Neurocognitive Function in Pediatric Bipolar Disorder: 3-Year Follow-up Shows Cognitive Development Lagging Behind Healthy Youths |
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| Authors: | Mani N. Pavuluri Amy West S. Kristian Hill Kittu Jindal John A. Sweeney |
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| Affiliation: | 1. Medical Research Council Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology and Neuroscience, King''s College London, London, UK;2. Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King''s College London, London, UK;3. National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London, UK;1. Bipolar Disorders Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina;2. National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina;3. Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina;1. Department of Psychiatry and Department of Obstetrics and Gynecology, Western University, London, ON, Canada;2. Parkwood Institute, London, ON, Canada;3. Department of Psychiatry and Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA;4. Department of Psychiatry, Erasmus Medical Center, Rotterdam, Netherlands;5. Innovation in Mental and Physical Health and Clinical Treatment Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia;6. Orygen, the National Centre of Excellence in Youth Mental Health, Florey Institute for Neuroscience and Mental Health, and the Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia;7. Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India;8. National Centre for Register-based Research, Aarhus University, Aarhus, Denmark;9. Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark;10. Cleveland Clinic, Cleveland, OH, USA;11. Massachusetts General Hospital, Boston, MA, USA;12. Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada;1. University of Oxford, Oxford, England;2. Warneford Hospital, Oxford, England;3. Nuffield Department of Population Health, University of Oxford;4. National Institute of Mental Health, Bethesda, MD;1. Institute of Engineering and Technology (ENTEG), Faculty of Science and Engineering, University of Groningen, Groningen, The Netherlands;2. Delft Center for Systems and Control, Delft University of Technology, Delft, The Netherlands;3. Institute for Problems of Mechanical Engineering of Russian Academy of Sciences (IPME RAS), St. Petersburg, Russia;4. ITMO University, St. Petersburg, Russia |
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| Abstract: | ObjectiveLongitudinal follow-up of neurocognitive functioning in people with pediatric bipolar disorder (PBD) was conducted to characterize the developmental trajectory of cognitive disabilities in this disorder.MethodPatients with PBD (n = 26) and controls (HC; n = 17; mean age 11.66 ± 2.70 years) completed cognitive testing at baseline and then again at a 3-year follow-up. Groups were matched at baseline on age, sex, race, parental socioeconomic status, general intelligence, and single-word reading ability. The PBD group received treatment guided by a standardized medication algorithm during the 3-year period. A battery of neuropsychological tests was administered to assess attention, executive function, working memory, verbal memory, visual memory, and visuospatial perception at baseline and follow-up.ResultsAt baseline and follow-up, the patients showed deficits in all of the examined domains. At 3-year follow-up, developmental progress in executive functions and verbal memory was significantly less in the patients with PBD than in the HC. Improvement on attention, working memory, visual memory, and visuospatial perception tasks in the patients with PBD was comparable to that of the HC, but the patients with PBD remained impaired in all domains relative to the HC.ConclusionsThe developmental delay in some neurocognitive functioning in PBD suggests that the illness disrupts cognitive development with potential lifelong implications for reduced functional ability. Treating bipolar symptoms does not seem to prevent the lag in cognitive development. This dysmaturation may be a direct effect of the illness on brain function, or it may represent indirect consequences of psychopathology or medications on cognitive development. |
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