Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-23T00:28:09.007Z Has data issue: false hasContentIssue false

Decision making in euthymic bipolar I and bipolar II disorders

Published online by Cambridge University Press:  22 September 2010

D. J. Martino
Affiliation:
Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina
S. A. Strejilevich*
Affiliation:
Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina
T. Torralva
Affiliation:
Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina
F. Manes
Affiliation:
Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina
*
*Address for correspondence: Dr S. A. Strejilevich, Congreso 2477 Dto. D, 1428 Ciudad de Buenos Aires, Argentina. (Email: [email protected])

Abstract

Background

The main aim of this study was to compare a large population of patients with bipolar disorder (BD) types I and II strictly defined as euthymic with healthy controls on measures of decision making. An additional aim was to compare performance on a decision-making task between patients with and without a history of suicide attempt.

Method

Eighty-five euthymic patients with BD-I or BD-II and 34 healthy controls were included. All subjects completed tests to assess verbal memory, attention and executive functions, and a decision-making paradigm (the Iowa Gambling Task, IGT).

Results

Both groups of patients had worse performance than healthy controls on measures of verbal memory, attention and executive function. No significant differences were found between BD-I, BD-II and healthy controls on measures of decision making. By contrast, patients with a history of suicide attempt had lower performance in the IGT than patients without a history of suicide attempt.

