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Differentiation of executive and attention impairments in affective illness

Published online by Cambridge University Press:  02 May 2007

SAMUEL D. R. STODDART
Affiliation:
Department of Psychiatry, Division of Neuroscience, University of Birmingham, UK
NICK J. CRADDOCK
Affiliation:
Department of Psychiatry, Division of Neuroscience, University of Birmingham, UK Department of Psychological Medicine, School of Medicine, Cardiff University, UK
LISA A. JONES*
Affiliation:
Department of Psychiatry, Division of Neuroscience, University of Birmingham, UK
*
*Address for correspondence: Dr Lisa A. Jones, Department of Psychiatry, Division of Neuroscience, University of Birmingham, Queen Elizabeth Psychiatric Hospital, Edgbaston, Birmingham B15 2QZ, UK. (Email: [email protected])

Abstract

Background

Executive impairments have been reported in affective illness, but the influence of attention on executive performance has not been fully considered. The purpose of this study was to investigate whether executive impairments in affective illness were independent of attention impairments, and whether independent executive impairments were specific to bipolar (BP) affective illness.

Method

Forty-two individuals with major affective disorders [20 unipolar (UP) depression and 22 BP disorder] were compared with 40 healthy controls on measures of attention and executive function. None of the patients were currently experiencing an episode of affective illness.

Results

As expected, both UP and BP patient groups showed significant neuropsychological impairments relative to controls. Significant differences in performance on executive function measures were also observed between UP and BP patients, even after the influence of attention had been taken into account. These impairments were not attributable to current levels of affective symptomatology or to medication.

Conclusions

A single neuropsychological dissociation appears to be present between UP and BP affective illness, with BP individuals showing a specific executive deficit that is independent of attention impairment on the Hayling Sentence Completion Test (HSCT).

