
Research view
Title: | Sex differences in cognitive dysfunction among bipolar disorder patients |
Author: | Heba Aly, Hoda Salama, Soha Ibrahim , Hesham El-Shestawy |
Abstract: |
Introduction
Studies have proposed that cognitive defi cits are present in a variety of mood states in bipolar
disorder (BD). In addition, a few studies have pointed to the presence of sex-related differences
in cognitive dysfunction in BD.
Aim of the work
This comparative study aimed to study the cognitive functioning of BD patients in different
episodes, and detect any sex-related differences in cognitive functioning in the studied sample.
Patients and methods
The recruited sample consisted of 150 patients selected at random from El Maamoura
Mental Hospital over 6 months. Four groups were formed: group I, comprising 38 (19 male
and 19 female) BD patients having manic episodes; group II, comprising 26 (12 male and
14 female) BD patients having depressive episodes; group III, comprising 36 (20 male and
16 female) patients in remission (euthymic); and group IV, comprising 50 controls matched for
age, sex, and education. Clinical and psychiatric evaluations were carried out and psychometric
assessment was performed using the 17-item Hamilton Depressive Scale and the Young Mania
Rating Scale, as well as cognitive assessments using three tests: Wisconsin’s Card Sorting
Test ( WCST), the digit span subtest of the WAIS-R and DSST (the digit symbol subtest of
the WAIS-R).
Results
The BD patients in the three groups having BD showed signifi cant cognitive defi cits compared
with controls. Manic and depressive patients showed impairment in attention, working memory,
and executive functions. Euthymic patients showed signifi cant impairment in working memory
and executive functions. Only euthymic patients revealed a statistically signifi cant sex-related
difference in terms of short-term memory, attention, and working memory, with women being
worse than men. Interestingly, in the control group a difference in executive functions was
reported wherein healthy control women performed signifi cantly better than control men on the
WCST-128 (completed signifi cantly more number of categories and committed signifi cantly
fewer perseverative errors).
Conclusion
Cognitive dysfunction should be regarded as a core feature of BD as it was present across
all mood states in our sample. In addition, discrepancy has been found between male and
female euthymic patients regarding cognitive functions, suggesting a sex-related difference
in the clinical expression of BD.
Keywords:
17-item Hamilton Depressive Scale, bipolar disorder, cognitive assessments, cognitive
dysfunction, digit span subtest of the WAIS-R and DSST (the digit symbol subtest of the
WAIS-R), sex difference, Wisconsin’s Card Sorting Test, Young Mania Rating Scale
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Journal: | Egyptian Journal of Psychiatry 2015, 36:1–8 |
Text: | |
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