Cognitive impairment in bipolar disorder and schizophrenia: a systematic review
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AIMS: Previous comparisons of cognitive decline among patients with bipolar disorder (BD) and schizophrenia (SZ) have found somehow quite similar profiles of deficits, but results have varied between studies. Therefore an extensive and thoughtful systematic review of the matter is warranted. METHODS: Studies were found through systematic search (PubMed) following PRISMA guidelines. To be included, studies must have assessed the following cognitive functions: executive functions, memory, IQ, attention-concentration, and perceptuomotor function. In order to make comparison between the two entities, studies should include BD patients with operationally defined euthymia, schizophrenic patients in remission, and third group of healthy control patients. Comparisons were made after controlling for years of schooling and residual affective symptoms. RESULTS: We found that overall both SZ and BD patients present deficits on all neurocognitive measures compared to healthy controls. In particular, SZ patients show more severe and pervasive cognitive deficits while BD patients present a milder and more confined impairment. In addition, evidence from the literature suggests that SZ and BD patients share a similar cognitive impairment profile with different degrees of deficits. Therefore, the difference between the two groups seems to be more quantitative (degree of deficit) rather than qualitative (profile), supporting a dimensional approach to the two clinical entities. Limitations of the present review includes the impossibility to control for effects of medication, varying time required for assessment across studies, illness diagnosis reliability, and course severity. CONCLUSION: Patients with BD might exhibit a cognitive impairment that could be similar to SZ in terms of their profile, although patients with SZ may have more severe and widespread impairments.
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The similarity of non-social prediction ability in BD to HC is consistent with previous literature reporting non-significant differences in cognitive performance between BD and HC.
“consistent with previous literature reporting non-significant dif ferences in cognitive performance between BD and HC (V ¨ ohringer et al., 2013).”
From Predictive coding in neuropsychiatric disorders: a systematic transdiagnostic review. (2025) · cites this paper as Vöhringer et al., 2013
The Results table reports no significant BD–HC differences on some measures, including executive functioning in Joshua et al. and most neurocognitive subscores in the non-psychotic BD subgroup in Simonsen et al. But the Results summary says BD patients showed deficits on almost all neurocognitive measures compared with healthy controls, with only a few exceptions. The citation therefore supports similarity on particular measures or in particular samples, not a general absence of cognitive-performance differences. (LLM, conf=0.88)
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“Conversely, the non-social prediction ability in BD is similar to HC, consistent with previous literature reporting non-significant differences in cognitive performance between BD and HC (V ¨ ohringer et al., 2013).”
- Authors
- Vöhringer, P. A., Barroilhet, S. A., Amerio, A., Reale, M. L., Alvear, K., Vergne, D., & Ghaemi, S. N.
- Affiliations
- Tufts Medical Center (US)
- University of Parma (IT)
- Universidad Diego Portales (CL)
- Corresponding author
- Vöhringer, Paul A.
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2013
- Volume
- 4
- Pages
- 87-87
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC3737461
- OpenAlex
- W2078481226
- Cited by
- 165
- References
- 50
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 11 · 2023: 8 · 2022: 12 · 2021: 10 · 2020: 9 · 2019: 18 · 2018: 13 · 2017: 16 · 2016: 16 · 2015: 23 · 2014: 14 · 2013: 2
- FWCI
- 2.50
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- cognitive impairment, bipolar disorder, schizophrenia, executive function, memory, attention, IQ, euthymic bipolar patients, remitted schizophrenia, dimensional approach, neurocognitive impairment
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