ASPOFAFF :: Journal - Volume 2 :: Volume 2 - Issue 1 :: Vol 2 - Iss 1 - Short Communication - Cognitive Executive Functions and Functional Status: its relationship in an outpatient euthymic bipolar sample


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ASPOFAFF :: Journal - Volume 2 :: Volume 2 - Issue 1 :: Vol 2 - Iss 1 - Short Communication - Cognitive Executive Functions and Functional Status: its relationship in an outpatient euthymic bipolar sample

Vol 2 - Iss 1 - Short Communication - Cognitive Executive Functions and Functional Status: its relationship in an outpatient euthymic bipolar sample #67

Cognitive Executive Functions and Functional Status: its relationship in an outpatient euthymic bipolar sample Miguélez-Pan, M.; Pousa E.; Cobo, JV; Prats, R.; Duñó R: Mental Health Department, Corporació Sanitària Parc Taulí, Sabadell, Barcelona (Spain). Introduction: Up to 30-50% of bipolar patients do not reach the expected functional status (FS) of an adult person (1): they may fail in the labour, social and/or affective areas. Several studies have indicated that certain symptoms of the disorder and some evolution characteristics have an influence over the FS achieved by bipolar patients when euthymic (2). Moreover, some recent findings reflect that cognitive capabilities may play an important role in the prediction of FS, even exceeding the predictive value of clinic characteristics (3). According to that, executive functions (EF), may play a role in the prediction of daily functioning. Objective: To explore the relationship between FS and executive capabilities in a sample of stable bipolar patients controlled in an out-patient clinic. Method: 28 adult patients (64,3% male) diagnosed as BD type I (DSM-IV-RT criteria) were interviewed. They had no other concomitant psychiatric disorder, neither they had history of neurological or developmental disorders. They were regularly (96,4%) visited by a psychiatrist, were clinically stable [mean YMRS=2,39 (SD=2,01); mean HDRS=3,75 (SD=2,44); mean GAF=74 (SD=9,59)], and were on maintenance psychopharmacological treatment. Patients with current drug misuse (other than tobacco) were excluded, as well as those patients with inferior IQ, attentional or language comprehension deficit. Clinical and functional data were gathered through interview. Different components of EF were evaluated using neuropsychological test battery. Statistical analysis was conducted using the SPSS package (11.5 version). Descriptive analysis of functional and cognitive data was carried out. Correlational analysis and Mann-Whitney U test were performed to analyse the relationship between EF and FS. Results: Included patients were 41,07 (SD=11,36) years old on average and had 11,00 (SD=3,64) years of education. The majority of them had stable couple, lived independent, were labourly inactive and had qualified occupations. The average age of BD onset was 27,53 (SD=10,02) with 13,68 (SD=9,15) years of illness evolution. 1. Mean scores in functional measures indicated a low-normal level of functioning. 2. As a group, their scores in EF tests were located within normality, even though the worst performance was obtained on certain Tower of London scores, TMT-B, and FAS. In all executive variables a proportion of patients performed below 1 SD from the normal mean. 3. No significant correlations were found between EF and global measures of FS (GAF or total-SFS). 4. Nonetheless, significant mild-to-moderate correlations (p<0.05) were obtained, even when education and age were controlled, between certain components of FS and measures of elaboration and implementation of plans, abstraction and verbal fluency. The worse the patients performed on EF tasks, the poorer they scored on the above-mentioned FS variables. Conclusion: 1. Stable BD patients with low to normal level at EF showed difficulties in certain aspects of FS. 2. Mild difficulties in some EF abilities may be enough to have an impact on FS. References: (1) Quraishi S y Frangou S. (2002) Neuropsychology of bipolar disorder: a review. Journal of Affective disorders 72:209-226. (2) MacQueen, GL, Young, LT y Joffe RT. (2001). A review of psychosocial outcome in patients with bipolar disorder. Acta Psychiatrica Scandinavica 2001; 103: 163-170 (3) Martínez-Arán A, Godwin GM y Vieta E. (2001). El mito de la ausencia de disfunciones cognitivas en el trastorno bipolar. En: E.Vieta (ed.) Trastornos bipolares. Avances clínicos y terapéuticos (pp. 51-85). Madrid: Editoral Médica Panamericana. (4) Vazquez Morejon AJ, Jimenez Ga-Boveda R. (2000). Social functioning scale: new contributions concerning its psychometric characteristics in a Spanish adaptation. Psychiatry Research 93(3):247-56.

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