Type
Original Article
Copyright
Copyright © Cambridge University Press 2007

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References

REFERENCES

APA (1994). Diagnostic and Statistical Manual of Mental Disorders (4th edn). American Psychiatric Association: Washington, DC.Google Scholar
Atre-Vaidya, N., Taylor, M. A., Seidenberg, M., Reed, R., Perrine, A. & Glick-Oberwise, F. (1998). Cognitive deficits, psychopathology, and psychosocial functioning in bipolar mood disorder. Neuropsychiatry, Neuropsychology, and Behavioral Neurology 11, 120126.Google ScholarPubMed
Burgess, P. W. & Shallice, T. (1997). The Hayling and Brixton Tests. Thames Valley Test Company: Bury St Edmunds, UK.Google Scholar
Clark, L., Iversen, S. D. & Goodwin, G. M. (2002). Sustained attention deficit in bipolar disorder. British Journal of Psychiatry 180, 313319.CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences. Lawrence Erlbaum: New Jersey.Google Scholar
Craddock, N. & Owen, M. J. (1996). Modern molecular genetic approaches to psychiatric disease. British Medical Bulletin 52, 434452.CrossRefGoogle ScholarPubMed
Crews, W. D. J. & Harrison, D. W. (1995). The neuropsychology of depression and its implications for cognitive therapy. Neuropsychology Review 5, 81123.CrossRefGoogle ScholarPubMed
Delis, D. C., Kaplan, E. & Kramer, J. (2001). Delis Kaplan Executive Function System. The Psychological Corporation: San Antonio, TX.Google Scholar
Den Hartog, H. M., Derix, M. M. A., Van Bemmel, A. L., Kremer, B. & Jolles, J. (2003). Cognitive function in young and middle-aged unmedicated outpatients with major depression: testing effort and cognitive speed hypotheses. Psychological Medicine 33, 14431451.CrossRefGoogle Scholar
Endicott, J., Spitzer, R. L., Fleiss, J. L. & Cohen, J. (1976). The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry 33, 766771.CrossRefGoogle Scholar
Ferrier, I. N., Chowdhury, R., Thompson, J. M., Watson, S. & Young, A. H. (2004). Neurocognitive function in unaffected first-degree relatives of patients with bipolar disorder: a preliminary report. Bipolar Disorders 6, 319322.CrossRefGoogle ScholarPubMed
Ferrier, I. N., Stanton, B. R., Kelly, T. P. & Scott, J. (1999). Neuropsychological function in euthymic patients with bipolar disorder. British Journal of Psychiatry 175, 246251.CrossRefGoogle ScholarPubMed
Frangou, S., Donaldson, S., Hadjulis, M., Landau, S. & Goldstein, L. H. (2005 a). The Maudsley Bipolar Disorder Project: executive dysfunction in bipolar disorder I and its clinical correlates. Biological Psychiatry 58, 859864.CrossRefGoogle ScholarPubMed
Frangou, S., Haldane, M., Roddy, D. & Kumari, V. (2005 b). Evidence for deficit in tasks of ventral, but not dorsal, prefrontal executive function as an endophenotypic marker for bipolar disorder. Biological Psychiatry 58, 838839.CrossRefGoogle Scholar
Gottesman, I. I. & Gould, T. D. (2003). The endophenotype concept in psychiatry: etymology and strategic intentions. American Journal of Psychiatry 160, 636645.CrossRefGoogle ScholarPubMed
Gourovitch, M. L., Torrey, E. F., Gold, J. M., Randolph, C., Weinberger, D. R. & Goldberg, T. E. (1999). Neuropsychological performance for monozygotic twins discordant for bipolar disorder. Biological Psychiatry 45, 639646.CrossRefGoogle ScholarPubMed
Hamilton, M. (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology 6, 278296.CrossRefGoogle ScholarPubMed
Keri, S., Kelemen, O., Benedek, G. & Janka, Z. (2001). Different trait markers for schizophrenia and bipolar disorder: a neurocognitive approach. Psychological Medicine 31, 915922.CrossRefGoogle ScholarPubMed
Linnoila, M., Rudorfer, M. V., Dubyoski, K. V., Rawlings, R. R. & Eckardt, M. J. (1986). Effects of one-week lithium treatment on skilled performance, information processing, and mood in healthy volunteers. Journal of Clinical Psychopharmacology 6, 356359.CrossRefGoogle ScholarPubMed
Nelson, H. E. (1982). National Adult Reading Test (NART): Test Manual. NFER Nelson: Windsor, UK.Google Scholar
Norman, D. A. & Shallice, T. (1986). Attention to action: willed and automatic control of behavior. In Consciousness and Self-Regulation (ed. Davidson, R. J., Schwartz, G. E. and Shapiro, D.), pp. 118. Plenum Press: New York.Google Scholar
Olley, A. L., Malhi, G. S., Bachelor, J., Cahill, C. M., Mitchell, P. B. & Berk, M. (2005). Executive functioning and theory of mind in euthymic bipolar disorder. Bipolar Disorders 7, 4352.CrossRefGoogle ScholarPubMed
Peretti, C. S., Danion, J. M., Kauffmann-Muller, F., Grange, D., Patat, A. & Rosenzweig, P. (1997). Effects of haloperidol and amisulpride on motor and cognitive skill learning in healthy volunteers. Psychopharmacologia 131, 329338.CrossRefGoogle ScholarPubMed
Porter, R. J., Gallagher, P., Thompson, J. M. & Young, A. H. (2003). Neurocognitive impairment in drug-free patients with major depressive disorder. British Journal of Psychiatry 182, 214220.CrossRefGoogle ScholarPubMed
Quraishi, S. & Frangou, S. (2002). Neuropsychology of bipolar disorder: a review. Journal of Affective Disorders 72, 209226.CrossRefGoogle ScholarPubMed
Robinson, L. J., Thompson, J. M., Gallagher, P., Goswami, U., Young, A. H., Ferrier, I. N. & Moore, P. B. (2006). A meta-analysis of cognitive deficits in euthymic patients with bipolar disorder. Journal of Affective Disorders 93, 105115.CrossRefGoogle ScholarPubMed
Spielberger, C. D., Gorsuch, R. L. & Lushene, R. E. (1983). Manual for the State-Trait Anxiety Inventory. Consulting Psychologists Press: Palo Alto, CA.Google Scholar
Stroop, J. R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology 18, 643662.CrossRefGoogle Scholar
Swann, A. C., Katz, M. M., Bowden, C. L., Berman, N. G. & Stokes, P. E. (1999). Psychomotor performance and monoamine function in bipolar and unipolar affective disorders. Biological Psychiatry 45, 979988.CrossRefGoogle ScholarPubMed
Thompson, J. M., Gallagher, P., Hughes, J. H., Watson, S., Gray, J. M., Ferrier, I. N. & Young, A. H. (2005). Neurocognitive impairment in euthymic patients with bipolar affective disorder. British Journal of Psychiatry 186, 3240.CrossRefGoogle ScholarPubMed
Weiland-Fiedler, P., Erickson, K., Waldeck, T., Luckenbaugh, D. A., Pike, D., Bonne, O., Charney, D. S. & Neumeister, A. (2005). Evidence for continuing neuropsychological impairments in depression. Journal of Affective Disorders 82, 253258.CrossRefGoogle Scholar
Wing, J. K., Babor, T., Brugha, T., Burke, J., Cooper, J. E., Giel, R., Jablenski, A., Regier, D. & Sartorius, N. (1990). SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Archives of General Psychiatry 47, 589593.CrossRefGoogle ScholarPubMed
Young, R. C., Biggs, J. T., Ziegler, V. E. & Meyer, D. A. (1978). A rating scale for mania: reliability, validity and sensitivity. British Journal of Psychiatry 133, 429435.CrossRefGoogle ScholarPubMed