Cognitive dysfunction may worsen quality of life in bipolar.

WASHINGTON -- Poor cognitive function in patients with bipolar disorder might contribute to worse quality of life, results of a Portuguese study of 55 patients show.

Poorer self-reported quality of life was significantly correlated with worse cognitive performance. In particular, poor executive functioning and verbal abstraction were strong predictors of poor self-reported quality of life, Dr. Soni Brissos of the Centro Hospitalar Psiquiatrico de Lisboa in Portugal and her colleagues reported in a poster presented at the annual meeting of the American Psychiatric Association.

The study included 55 patients with type I bipolar disorder (60% women) between the ages of 17 and 63 years, who were diagnosed according to DSM-IV criteria. Patients were considered to be euthymic if they had a score not greater than 6 on the Young Mania Rating Scale and a score no greater than 7 on the Hamilton Rating Scale for Depression.

Exclusion criteria included clinical comorbidities, substance abuse/dependence, or electroconvulsive therapy in the last 6 months. Slightly more than half (56%) had past psychotic symptoms. In all, 95% were on mood stabilizers. The most common was valproate (67%), followed by lithium (38%), and lamotrigine (29%). In addition, 60% were on oral antipsychotics, 7% were on depot antipsychotics, 33% were on antidepressants, 5% were on topiramate (Topamax), and 22% were on benzodiazepines.

The researchers also recruited 50 healthy controls (68% women).

Quality of life was assessed using the World Health Organization Quality of Life Assessment--Abbreviated Version (WHOQOL-BREF) in Portuguese. A neuropsychological test battery focused on assessing the cognitive domains of attention and mental control, perceptual-motor skills, executive functions, verbal fluency, verbal abstraction, visual-spatial attention, and memory function.

Scores for each of the four domains of the WHOQOL-BREF were significantly lower for those with bipolar disorder, compared with the controls.

"Cognitive dysfunction may explain part of the quality of life impairment in bipolar disorder," the researchers wrote.

BY KERRI WACHTER

Senior Writer