A meta-analytic investigation of neurocognitive deficits in bipolar illness: profile and effects of clinical state.
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A meta-analysis of neuropsychological studies of patients with bipolar disorder comprised of 42 studies of 1,197 patients in euthymia, 13 studies consisting of 314 patients in a manic/mixed phase of illness, and 5 studies of 96 patients in a depressed state. Cohen d values were calculated for each study as the mean difference between patient and control group score on each neuropsychological measure, expressed in pooled SD units. For euthymia, results revealed impairment across all neuropsychological domains, with d values in the moderate-to-large range (d = .5 - .8) for the vast majority of measures. There was evidence of large effect-size impairment on measures of verbal learning (d = .81), and delayed verbal and nonverbal memory (d = .80 - .92), while effect-size impairment on measures of visuospatial function was small-to-moderate (d <or= .55). Patients tested during a manic/mixed or depressed phase of illness showed exaggerated impairment on measures of verbal learning, whereas patients tested during a depressed phase showed greater decrement on measures of phonemic fluency. These results suggest that bipolar illness during euthymia is characterized by generalized moderate level of neuropsychological impairment with particular marked impairment in verbal learning and memory. These results also show that a subset of these deficits moderately worsen during acute disease states.
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EF deficits are primarily state-independent (manifest even when illness symptoms are not present).
“Moreover, there is some evidence that EF deficits are primarily state-independent (manifest even when illness symptoms are not present, (e.g., Kurtz and Gerraty, 2009; Snyder, 2013) and present in attenuated form in unaffected family members of individuals with schizophrenia, BD, OCD, and PTSD, suggesting EF deficits may be an endophenotype for many forms of psychopathology (e.g., Barch, 2005; Gil”
From Advancing understanding of executive function impairments and psychopathology: bridging the gap between clinical and cognitive approaches (2015) · cites this paper as Kurtz and Gerraty, 2009
The Results (Neurocognitive Deficits in Euthymia; page unavailable) report moderate-to-large executive-function impairments in patients classified as euthymic, supporting the claim that deficits persist outside acute mood episodes. The Discussion (Effect of Symptoms; page unavailable) cautions that many euthymic samples included substantial residual symptoms and that their effects could not be quantified. Thus, the paper does not establish that EF deficits occur when symptoms are absent or are primarily state-independent. (LLM, conf=0.86)
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- Authors
- Kurtz, M. M., & Gerraty, R. T.
- Affiliations
- Wesleyan University (US)
- Venue
- Neuropsychology
- Published
- 2009
- Volume
- 23
- Issue
- 5
- Pages
- 551-562
- ISSN
- 0894-4105 (ISSN-L)
- 1931-1559
- PMC
- PMC2804472
- OpenAlex
- W2027687863
- Cited by
- 433
- References
- 79
- Citations by year
- 2026: 23 · 2025: 19 · 2024: 24 · 2023: 32 · 2022: 21 · 2021: 20 · 2020: 32 · 2019: 25 · 2018: 26 · 2017: 27 · 2016: 36 · 2015: 35 · 2014: 26 · 2013: 26 · 2012: 32
- FWCI
- 12.58
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Neuropsychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K08 MH-69888)
- National Alliance for Research on Schizophrenia and Depression
- 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 › Psychopathy, Forensic Psychiatry, Sexual Offending
- Keywords
- bipolar disorder, neurocognitive impairment, neuropsychological deficits, clinical status, euthymia, manic phase, mixed states, depressive phase, verbal learning, memory impairment, visuospatial ability
- MeSH terms
- Attention, Bipolar Disorder, Cognition Disorders, Depression, Female, Humans, Male, Memory, Short-Term, Neuropsychological Tests, Problem Solving, Retrospective Studies, Verbal Behavior, Confidence Intervals, Odds Ratio, MEDLINE
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