Toward the identification of neurocognitive subtypes in euthymic patients with bipolar disorder
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Background Cross-sectional and meta-analytic studies showed that patients with bipolar disorder (BD) had neurocognitive impairments even during periods of euthymia. The aim of this study was to estimate the prevalence of BD patients with and without clinically significant cognitive impairments, as well as to analyze clinical and functional variables in these subgroups.Methods Hundred patients with BD and 40 healthy controls were assessed with an extensive neurocognitive assessment. Soft (some cognitive domain with a performance below 1.5 SD of the mean) and hard (at least two domains with values below 2 SD of the mean) criteria were utilized to define clinically significant cognitive impairments.Results Using both soft and hard criteria, the prevalence of clinically significant cognitive impairments was higher in people with BD than in healthy controls. 70% of patients only showed failures of small effect (d=0.21-0.35) in 2 measures of executive functions. Moreover, 30% of patients were indistinguishable from healthy subjects in terms of both neurocognitive and psychosocial functioning. On the contrary, 30% of the sample showed more severe cognitive deficits than those usually reported in literature and had the worst psychosocial functioning.Conclusions The fact that cognitive impairments are very heterogeneous among euthymic patients with BD could contribute to understanding differences in functional outcome. Theoretical and practical implications of these findings are discussed.
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Rossetti, M. G., Bonivento, C., Garzitto, M., Caletti, E., Perlini, C., Piccin, S., Lazzaretti, M., Marinelli, V., Sala, M., Abbiati, V., et al. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.04.063 · Cited by 10 · see citing works
Accuracy of the number of previous episodes reported by patients with bipolar disorder
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Self-citationLomastro, J., Valerio, M. P., Szmulewicz, A. G., & Martino, D. J. (2021) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13303 · Cited by 9 · see citing works
Self-citationEvidence for inhibited temperament as a transdiagnostic factor across mood and psychotic disorders
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Ribera, C., Vidal-Rubio, S. L., Romeu-Climent, J. E., Vila‐Francés, J., Rheenen, T. E. V., & Balanzá‐Martínez, V. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.05.003 · Cited by 8 · see citing works
Irwin, K. E., Freudenreich, O., Peppercorn, J. M., Taghian, A. G., Freer, P. E., & Gudewicz, T. M. (2016) · New England Journal of Medicine · doi:10.1056/nejmcpc1609309 · Cited by 8 · see citing works
Amoretti, S., Prisco, M. D., Clougher, D., Garriga, M., Montse Corrales, F., Fadeuilhe, C., Forte, M. F., Martínez‐Arán, A., Oliva, V., Parramón, G., et al. (2025) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2025.106081 · Cited by 6 · see citing works
Martino, D. J. (2024) · Psychological Medicine · doi:10.1017/s0033291724003210 · Cited by 6 · see citing works
Self-citationSwidzinski, S., Tsapekos, D., Swidzinska, P., Zhang, W., Zheng, M., Millgate, E., Strawbridge, R., Short, R., Carter, B., Gallagher, P., et al. (2025) · Psychological Medicine · doi:10.1017/s0033291725101827 · Cited by 4 · see citing works
Cognitive and affective theory-of-mind impairment in people with early-stage bipolar disorder
Chan, J. M. T., Lo, H. K. Y., Chau, A. K. C., Mok, A. S. Y., Tong, C. C. H. Y., Kam, C. T. K., Fang, C. Z., & Chang, W. C. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-06808-1 · Cited by 4 · see citing works
Sarmento, S., Bittencourt, L., Filho, E. J. D. M., Abreu, N., Lacerda, A. L. T., & Miranda‐Scippa, Â. (2020) · Cognitive and Behavioral Neurology · doi:10.1097/wnn.0000000000000231 · Cited by 4 · see citing works
A Longitudinal Mirror-Image Assessment of Morbidity in Bipolar Disorder
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Self-citationFamilial aggregation analysis of cognitive performance in early-onset bipolar disorder
