TY - JOUR
T1 - Cognitive impairment in individuals with bipolar disorder with and without comorbid alcohol and/or cocaine use disorders
AU - Li, Chengxi
AU - Palka, Jayme M.
AU - Brown, E. Sherwood
N1 - Funding Information:
Financial support for the clinical trials analyzed by this study was provided by the Stanley Medical Research Institute (grant numbers 03T-439 , 05T-704 , 13T-001 ), the National Institute on Drug Abuse (grant number 5R01DA022460 ), and an investigator-initiated grant from Otsuka America Pharmaceutical Inc. and Lundbeck Inc. (grant number 331-201-00101 ). The sponsors did not participate in study design, experimental conduct, data analysis, manuscript writing, or the decision to submit the article for publication.
Publisher Copyright:
© 2020
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Background: Bipolar disorder (BD) frequently co-occurs with substance use disorders (SUDs), and both are associated with cognitive impairment. This study compares cognition between individuals with BD with and without current alcohol use disorder (AUD), cocaine use disorder (CUD), or both, as these disorders may be linked with additive cognitive impairment. Methods: Baseline data were analyzed from five clinical studies of individuals with the aforementioned disorders (N = 373). Participants were grouped as follows: BD-only, BD + AUD, BD + CUD, or BD + AUD + CUD. Cognition was assessed with the Rey Auditory Verbal Learning Test (RAVLT) (verbal learning and memory) and Stroop Color Word Test (executive function). Multiple linear regression models determined if SUD diagnosis, among other demographic and clinical variables, predicted each cognitive test's T-score. Regression equations were used to compute each group's mean T-scores. Results: All groups demonstrated below-average mean T-scores on all tests, with no significant between-group score differences. RAVLT total T-scores were lower than Stroop color-word T-scores within all groups (non-overlapping 95% confidence intervals). Higher daily cocaine use predicted higher Stroop T-scores (p < 0.01) and RAVLT delayed recall T-scores (p < 0.05). No other non-demographic variable, including AUD/CUD group status, predicted cognitive performance. Limitations: A full cognitive battery and some relevant variables (e.g. BD lifetime illness course) were not available. Many participants (42.1%) had additional SUDs. Conclusions: BD with and without AUD/CUD was found to be associated with greater deficits in verbal learning and memory than in executive function. Addressing these impaired domains in dually-diagnosed patients may improve treatment and functional outcomes.
AB - Background: Bipolar disorder (BD) frequently co-occurs with substance use disorders (SUDs), and both are associated with cognitive impairment. This study compares cognition between individuals with BD with and without current alcohol use disorder (AUD), cocaine use disorder (CUD), or both, as these disorders may be linked with additive cognitive impairment. Methods: Baseline data were analyzed from five clinical studies of individuals with the aforementioned disorders (N = 373). Participants were grouped as follows: BD-only, BD + AUD, BD + CUD, or BD + AUD + CUD. Cognition was assessed with the Rey Auditory Verbal Learning Test (RAVLT) (verbal learning and memory) and Stroop Color Word Test (executive function). Multiple linear regression models determined if SUD diagnosis, among other demographic and clinical variables, predicted each cognitive test's T-score. Regression equations were used to compute each group's mean T-scores. Results: All groups demonstrated below-average mean T-scores on all tests, with no significant between-group score differences. RAVLT total T-scores were lower than Stroop color-word T-scores within all groups (non-overlapping 95% confidence intervals). Higher daily cocaine use predicted higher Stroop T-scores (p < 0.01) and RAVLT delayed recall T-scores (p < 0.05). No other non-demographic variable, including AUD/CUD group status, predicted cognitive performance. Limitations: A full cognitive battery and some relevant variables (e.g. BD lifetime illness course) were not available. Many participants (42.1%) had additional SUDs. Conclusions: BD with and without AUD/CUD was found to be associated with greater deficits in verbal learning and memory than in executive function. Addressing these impaired domains in dually-diagnosed patients may improve treatment and functional outcomes.
KW - Alcohol use disorder
KW - Bipolar disorder
KW - Cocaine use disorder
KW - Cognitive impairment
KW - Dual diagnosis
KW - Executive function
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U2 - 10.1016/j.jad.2020.03.179
DO - 10.1016/j.jad.2020.03.179
M3 - Article
C2 - 32553378
AN - SCOPUS:85084291237
SN - 0165-0327
VL - 272
SP - 355
EP - 362
JO - Journal of affective disorders
JF - Journal of affective disorders
ER -