Cognitieve stoornissen bij patienten met een bipolaire stoornis: determinanten en consequenties [Cognitive dysfunction in bipolar disorder: determinants and functional outcome]

BACKGROUND: Research into the nature and extent of cognitive dysfunction in patients suffering from bipolar disorder has increased greatly over the last 10 years because the dysfunction is known to persist even if the mood symptoms are in remission and can influence a patient’s psychosocial functioning. AIM: To provide an overview of 1) the nature and extent of cognitive dysfunction in bipolar patients; 2) clinically relevant factors such as illness characteristics, comorbidity and psychotropic/psychoactive drugs and 3) the consequences of cognitive dysfunction. METHOD: We searched the literature in PubMed using the following search terms: bipolar disorder, neuropsychological, cognitive functioning, cognition, functional outcome, determinants, psychotropic/psychoactive drugs. RESULTS: Attentional deficits, memory lapses and aberrant executive functioning occur in both manic and depressive episodes, and may persist even in absence of mood symptoms. The precise cause of cognitive dysfunction is unknown. Persistent cognitive dysfunction frequently interferes with daily functioning. CONCLUSION: Since the treatment of bipolar patients is nowadays directed towards complete recovery rather than symptomatic remission, it is important to take into account the possibility that these patients are also suffering from cognitive dysfunction.