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2 results

  • Meta-analyses of cognitive functioning in euthymic bipolar patients and their first-degree relatives

  • B. Arts, N. Jabben, L. Krabbendam, J. van Os
  • Journal:
    Psychological Medicine / Volume 38 / Issue 6 / June 2008
    Published online by Cambridge University Press:
    09 October 2007, pp. 771-785
  • Background

    Previous work suggests that impairments in executive function and verbal memory in particular may persist in euthymic bipolar patients and serve as an indicator of genetic risk (endophenotype).

    Method

    A systematic review of the literature was undertaken. Effects sizes were extracted from selected papers and pooled using meta-analytical techniques.

    Results

    In bipolar patients, large effect sizes (d>0.8) were noted for executive functions (working memory, executive control, fluency) and verbal memory. Medium effect sizes (0.5<d<0.8) were reported for aspects of executive function (concept shifting, executive control), mental speed, visual memory, and sustained attention. Small effect sizes (d<0.5) were found for visuoperception. In first-degree relatives, effect sizes were small (d<0.5), but significantly different from healthy controls for executive function and verbal memory in particular.

    Conclusions

    Executive function and verbal memory are candidate bipolar endophenotypes given large deficits in these domains in bipolar patients and small, but intermediate, cognitive impairments in first-degree relatives.

  • 8 - Schizoaffective mixed states

  • Edited by Andreas Marneros, Martin Luther-Universität Halle-Wittenburg, Germany, Frederick Goodwin, George Washington University, Washington DC
  • Book:
    Bipolar Disorders
    Published online:
    10 August 2009
    Print publication:
    06 October 2005, pp 187-206

  • Summary

    The paradox of the extremely rare research on schizoaffective mixed states can be better understood when one considers the development of the definitions, concepts, and nosological allocations of schizoaffective disorders. In Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), schizoaffective disorders belonged to the category "other psychotic disorders" with almost the same diagnostic criteria and the same subtypes as in DSM-III-R. In the Tenth Revision of the International Classification of Diseases (ICD-10), schizoaffective disorders landed in a category of their own within schizophrenia and delusional disorders, with five subcategories: schizoaffective disorders, at the present manic, schizoaffective disorders, at the present depressive, mixed schizoaffective disorder, other schizoaffective disorders, and schizoaffective disorders not otherwise specified. The age at onset is lower, the duration of schizoaffective mixed episodes can be longer, and the patients having schizoaffective mixed episodes exhibited more inability to work at a younger age.