Background: Neurocognitive impairment has consistently been considered a central and stable feature in schizophrenia. As this possibility has been far less studied in bipolar disorder, we aimed to prospectively investigate the stability and specificity of cognitive performance in bipolar disorder compared to schizophrenia. Methods: Fifteen DSM-IV bipolar type I patients and 15 schizophrenic patients were assessed twice with a comprehensive neuropsychological battery and the Positive and Negative Syndrome Scale over a 3-year follow-up. The cognitive performance of the groups was compared at baseline and 3 years later as a mean with that of 26 healthy volunteers. Endpoint and baseline assessments were also compared for each patient group in order to evaluate the stability of cognitive impairment. Results: At both time points, bipolar and schizophrenic patients showed significant deficits on most of the cognitive tasks compared to healthy subjects. Overall, the cross-sectional cognitive profile was similar for both patient groups. Moreover, after controlling for age and length of illness, the two groups’ cognitive function did not differ over time in any test. With the exception of the Stroop color-word interference task, performance at baseline for each test but neither length of illness nor diagnostic category predicted the endpoint performance. Conclusion: This preliminary study suggests that cognitive impairment is also mainly stable over time in bipolar I disorder and thus not specific to schizophrenia.

1.
Elvevag B, Goldberg TE: Cognitive impairment in schizophrenia is the core of the disorder. Crit Rev Neurobiol 2000;14:1–21.
2.
Liddle PF: Cognitive impairment in schizophrenia: Its impact on social functioning. Acta Psychiatr Scand 2000;101:11–16.
3.
Martínez-Arán A, Vieta E, Colom F, Reinares M, Benabarre A, Gastó C, Salamero M: Cognitive dysfunctions in bipolar disorder: Evidence of neuropsychological disturbances. Psychother Psychosom 2000;69:2–18.
4.
Goodwin FK, Jamison KR: Manic-depressive Illness. New York, Oxford University Press, 1990.
5.
Selva G, Tabarés R, Salazar J, Balanzá V, Ballester F, Cózar R, Leal C: ¿Inespecificidad de los hallazgos neurocognitivos en las psicosis? Actas Esp Psiquiatr 2000;28:313–324.
6.
Martínez-Arán A, Penadés R, Vieta E, Colom F, Reinares M, Benabarre A, Salamero M, Gastó C: Executive function in patients with remitted bipolar disorder and schizophrenia and its relationship with functional outcome. Psychother Psychosom 2002;71:39–46.
7.
Torrey EF, Knable MB: Are schizophrenia and bipolar disorder one disease or two? Introduction to the symposium. Schizophr Res 1999;39:93–94.
8.
Rund BR: A review of the longitudinal studies of cognitive functions in schizophrenia patients. Schizophr Bull 1998;24:425–435.
9.
Engelsmann F, Katz J, Ghadirian AM, Schachter D: Lithium and memory: A long-term follow-up study. J Clin Psychopharmacol 1988;8:207–212.
10.
Dhingra U, Rabins PV: Mania in the elderly: A 5- to 7-year follow-up. J Am Geriatr Soc 1991;39:581–583.
11.
Fleming K, Green MF: Backward masking performance during and after manic episodes. J Abnorm Psychol 1995;104:63–68.
12.
Mc Grath J, Scheldt S, Welham J, Clair A: Performance on tests sensitive to impaired executive ability in schizophrenia, mania and well controls: Acute and subacute phases. Schizophr Res 1997;26:127–137.
13.
Mc Grath J, Chapple B, Wright M: Working memory in schizophrenia and mania: Correlation with symptoms during the acute and subacute phases. Acta Psychiatr Scand 2001;103:181–188.
14.
Liu SK, Chiu CH, Chang CJ, Hwang TJ, Hwu HG, Chen WJ: Deficits in sustained attention in schizophrenia and affective disorders: Stable versus state-dependent markers. Am J Psychiatry 2002;159:975–982.
15.
Tabarés-Seisdedos R, Balanzá-Martínez V, Pallardó Y, Salazar-Fraile J, Selva G, Vilela C, Vallet M, Leal C, Gómez-Beneyto M: Similar effect of family history of psychosis on Sylvian fissure size and auditory P200 amplitude in schizophrenic and bipolar subjects. Psychiatry Res Neuroimaging 2001;108:29–38.
16.
Wing JK, Babor T, Brugha T, Burke J, Cooper J, Giel R, Jablensky A, Regier D, Sartorius N: SCAN: Schedules for Clinical Assessment in Neuropsychiatry. Arch Gen Psychiatry 1990;47:589–593.
17.
Lezak MD: Neuropsychological Assessment, ed 3. New York, Oxford University Press, 1995.
18.
Kay SR, Fiszbein A, Opler LA: The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull 1987;13:261–276.
19.
Tabarés-Seisdedos R, Sanjuan-Arias J, Gómez-Beneyto M, Leal-Cercós C: Early age of onset, brain morphological changes and non-consistent motor asymmetry in schizophrenic patients. Schizophr Res 1999;37:225–231.
20.
Wechsler D: Wechsler Adult Intelligence Scale Revised. Cleveland, Psychological Corporation, 1981.
21.
Hamilton M: A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56–62.
22.
Altman EG, Hedeker DR, Janicak PG, Peterson JL, Davis JM: The Clinician-Administered Rating Scale for Mania (CARS-M): Development, reliability, and validity. Biol Psychiatry 1994;36:124–134.
23.
Marangell LB, Yudofsky Sc, Silver JM: Antipsychotic drugs; in Hales RE, Yudofsky SC, Talbott JA (eds): Textbook of Psychiatry, ed 3. Washington, American Psychiatric Press, 1999, p 1064.
24.
Hennen J: Statistical methods for longitudinal research on bipolar disorders. Bipolar Disord 2003;5:156–168.
25.
Martínez-Arán A, Vieta E, Reinares M, Colom F, Torrent C, Sánchez-Moreno J, Benabarre A, Goikolea JM, Comes M, Salamero M: Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. Am J Psychiatry 2004;161:262–270.
26.
Martínez-Arán A, Vieta E, Colom F, Reinares M, Benabarre A, Torrent C, Goikolea JM, Corbella B, Sanchez-Moreno J, Salamero M: Neuropsychological performance in depressed and euthymic bipolar patients. Neuropsychobiology 2002;46:16–21.
27.
Goldberg JF, Harrow M: Bipolar Disorders: Clinical Course and Outcome. Washington, American Psychiatric Press, 1999.
28.
Rund BR, Borg NE: Cognitive deficits and cognitive training in schizophrenic patients: A review. Acta Psychiatr Scand 1999;100:89–95.
29.
Vieta E, Colom F, Martinez-Aran A: Chronicity, milder forms, and cognitive impairment in bipolar disorder; in Maj M, Akiskal HS, López-Ibor JJ, Sartorius N (eds): Bipolar Disorders. WPA Series Evidence and Experience in Psychiatry, Wiley. Chichester, Wiley, 2002, pp 182–184.
30.
Cannon M, Caspi A, Moffitt TE, Harrington HL, Taylor A, Murray RM, Poulton R: Evidence for early-childhood, pan-developmental impairment specific to schizophreniform disorder. Arch Gen Psychiatry 2002;59:449–456.
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