Neuropsychological impairment among Manic, Depressed, & Mixed-Episode inpatients with Bipolar Disorder

Basso, M.R., Bornstein, R.A., Lowery, N., Neel, J., Purdie, R. (2002). Neuropsychological

Impairment among manic, depressed, & mixed-episode inpatients with Bipolar Disorder.

Neuropsychology, 16(1), 84-91. doi: 10.1037//0894-4105.16.1.84

Retrieved from PsychArticles.

Bipolar Disorder can cause problems with memory, perception, attention, executive functions, and the speed at which things are processed. Imaging techniques can be used to show the abnormalities caused by the disorder. The abnormalities that show up most in these studies lie in the frontal and temporal lobes, hippocampus, amygdala, basal ganglia, cerebral ventricles, cerebellum and in the subcortical white matter. This study is trying to find out if there are different degrees of abnormalities in the bipolar disorder subtypes of mania, depressed, mixed-episodes. 86 patients, who were currently admitted to the hospital, were used and all met the DSM-IV criteria for Bipolar I Disorder. Bipolar with mania symptoms were: mood changes, depressed sleep, extreme ideas and pleasure activities. Bipolar with depression symptoms were: prior manic period, decreased mood, decreased sleep and eating patterns, decrease in concentration, and feelings of worthlessness. To receive a diagnosis of bipolar with mixed episodes patients must meet all of the above criteria for manic and depressed states. 31 control subjects who had no history of psychological illness were used as controls. The attending psychologist determined that 37 patients were manic, 25 were in a depressed state and 24 were mixed-episode. The patients were given the California Verbal Learning test, the F-A-S verbal Fluency test, Trail making tests A & B, and the Grooved Pegboard test. The MMPI-2 was also given to look at the strength of symptomology. Impairment is classified as being one SD below the mean on the tests scored. The three patient groups were impaired on 50% or more of the impairment tests and they scored worse on memory performance than the control group. The manic patients performed worse on the CVLT than the depressed and the mixed-episode. On the other tests given the patients performed worse than the control but there were no differences within the three patient groups. In conclusion, the results showed that cerebral dysfunction is a primary symptom of Bipolar disorder no matter what mood state the patient is in. EEG patterns show that depression causes greater fronto-temporal activity in the right hemisphere than the left. But mania corresponded with a pattern of arousal. PET scans show that depressed and mixed-episode patients have a lower brain glucose metabolism than manic patients and the control group but it does increase when they enter a manic state. Even though there were no significant differences between the three subtypes the disorder itself does have different effects on different areas of the brain.