NEUROPSYCHOLOGICAL FUNCTION IN MANIC-DEPRESSIVE PSYCHOSIS - EVIDENCE FOR PERSISTENT DEFICITS IN PATIENTS WITH CHRONIC, SEVERE ILLNESS

Background. While neuropsychological deficits are recognised to occur in manic-depressive psychosis during episodes of depression and to rev erse with clinical recovery, it is uncertain whether they can ever be seen outside episodes of illness. Method. Forty-five patients meeting DSM-III-R criteria for major depression or bipolar disorder were scree ned using tests of memory, executive function and overall intellectual function. All testing was carried out during remission of affective s ymptoms. Results. None of 24 young patients and 11 elderly patients sc ored in the impaired range on any of the tests. However, five of ten p atients with chronic, severe affective disorder were impaired on one o r more of the measures. On more detailed neuropsychological investigat ion, these five patients were found to show a variable pattern of impa irment, ranging from memory and executive deficits in relative isolati on, to widespread poor performance. Conclusions. Enduring neuropsychol ogical deficits may be a feature of chronic, severe manic-depressive i llness.