Louis Lariboisière–Fernand Widal Hospital, AP-HP; UMR-S 1144, Paris Diderot University, France; and Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
Jean-Pierre Kahn
Affiliation:
Psychiatrist, Researcher, Centers of Expertise, Fondamental Foundation; Department of Psychiatry and Clinical Psychology, Psychotherapy Center of Nancy; and School of Medicine, Lorraine University, France
Marion Leboyer
Affiliation:
Psychiatrist, Researcher, Centers of Expertise, Fondamental Foundation; Department of Psychiatry and Addictology, DHU Pepsy, Henri Mondor Hospital, AP-HP; School of Medicine, Paris Est University; and Translational Psychiatry Unit, U955, Mondor, Institute for Biomedical Research, INSERM, France
Emilie Olié
Affiliation:
Psychiatrist, Researcher, Centers of Expertise, Fondamental Foundation; Department of Emergency Psychiatry & Post-Acute Care, Montpellier Hospital; and Neuropsychiatry, Epidemiological and Clinical Research, U1061, INSERM, University of Montpellier, France
Christine Passerieux
Affiliation:
Psychiatrist, Researcher, Department of Adult Psychiatry, Versailles Hospital; HandiRESP Laboratory, EA4047, Department of Health Sciences, University of Versailles Saint-Quentin-En-Yvelines; and Centers of Expertise, Fondamental Foundation, France
Paul Roux
Affiliation:
Psychiatrist, Researcher, Department of Adult Psychiatry, Versailles Hospital; HandiRESP Laboratory, EA4047, Department of Health Sciences, University of Versailles Saint-Quentin-En-Yvelines; and Centers of Expertise, Fondamental Foundation, France
the FondaMental Advanced Centers of Expertise in Bipolar Disorders (FACE-BD) Collaborators
Affiliation:
(listed in Acknowledgements)
Corresponding
E-mail address:

Abstract

Background

Longitudinal studies of the relationship between cognition and functioning in bipolar disorder are scarce, although cognition is thought to be a key determinant of functioning. The causal structure between cognition and psychosocial functioning in bipolar disorder is unknown.

Aims

We sought to examine the direction of causality between cognitive performance and functional outcome over 2 years in a large cohort of euthymic patients with bipolar disorder.

Method

The sample consisted of 272 adults diagnosed with bipolar disorder who were euthymic at baseline, 12 and 24 months. All participants were recruited via the FondaMental Advanced Centers of Expertise in Bipolar Disorders. We used a battery of tests, assessing six domains of cognition at baseline and 24 months. Residual depressive symptoms and psychosocial functioning were measured at baseline and 12 and 24 months. The possible causal structure between cognition and psychosocial functioning was investigated with cross-lagged panel models with residual depressive symptoms as a covariate.

Results

The analyses support a causal model in which cognition moderately predicts and is causally primary to functional outcome 1 year later, whereas psychosocial functioning does not predict later cognitive performance. Subthreshold depressive symptoms concurrently affected functioning at each time of measure.

Conclusions

Our results are compatible with an upward causal effect of cognition on functional outcome in euthymic patients with bipolar disorder. Neuropsychological assessment may help specify individual prognoses. Further studies are warranted to confirm this causal link and evaluate cognitive remediation, before or simultaneously with functional remediation, as an intervention to improve functional outcome.

Type
Papers
Copyright
Copyright © The Royal College of Psychiatrists 2019

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Footnotes

*

The FACE-BD Collaborators are listed in the Acknowledgements.

Declaration of interest None.

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