Conclusions

Patients with euthymic BD-I and BD-II had intact decision-making abilities, suggesting that this does not represent a reliable trait marker of the disorder. In addition, our results provide further evidence of an association between impairments in decision making and vulnerability to suicidal behavior.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adida, M, Clark, L, Pomietto, P, Kaladjian, A, Besnier, N, Azorin, JM, Jeanningros, R, Goodwin, G (2008). Lack of insight may predict impaired decision making in manic patients. Bipolar Disorders 10, 829837.CrossRefGoogle ScholarPubMed
Bechara, A, Damasio, A, Damasio, H, Anderson, S (1994). Insensitivity to future consequences following damage to human prefrontal cortex. Cognition 50, 7–15.CrossRefGoogle ScholarPubMed
Bechara, A, Tranel, D, Damasio, H (2000). Characterization of the decision-making deficit of patient with ventromedial prefrontal cortex lesions. Brain 123, 21892202.CrossRefGoogle ScholarPubMed
Benton, A, Hamsher, K, Sivan, A (1983). Multilingual Aphasia Examination, 3rd edn. AJA Associates: Iowa City, IA.Google Scholar
Christodoulou, T, Lewis, M, Ploubidis, G, Frangou, S (2006). The relationship of impulsivity to response inhibition and decision-making in remitted patients with bipolar disorder. European Psychiatry 21, 270273.CrossRefGoogle ScholarPubMed
Clark, L, Iversen, S, Goodwin, G (2001). A neuropsychological investigation of prefrontal cortex involvement in acute mania. American Journal of Psychiatry 158, 16051611.CrossRefGoogle ScholarPubMed
Clark, L, Iversen, S, Goodwin, G (2002). Sustained attention deficit in bipolar disorder. British Journal of Psychiatry 180, 313319.CrossRefGoogle ScholarPubMed
Daban, C, Martinez-Arán, A, Torrent, C, Tabaréz-Seisdedos, R, Balanza-Martinez, V, Salazar-Fraile, J, Selva-Vera, G, Vieta, E (2006). Specificity of cognitive deficits in bipolar disorder versus schizophrenia. A systematic review. Psychotherapy and Psychosomatics 75, 7284.CrossRefGoogle ScholarPubMed
Ernst, M, Bolla, K, Mouratidis, M, Contoreggi, C, Matochik, JA, Kurian, V, Cadet, JL, Kimes, AS, London, ED (2002). Decision-making in a risk-taking task: a PET study. Neuropsychopharmacology 26, 682691.CrossRefGoogle Scholar
First, M, Spitzer, R, Gibbon, M, Williams, J (1996). Structured Clinical Interview for DSM-IV Axis I Disorders – Clinical Version (SCID-CV). American Psychiatric Press: Washington, DC.Google Scholar
Glahn, D, Bearden, C, Niendam, T, Escamilla, M (2004). The feasibility of neuropsychological endophenotypes in the search for genes associated with bipolar affective disorder. Bipolar Disorders 6, 171182.CrossRefGoogle ScholarPubMed
Hamilton, M (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry 23, 5662.CrossRefGoogle ScholarPubMed
Heaton, R (1981). Wisconsin Card Sorting Test. Psychological Assessment Resources: Odessa, FL.Google Scholar
Jabben, N, Arts, B, Krabbendam, L, van Os, J (2009). Investigating the association between neurocognition and psychosis in bipolar disorder: further evidence for the overlap with schizophrenia. Bipolar Disorders 11, 166177.CrossRefGoogle ScholarPubMed
Jollant, F, Bellivier, F, Leboyer, M, Astruc, B, Torres, S, Verdier, R, Castelnau, D, Malafosse, A, Courtet, Ph (2005). Impaired decision making in suicide attempters. American Journal of Psychiatry 162, 304310.CrossRefGoogle ScholarPubMed
Jollant, F, Guillaume, S, Jaussent, I, Bellivier, F, Leboyer, M, Castelnau, D, Malafosse, A, Courtet, Ph (2007). Psychiatric diagnoses and personality traits associated with disadvantageous decision-making. European Psychiatry 22, 455461.CrossRefGoogle ScholarPubMed
Judd, LL, Akiskal, HS, Schettler, PJ, Coryell, W, Endicott, J, Maser, JD, Solomon, DA, Leon, AC, Keller, MB (2003). A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder. Archives of General Psychiatry 60, 261269.CrossRefGoogle ScholarPubMed
Judd, LL, Akiskal, HS, Schettler, PJ, Endicott, J, Maser, J, Solomon, DA, Leon, AC, Rice, JA, Keller, MB (2002). The long-term natural history of the weekly symptomatic status of bipolar I disorder. Archives of General Psychiatry 59, 530537.CrossRefGoogle ScholarPubMed
Malloy-Diniz, L, Neves, F, Abrantes, S, Fuentes, D, Correa, H (2009). Suicide behavior and neuropsychological assessment of type I bipolar patients. Journal of Affective Disorders 112, 231236.CrossRefGoogle ScholarPubMed
