COGNITIVE IMPAIRMENT IN EUTHYMIC BIPOLAR PATIENTS WITH AND WITHOUT PRIOR ALCOHOL DEPENDENCE - A PRELIMINARY-STUDY

Background: Few studies of the neurocognitive performance of patients with bipolar disorder have been performed while patients are in the eu thymic state. Methods: Twenty-five euthymic bipolar patients (12 with and 13 without a history of alcohol dependence) were compared with 22 normal control subjects on a neuropsychological test battery assessing a range of cognitive domains. The relationship between subjects' neur ocognitive performance and the course-of-illness variables (lifetime e pisodes and duration of mania, depression, or both), as well as curren t lithium level, was determined. Results: The results indicated differ ences across the groups, with the bipolar patients with and without al cohol dependence performing more poorly than controls on tests of verb al memory. Furthermore, bipolar subjects with a history of alcohol dep endence had additional decrements in executive tie, frontal lobe) func tions when compared with controls. For subjects in the bipolar group, lifetime months of mania and depression were negatively correlated wit h performance in verbal memory and several executive function measures . Conclusions: Our findings support the presence of persistent neuroco gnitive difficulties in patients with longstanding bipolar disorder wh o are not in the psychiatrically acute stale or who are suffering the effects of alcohol abuse and suggest that there may be an aggregate ne gative effect of lifetime duration of bipolar illness on memory and fr ontal or executive systems.