Research paperNeurocognition in patients with psychotic and non-psychotic bipolar I disorder. A comparative study with individuals with schizophrenia

- Neurocognitive impairment in BD is independent of history of psychotic symptoms.
- Neurocognitive profile does not support a distinction between BD-P and BD-NP.
- Neurocognition does not contribute to differential diagnosis SZ/affective psychosis.

BackgroundIt has been suggested that patients with bipolar disorder with psychotic symptoms (BD-P) have larger neurocognitive impairment than patients with bipolar disorder without a history of psychotic symptoms (BD-NP). The objective of this study was to compare neurocognitive performance of BD-P and BD-NP relative to a group of patients with schizophrenia (SZ), and healthy controls (HC).MethodsNeurocognitive function was examined in 100 subjects with bipolar I disorder (50 BD-P, 50 BD-NP), 50 SZ, and 51 HC. All patients with BD fulfilled criteria for euthymia, while all SZ patients were stabilised for at least the previous 3 months.ResultsPatients with BD-P and BD-NP performed worse than HC in all neurocognitive measures, except for sustained attention. Differences between BD-P and BD-NP were subtle and circumscribed to the working memory domain (effect size: 0.29). SZ performed worse than BD-NP in the neurocognitive composite index (NCI) and in the working memory domain. There were no differences between SZ and BD-P in any neurocognitive measure.LimitationsThe relatively small sample size, the cross-sectional design and, that patients were receiving pharmacological treatment are the main limitations of this study.ConclusionsOur findings show that the three groups of patients have a large neurocognitive impairment. Differences are quantitative and only present in some neurocognitive domains, such as working memory. These results suggest that patients with BD and SZ can benefit from the same strategies of cognitive remediation.