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Katharine Burns, BA

Job Title

Clinical Research Coordinator

Academic Rank

Staff/Research Assistant

Department

Psychiatry

Authors

Burns, K. C., Nicoloro-Santabarbara, J., Gunning, F., Burdick, K. E.

Principal Investigator

Katherine E. Burdick

Categories

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Subjective Cognitive Complains in Bipolar Disorder and Depression do not Correlate with Objective Measures of Cognitive Functioning

Scientific Abstract

Many patients with bipolar disorder (BD) and major depressive disorder (MDD) exhibit impairment on objective measures of cognition and subjective impairment is commonly reported. Research suggests that subjective impairment does not reflect objective cognitive ability, but rather tends to correlate more strongly with mood symptom severity. We examined the correlations between subjective and objective cognition in individuals with BD/MDD (n=102) compared to healthy controls (HC; n=78). Symptoms of depression (the Hamilton Depression Rating Scale; HDRS), mania (Young Mania Rating Scale; YMRS), objective cognitive functioning (the MATRICS Consensus Cognitive Battery; MCCB), and subjective cognitive functioning (the Functional Assessment Short Test; FAST and WHO Disability Assessment Schedule; WHODAS) were assessed. Cognitive scores were normalized for age and sex. Within controls, several significant correlations (p<.05) were observed between the objective and subjective measures of cognition. However, only two significant associations were observed between subjective and objective measures of cognition in patients. Additionally, mood symptoms were significantly associated with total FAST and WHODAS scores. These findings suggest that patients with a mood disorder may be less accurate at evaluating their cognitive impairment than healthy controls, which may be due to their mood symptoms affecting their self-appraisal.

Lay Abstract

Many individuals diagnosed with bipolar disorder (BD) and major depressive disorder (MDD) experience cognitive impairment (e.g., trouble remembering, concentrating, learning). Impairment is measured objectively through neuropsychological testing and is frequently subjectively reported by the patients themselves; however, these two methods of assessing impairment do not always correspond. Rather, subjective impairment corresponds more with depressive and manic symptoms. We examined the relationship between subjective and objective measures of cognition within a group of 102 MDD and BD volunteers and 78 healthy volunteers (HC). They answered questionnaires about their cognitive abilities (FAST and WHODAS) as subjective measures, completed neuropsychological testing as an objective measure of cognition, and rated their depressive and manic symptoms. We found that, for the HC group, answers on many questions from the FAST and WHODAS corresponded with objective cognitive scores while there were only two questions on the FAST that corresponded to objective cognitive scores in the MDD/BD group. Depressive symptoms corresponded with the FAST in both groups and manic symptoms corresponded with the FAST in the MDD/BD group. These findings suggest that MDD and BPD patients are not as accurate at assessing their cognitive ability which may be due to their depressive and manic symptoms.

Clinical Implications

Patients with MDD and BD may not be reliable reporters of their cognitive impairment due to their mood symptoms. Therefore, objective measures should be used to verify cognitive complaints to ensure that appropriate steps are taken to address them.