martes, 28 de abril de 2009

Rendimiento Neuropsicologico como predictor de recuperación clínica en pacientes bipolares

Brief report
Neuropsychological performance predicts clinical recovery in bipolar patients

Staci A. Gruber ., Isabelle M. Rosso, Deborah Yurgelun-Todd
Cognitive Neuroimaging Laboratory, Brain Imaging Center, McLean Hospital, and Department of Psychiatry, Harvard Medical School,
115 Mill Street, Belmont, MA 02478, USA

Received 6 October 2006; received in revised form 30 March 2007; accepted 18 April 2007
Available online 23 May 2007


Abstract

Background: Although a number of investigations have reported cognitive deficits in patients with bipolar disorder, relatively few have focused on the relationship between these impairments and clinical outcome.
Methods: In order to help clarify the pattern of and extent to which cognitive deficits are present at the onset of illness and their relationship to outcome, we examined 26 bipolar patients during their first hospitalization and 20 psychiatrically healthy control subjects. All subjects completed tests of frontal/executive control, psychomotor speed and memory function at baseline and selfreports of clinical recovery (time to recover in days) at 12 months post study enrollment.
Results: At baseline, first episode bipolar patients demonstrated greater deficits relative to control subjects on neurocognitive measures, and a significant association was detected between time to recover and performance on a measure of frontal/executive function (interference condition of the Stroop; p=.05; derived interference: p=.04). A trend towards significance was also demonstrated between time to clinical recovery and verbal fluency ( p=.06).
Conclusions: These findings indicate that neuropsychological deficits are seen early in the course of bipolar disorder, prior to the effects of multiple or prolonged episodes, and may be associated with clinical outcome. Future studies are needed to determine whether
changes in inhibitory processing or other cognitive function predict clinical outcome or are associated with treatment response.

© 2007 Elsevier B.V. All rights reserved.
Keywords: Bipolar; Neurocognition; Recovery; Inhibitory function; Stroop

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