Cognitive deficits in bipolar disorder

Abstract

Bipolar disorder (BD) is a debilitating psychiatric disorder characterized by recurrent mood episodes following a relapsing-remitting course. One of its hallmarks is cognitive dysfunction, with more than half of individuals with BD experiencing a range of cognitive deficits, spanning from mild to severe cognitive deficits in various domains, with a pronounced impact on executive functions, verbal learning, memory, as well as global cognition. These cognitive impairments can be more pronounced during mood episodes but can also manifest during periods of remission, at any stage of the illness, and even before the onset of BD. Additionally, cognitive dysfunction has been identified in young individuals at risk of developing BD and in unaffected first-degree relatives of individuals with BD. Factors such as BD subtypes, the clinical trajectory of the illness, and medication use contribute to the severity of cognitive deficits in BD. Importantly, despite these factors, the severity of cognitive impairment tends to remain stable over the years. Cognitive dysfunction significantly affects psychosocial functioning and the overall prognosis of individuals living with BD. Although there is a growing recognition of the importance of assessing cognitive function in BD, there remains a lack of knowledge on how to effectively integrate cognitive assessments and treatments into clinical settings.