Soler, J., Lera‐Miguel, S., Lázaro, L., Calvo, R. M., Ferentinos, P. P., Fañanás, L., & Fatjó‐Vilas, M. (2020) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-020-01486-8 · Cited by 3 · see citing works
Özdemir, A., Poyraz, C. A., Baş, T. Ö., Erten, E., & Bayar, R. (2015) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2015.09.001 · Cited by 3 · see citing works
Letter to the editor: Longitudinal stability of neurocognitive subtypes in bipolar disorder
Martino, D. J., Scápola, M., & Strejilevich, S. (2017) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2017.07.026 · Cited by 3 · see citing works
Self-citationLi, H., Wu, Q., Wang, J., Zhang, X., Song, H., & Wang, D. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-06427-2 · Cited by 2 · see citing works
Roux, P., Carminati, M., & Cannavo, A. S. (2018) · French Journal of Psychiatry · doi:10.1016/s2590-2415(19)30154-0 · Cited by 2 · see citing works
Facial emotion recognition, affective empathy and psychosocial functioning in euthymic BD‐I
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Protein biomarkers for bipolar II disorder are correlated with affective cognitive performance
Lee, S., Li, S., Wang, T.-Y., Lu, R., Wang, L., & Tsai, K. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-07104-8 · Cited by 2 · see citing works
Vieillissement cognitif dans le trouble bipolaire et la schizophrénie
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Cognition and Bipolar Disorder in Older Adults (Including Question of “Neuroprogression”)
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Emotions and Cognitions in Bipolar Disorder
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Cognitive Impairment in Bipolar Disorder: Comparison with Cognitive Impairment in Schizophrenia
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Cognition and Bipolar Disorder in Older Adults (Including Question of ‘Neuroprogression’)
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Self-citationTreatment Over the Lifespan in Bipolar Disorder
Reif, A., Popović, D., & RYBAKOWSKI, J. K. (2023) · Frontiers research topics · doi:10.3389/978-2-8325-3212-6
Psychosocial Impairment in Older Patients With Bipolar I Disorder
Vahapoğlu, B., Poyraz, C. A., & Özdemir, A. (2024) · Journal of Psychiatric Practice · doi:10.1097/pra.0000000000000767
Troubles neurocognitifs dans les troubles bipolaires de l'humeur
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Premorbid and postmorbid correlates of global neurocognitive dysfunction in bipolar disorder
Igoa, A., & Martino, D. J. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.121889
Self-citation
- Authors
- Martino, D. J., Strejilevich, S. A., Marengo, E., Ibañez, A., Scápola, M., & Igoa, A.
- Affiliations
- Consejo Nacional de Investigaciones Científicas y Técnicas (AR)
- Favaloro University (AR)
- Corresponding author
- Martino, Diego J.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2014-10
- Volume
- 167
- Pages
- 118-124
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2040012070
- Cited by
- 75
- References
- 46
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 3 · 2023: 2 · 2022: 1 · 2021: 6 · 2020: 13 · 2019: 4 · 2018: 2 · 2017: 8 · 2016: 14 · 2015: 13 · 2014: 3
- FWCI
- 9.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- CONICET Digital (CONICET) (submittedVersion, cc-by-nc-sa)
- Funders
- Fundación INECO
- Consejo Nacional de Investigaciones Científicas y Técnicas (1130920)
- Comisión Nacional de Investigación Científica y Tecnológica (1140114, 1130920)
- Fondo para la Investigación Científica y Tecnológica (2012-0412, 2012‐1309, PICT 2012)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- bipolar disorder, euthymia, neurocognitive impairment, cognitive subtypes, executive function, cognitive heterogeneity, psychosocial functioning, functional outcome
- MeSH terms
- Adult, Bipolar Disorder, Cyclothymic Disorder, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Prevalence, Executive Function, Cognitive Dysfunction
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