2021-11-29

047_ Predominant polarity: investigating the effect of manic episodes in cognitive performance of patients with bipolar disorder

Research Question and Aims

Bipolar disorder is a chronic mood disorder with episodic progress and high relapse rate. Patients with bipolar disorder show cognitive deficits regardless of the phase of the illness. The concept of predominant polarity (PP) is defined as presenting more symptoms of one polarity, which could represent an important specifier for bipolar disorder, establishing distinct groups of patients and providing a potential tool for tailored treatment. Although there is a lack of consensus on a unifying definition, previous studies have defined PP as one polarity (either depression or mania episodes) occurring during at least two-thirds of the lifetime. Different studies suggest that manic episodes may be associated to a higher number of hospitalizations, suicide attempts, episodes with psychotic symptoms and the presence of higher cognitive impairment in bipolar disorder, especially in verbal memory.
The objective of the study is to investigate the relationship between the PP specifier and the cognitive dysfunction often found in patients with bipolar disorder. As far as we know, only one study addressed the relationship between PP and cognitive performance with a relatively small sample size. Considering the association of manic episodes to cognitive impairment and the higher frequency of manic episodes in patients with manic PP we hypothesize that patients with a manic PP will show greater cognitive deficits than those with a depressive PP.

Analytic Plan

Considering the association of manic episodes to cognitive impairment and the higher frequency of manic episodes in patients with manic PP we hypothesize that patients with a manic PP will show greater cognitive deficits than those with a depressive PP.
Analysis will include the PsyCourse samples (patients) and the Barcelona Sample (patients). Using these data we will investigate the association of PP with cognitive variables. First, the whole sample will be divided in three groups according to the predominant polarity (depressive, manic or indeterminate). Potential differences between groups in sociodemographic, clinical and cognitive variables will be analyzed by means of linear mixed models with centre as random effect. A second series of correlations analyses will be run to investigate the association of cognitive variables and the number of the different type of episodes.

Resources needed

Clinical
v1_cur_psy_trm v1_age_1st_out_trm
v1_daypat_inpat_trm v1_age_1st_inpat_trm
v1_dur_illness v1_1st_ep

Medication
v1_Antidepressants
v1_Antipsychotics
v1_Mood_stabilizers
v1_Tranquilizers
v1_Other_psychiatric
v1_lith v1_lith_prd

Family
v1_fam_hist

Substance use
v1_ever_smkd
v1_lftm_alc_dep
v1_evr_ill_drg

Somatic disease
v1_chol_trig
v1_hyperten
v1_ang_pec
v1_heart_att
v1_stroke
v1_diabetes
v1_hyperthy
v1_hypothy
v1_osteopor
v1_asthma
v1_autoimm
v1_cancer
v1_stom_ulc
v1_kid_fail
v1_epilepsy
v1_migraine
v1_parkinson
v1_tbi
v1_liv_cir_inf

Suicide
v1_scid_evr_suic_ide
v1_suic_attmpt
v1_scid_no_suic_attmpt

Diagnostic
v1_scid_dsm_dx_cat
v1_scid_age_MDE
v1_scid_no_MDE
v1_scid_age_mania
v1_scid_no_mania
v1_scid_age_hypomania
v1_scid_no_hypomania
v1_scid_ever_delus
v1_scid_ever_halls
v1_scid_ever_psyc
v1_scid_age_fst_psyc

Scales:
v1_idsc_sum
v1_ymrs_sum
v1_gaf
v1_bdi2_sum
v1_whoqol_itm14
v1_whoqol_dom_glob
v1_whoqol_dom_phys
v1_whoqol_dom_psy
v1_whoqol_dom_soc
v1_whoqol_dom_env
v1_cape_itm37A