NEUROPSYCHOLOGICAL FUNCTIONING IN EUTHYMIC ADOLESCENT PATIENTS WITH BIPOLAR DISORDER

Abstract

Background: Wide ranging neuropsychological deficits have been found in the euthymic phase of bipolar disorder in both adult and adolescent patients in several studies. Aim: To assess sustained attention, auditory and visual short tenn memory, mental processing speed and set shifting abilities in adolescent patients with bipolar disorder, type I in the euthymic phase. Method: Thirty adolescent patients with bipolar disorder, between ages 13-19 yrs. of both sexes. were recruited fom Kasr el Eini psychiatric outpatient clinic and the diagnosis of bipolar disorder was ensured and exclusion of other psychiatric comorbidities was done using the K-SADS-PL. Euthymia was defined as scores 7 or below on both the HDRS and YMRS.A control group matched in age. sex and educational level was recruited and both cases and controls were subjected to the letter cancellation test,digit span and digit symbol subtests of the Arabic version of Wechsler intelligence scale, bender gestalt test and Wisconsin card sorting test. Results: The patients included in the study showed poorer performance than the controls in Hll the neuropsychological tests applied, with a statistically significant eli fference between the mean scores of the groups. The number of manic episodes and the age of illness onset was positively correlated to the mean number of omission errors in the letter cancellation test. Female patients showed a stntistically significant better performance than male patients in the digit symbol coding test. but there were no significant gender differences in the scores of the other tools applied. Conclusion: There are neuropsychological deficits in the areas of sustnincd attention, set shifting, proce sing speed and visual and auditory short term memory in cuthymic adolescent patients with bipolar disorder, type I. There is a significant correlation between the number of manic episodes as well as age of illness onset and sustained attention. The female patients in our study have a faster mental processing speed than male patients. The presence of the above mentioned neuropsychological deficits in the euthymic phase of bipolar disorder in adolescent patients with few number of episodes and short duration of illness may represent a possible trait marker of the illness, though more research in this area is needed to establish whether these deficits represent stable trait markers or not