Manes, F, Sahakian, B, Clark, L, Rogers, R, Antoun, N, Aitken, M, Robbins, T (2002). Decision-making processes following damage to the prefrontal cortex. Brain 125, 624639.CrossRefGoogle ScholarPubMed
Mann, JJ (2003). Neurobiology of suicide behaviour. Nature Reviews Neuroscience 4, 819828.CrossRefGoogle Scholar
Martinez-Arán, A, Vieta, E, Reinares, M, Colom, F, Torrent, C, Sanchez-Moreno, J, Benabarre, A, Goikolea, J, Comes, M, Salamero, M (2004). Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. American Journal of Psychiatry 161, 262270.CrossRefGoogle ScholarPubMed
Martino, D, Bucay, D, Butman, J, Allegri, R (2007). Neuropsychological frontal impairments and negative symptoms in schizophrenia. Psychiatry Research 152, 121128.CrossRefGoogle ScholarPubMed
McGirr, A, Turecki, G (2007). The relationship between impulsive aggressiveness to suicidality and other depression-linked behaviors. Current Psychiatry Reports 9, 460466.CrossRefGoogle ScholarPubMed
Muller-Oerlinghausen, B, Berghofer, A, Bauer, M (2002). Bipolar disorder. Lancet 359, 241247.CrossRefGoogle ScholarPubMed
Murphy, F, Rubinsztein, J, Michael, A, Rogers, R, Robbins, T, Paykel, E, Sahakian, B (2001). Decision making cognition in mania and depression. Psychological Medicine 31, 679693.CrossRefGoogle ScholarPubMed
Reitan, R (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual Motor Skills 8, 271276.CrossRefGoogle Scholar
Rihmer, Z, Benazzi, F (2010). Impact on suicidality of the borderline personality traits impulsivity and affective instability. Annals of Clinical Psychiatry 22, 212218.Google ScholarPubMed
Ritter, L, Meador-Woodruff, J, Dalack, G (2004). Neurocognitive measures of prefrontal cortical dysfunction in schizophrenia. Schizophrenia Research 68, 6573.CrossRefGoogle ScholarPubMed
Robinson, L, Ferrier, I (2006). Evolution of cognitive impairments in bipolar disorder: a systematic review of cross-sectional evidence. Bipolar Disorders 8, 103116.CrossRefGoogle ScholarPubMed
Rogers, R, Tunbridge, E, Bhagwagar, Z, Drevets, W, Sahakian, B, Carter, C (2003). Tryptophan depletion alters the decision-making of healthy volunteers through altered processing of reward cues. Neuropsychopharmacology 28, 153162.CrossRefGoogle ScholarPubMed
Rolls, E, Grabenhorst, F (2008). The orbitofrontal cortex and beyond: from affect to decision-making. Progress in Neurobiology 86, 216244.CrossRefGoogle ScholarPubMed
Rubinsztein, J, Michael, A, Underwood, B, Tempest, M, Sahakian, B (2006). Impaired cognition and decision-making in bipolar depression but no ‘affective bias’ evident. Psychological Medicine 36, 629639.CrossRefGoogle ScholarPubMed
Rubinsztein, J, Paykel, M, Sahakian, B (2000). Cognitive impairment in remission in bipolar affective disorder. Psychological Medicine 30, 10251036.CrossRefGoogle ScholarPubMed
Savitz, J, Solms, M, Ramesar, R (2005). Neurocognitive function as an endophenotype for genetic studies of bipolar affective disorder. Neuromolecular Medicine 7, 275286.CrossRefGoogle ScholarPubMed
Seidman, L, Kremen, W, Koren, D, Faraone, S, Goldstein, J, Tsuang, M (2000). A comparative profile analysis of neuropsychological functioning in patients with schizophrenia and bipolar psychoses. Schizophrenia Research 53, 3144.CrossRefGoogle Scholar
Selva, G, Salazar, J, Balanzá-Martínez, V, Martínez-Arán, A, Rubio, C, Daban, C, Sánchez-Moreno, J, Vieta, E, Tabarés-Seisdedos, R (2007). Bipolar I patients with and without a history of psychotic symptoms: do they differ in their cognitive functioning? Journal of Psychiatric Research 41, 265272.CrossRefGoogle ScholarPubMed
Shurman, B, Horan, W, Neuchterlein, K (2005). Schizophrenia patients demonstrate a distinctive pattern of decision-making impairment on the Iowa Gambling Task. Schizophrenia Research 72, 215224.CrossRefGoogle ScholarPubMed
Signoret, J, Whiteley, A (1979). A memory battery scale. International Neuropsychological Society Bulletin 9, 226.Google Scholar
Toulopoulou, T, Quraishi, S, McDonald, C, Murray, R (2006). The Maudsley Family Study: premorbid and general intellectual function levels in familial bipolar I disorder and schizophrenia. Journal of Clinical and Experimental Neuropsychology 28, 243259.CrossRefGoogle Scholar
Wechsler, D (1995). Wechsler Adult Intelligence Scale – Revised. Psychological Corporation: Cleveland, OH.Google Scholar
Young, R, Biggs, J, Ziegler, V, Meyer, D (1978). A rating scale for mania: reliability, validity and sensitivity. British Journal of Psychiatry 133, 429435.CrossRefGoogle ScholarPubMed