An updated review on the neuropsychological profile of subjects with bipolar disorder

Abstract Background In recent years, growing interest in the neuropsychology of bipolar disorder has emerged, giving rise to the accumulation of a robust body of evidence on this topic and to several related questions. Objective To provide a state-of-the-art overview of the neuropsychological profile of bipolar disorder. Method A thorough literature search was performed. Published research evidence was summarized and organized along three key pathways: findings from cross-sectional studies of cognition in bipolar patients, cognitive heterogeneity among affected subjects, and trajectory of neuropsychological deficits. Results At least two thirds of bipolar patients display neuropsychological deficits, even in euthymia. Although bipolar disorder was found to be associated with an increased risk of dementia, data from elderly subjects and longitudinal research do not support a worsening of cognitive performance over time. Discussion Cognitive dysfunctions are part of the clinical conceptualization of bipolar illness. However, they may not be present in all affected subjects and their course appears to be stable in most cases. Available evidence may be highlighting the fact that bipolar disorder is characterized by remarkable heterogeneity regarding cognitive outcomes. Different variables may be related to such heterogeneity and should be the focus of therapeutic approaches and further research.

Trastorno bipolar y DSM-5: aún lejos de la enfermedad / [Bipolar disorder and DSM-5: still far from the disease].

Although bipolar disorder is highly disabling, data from different regions of the world agree on the finding that there is a prolonged diagnostic delay in affected people. Among the main factors that could explain this phenomenon are contemporary conceptualizations of bipolar disorder and diagnostic criteria of the DSM-IV. Moreover, in recent years it has been cautioned about the risk of overdiagnosis of this disorder. In this context, the new edition of the DSM is presented. The modifications included in the DSM-5 regarding the diagnosis of bipolar disorder are described in this paper. Likewise, the practical implications of these changes are discussed.

Pacientes psiquiátricos que participan de investigaciones clínicas: repercusiones subjetivas y opiniones / Psychiatric patients involved in clinical investigations: their opinions and repercussions on their subjectivity

La participación de seres humanos en protocolos de investigación suele ser el punto final de muchos de los desarrollos de las ciencias médicas. Revisar los parámetros éticos y las implicancias que estas experiencias tienen para los participantes es una necesidad constante. Una de estas posibles consecuencias está determinada por la repercusión psicológica que puede tener la participación en estas experiencias. Se encuestó en forma anónima a 25 pacientes psiquiátricos que habían sido incluídos como sujetos experimentales en por lo menos un protocolo de investigación. Se indagaron sus sensaciones subjetivas y opiniones vinculadas con la experiencia. Los encuestados refirieron haberse sentido bien durante los estudios y procedimientos a los que fueron sometidos. Se obtuvieron respuestas positivas referidas a las consecuencias de estas experiencias sobre su enfermedad y tratamiento, tanto en aquéllos cuyo tratamiento fue modificado, como en los que éste no sufrió modificación alguna. Se propone una posible vinculación de este hecho con posibles acciones indirectas de corte psicoeducacional como producto de los procedimientos habituales en este tipo de estudios