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Emma Galante, BS

Job Title

Clinical Research Coordinator

Academic Rank

Staff/Research Assistant

Department

Psychiatry

Authors

Galante, E.V., Lebovitz, J.G., Burdick, K.E.

Principal Investigator

Katherine Burdick

Categories

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The Effects of Comorbid Anxiety on Cognitive Performance in Bipolar Disorder

Scientific Abstract

This study assessed whether comorbid anxiety disorders influence the severity of neurocognitive impairments in adults with a primary diagnosis of bipolar disorder (BD). 160 adult patients aged 19-68 were split into 3 diagnostic groups: healthy controls (HC), bipolar disorder (BD), and bipolar disorder with a comorbid anxiety diagnosis (BD-A). All patients completed the Matrics Consensus Cognitive Battery (MCCB) and between-group differences were evaluated by a one-way ANOVA with post-hoc comparisons. After correction for age and sex, both the BD (n=50) and BD-A (n=47) groups performed significantly worse than the HC group (n=63) on verbal learning (HC v. BD p < .001 ; HC v. BD-A p = .001) and overall MCCB composite score (HC v. BD p < .001; HC v. BD-A p < .001). The BD-A group also performed significantly worse than HCs (n=63) on domains of speed of processing (p< .001), working memory (p= .003), and visual learning (p .05). These results suggest that comorbid anxiety contributes to the cognitive problems reported in BD. Treatments targeting anxiety may alleviate some of the cognitive and functional disability noted in these individuals.

Lay Abstract

The goal of this study was to assess whether the presence of a comorbid anxiety disorder further impacted neurocognitive impairments in adults also diagnosed with bipolar disorder (BD). The patients were split into 3 groups: healthy controls (HC), bipolar disorder (BD), and bipolar disorder with an additional anxiety diagnosis (BD-A). All patients completed neurocognitive testing and the inter-group results were evaluated. The BD-A group performed significantly worse than HCs on speed of processing, working memory, and visual learning. These domains were not significantly worse in the BD group. Both the BD and BD-A groups performed significantly worse than HCs in verbal learning and on the overall MCCB composite score. The BD-A group displayed a significantly impaired performance compared to the HC group across several domains in which a significant impairment was not seen in the BD group. The BD-A group also had the lowest scores on all but one cognitive domain.

Clinical Implications

The inherent heterogeneity of BD combined with other comorbid psychiatric disorders creates a complicated symptomatology. In developing effective treatments for BD it is important to understand how comorbidities may impact responses to treatment and individual disease progression.