Cognitive deficits, psychopathology, and psychosocial functioning in bipolar mood disorder

The objective of this study was to study the relationship of poor functioni ng, cognition, and psychopathology in bipolar mood disorder. The authors as sessed 36 patients with bipolar mood disorder (23 VA, 13 community) for the presence of psychopathology, cognitive deficits, and psychosocial impairme nt. The authors assessed psychopathology using screening and follow-up ques tions based on the schedule for affective disorder and schizophrenia, lifet ime version (SPLDS-L), schedule for the assessment for negative symptoms (S ANS), and schedule for the assessment of positive symptoms (SAPS), and psyc hosensory features using the "Profile of Psychomotor Symptoms." They tested cognitive functioning in the following domains: 1) general intelligence an d language, 2) verbal and visual memory, and 3) visuospatial functioning. T hey also assessed psychosocial functioning using a structured scale to asse ss maladjustment and an impairment rating scale. Patients with bipolar diso rder showed significant impairment compared to age equivalent normals in se veral cognitive domains. Anhedonia was related to memory deficits. Memory d eficits were also associated with poor psychosocial functioning. This study demonstrates that nondemented, asymptomatic patients with bipolar disorder exhibit substantial cognitive deficits that are associated with poor funct ioning, and anhedonia and avolition best predict this outcome.