Cognitive profile during remission phase of bipolar mania

Background – Normally, it is considered that as the severity of bipolar disorder decreased the patients improve their cognitive function. But recently, cognitive impairment in bipolar disorder is coming under increasing scrutiny because of some poor cognitive performance in bipolar patients despite the improvement in their severity of illness and mood. And some deficits have been shown to be more persistent. The time course of cognitive impairment in bipolar disorder is not well studied. Purpose – The present study aims to investigate cognitive functioning of bipolar mania especially in remission phase of the illness so that an insight could be developed regarding prognosis and overall social and occupational management as well as therapeutic plan. Methods – Cognitive impairment was assessed on PGI-Battery for Brain Dysfunction to all 40 male and 40 female adult patients suffering from bipolar affective disorder with the manic episode during their remission phase and mostly recovered or in mild level of severity, and compared to normal controls. They were limited to less than five years of total illness duration including two to three episodes of mania or mania and depression with onset of illness after 18 years of age. Result – Findings suggested impairment in all domains of cognitive function included in the study. On memory scale 86.3%, on intelligence scale 63.8% and on scale assessing visuospatial/perceptuomotor abilities 50% patients performed poorer to normal control. They significantly performed poorer on all sub domains of memory scale, intelligence scale and visuospatial/perceptuomotor scale to normal control except difference between PQ & VQ of intelligence scale. Further, As higher score shows higher dysfunction on PGI-BBD, total score was positively correlated to total duration of present episode, but significant negative correlation was found between retention for similar pair and age of onset, BGT and total duration after 1st episode, and immediate recall, retention of dissimilar pair, recognition and duration of the present episode. Conclusion – Undoubtedly, many bipolar patients do not reach to optimum level of their cognitive abilities during remission phase or normal stage of the illness. It needs to take into consideration while formulation therapeutic or management plan for them.