In Paris, on Sunday- 4th September two pieces of new research were presented to do with cognitive function in bipolar disorder which in some ways gave good news for a change for people with bipolar disorder. This was their first public presentation.
It has increasingly been recognised and accepted that bipolar disorder is a ‘brain disorder’ in that there is clear evidence from lots of different types of research of changes in brain function and structure during acute episodes of illness and more recently it has also been recognised that cognitive function does not return fully to normal on symptomatic recovery and remission from depressive and manic symptoms when well and between episodes.
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This news that cognitive function is impaired in bipolar disorder even during periods when free of mood symptoms made for rather depressing reading and it was clear that such impairment was likley to have some impact on functional outcomes depending on the degree present in individuals.
Two studies were presented on Sunday which arose from the European Network of Bipolar Network Centres of a large pan-european network across 6 countries about cognitive impairment in bipolar disorder. In this instance the brought clarification and even some good news.
The first presented by Professor Guy Goodwin from Oxford University reanalysed the original data from earlier studies combined together with additonal unpublished data. This produced the largest, most powerful comparable dataset to do with cognitve funtion in bipolar disorder in the worl number some 990 people with bipolar disorder and 968 healthy controls
The very large dataset confirmed the previous findings of cognitive impairment in people with bipolar disorder which was not simply related to their mood state or medication.
The good news is that the size of the effect was not as great as previously described. Professor Goodwin proposed that this was likley to be due to the inclusion of the peviously unpublished data in the study and the fact that this probably made it more representitive of people with bipolar disorder in general
The second study presented came from the Barcelona Bipolar Research group lead by Professor Eduard Vieta and directly addressed the question- ” if there is impairment of cognitive function in some individuals with bipolar disorder, can we do anything to help?” The good news is that the answer seems to be yes.
The Barcelona group have developed a treatment programme consisting of weekly group sessions with a detailed program content over six months, which significantly enhances functional outcomes in individuals who started out with a clinically meaningful degree of cognitive and functional impairment.
So the bottom line is,
Bipolar disorder is associated with cognitive impairments
- which are independent of mood state
- which persist during periods of recovery
- which are not simply due to medication effects
- BUT which may not be as large as initial studies indicated due to the bias of unpublished data
- the functional consequences of which appear to respond well to an initial trial of a new “functional remediation” treatment strategy.