Sustained attention deficit in bipolar disorder
Open accessAbstract
Background: Recovery in bipolar disorder is central to its definition but is rarely complete. Previous work has suggested that neuropsychological impairment persists during the euthymic state but has been confounded partly by mild affective symptoms in remitted patients. Aims: To characterise neuropsychological functioning in the euthymic phase of bipolar disorder with an emphasis on tasks of executive functioning. Method: Thirty euthymic patients with bipolar disorder were compared with thirty healthy controls on neuropsychological tasks differentially sensitive to damage within prefrontal cortex. Results: Bipolar I patients were impaired on tasks of attentional set shifting, verbal memory and sustained attention. Only sustained attention deficit survived controlling for mild affective symptoms. This deficit was related to progression of illness, but was none the less present in a subgroup of patients near illness onset. Conclusions: Sustained attention deficit may represent a neuropsychological vulnerability marker for bipolar disorder, providing a focus for further understanding of the phenotype and analysis of the neuronal networks involved.
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The existence of residual cognitive deficits in remitted patient groups demonstrates that some cognitive features occur independently of mood state.
“Moreover, the existence of residual cognitive deficits in remitted patient groups demonstrates that some cognitive features occur independently of mood state (Clark et al. 2002; Tham et al. 1997).”
From Brain structural and functional abnormalities in mood disorders: implications for neurocircuitry models of depression (2008) · cites this paper as Clark et al. 2002
The Discussion reports that sustained-attention performance remained impaired in euthymic bipolar patients after controlling for low levels of affective symptoms. This supports a residual deficit not explained by those measured symptoms, but the paper says it *may* be a trait marker; the claim’s assertion that mood-state independence is demonstrated is stronger than the source’s conclusion. (LLM, conf=0.84)
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- Authors
- Clark, L., Iversen, S. D., & Goodwin, G. M.
- Affiliations
- Warneford Hospital (GB)
- University of Oxford (GB)
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2002-04
- Volume
- 180
- Issue
- 4
- Pages
- 313-319
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2169848110
- Cited by
- 539
- References
- 43
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 5 · 2023: 7 · 2022: 18 · 2021: 10 · 2020: 17 · 2019: 11 · 2018: 21 · 2017: 11 · 2016: 27 · 2015: 27 · 2014: 22 · 2013: 37 · 2012: 34
- FWCI
- 16.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Medical Research Council
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- bipolar disorder, sustained attention, attention deficits, euthymic state, executive function, set-shifting, verbal memory, prefrontal cortex, disease progression, disease onset, affective symptoms
- MeSH terms
- Adolescent, Adult, Analysis of Variance, Attention, Bipolar Disorder, Cognition Disorders, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Psychiatric Status Rating Scales, Case-Control Studies, Prefrontal Cortex, Statistics, Nonparametric
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