The Maudsley Bipolar Disorder Project: The Effect of Medication, Family History, and Duration of Illness on IQ and Memory in Bipolar I Disorder
J Clin Psychiatry 2003;64(1):86-93
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Despite the growing recognition of
the importance of cognitive impairment in psychiatric disorders,
the effect of clinical factors, such as medication use and family
history of affective disorders, on cognition in bipolar I
disorder patients still remains unclear. This study examines the
contribution of known and potential predictors to both general
intellectual function and memory in a representative population
of bipolar I disorder patients.
Method: Of the 425 patients receiving treatment
within a defined catchment area, 63 were identified as having
bipolar I disorder. Of these patients, 43 were enrolled in the
study and participated in a personal interview by a psychiatrist.
All patients were invited to participate in a personal interview
by a psychiatrist, and information on family history, past
psychiatric history, past and current treatments, duration of
illness, and age at onset was collected, in addition to
demographic data. Cognitive performance was assessed using the
Wechsler Adult Intelligence Scale-Revised, the National Adult
Reading Test, and the Wechsler Memory Test III.
Results: Forty-three patients with DSM-IV
bipolar I disorder were enrolled into the Maudsley Bipolar
Disorder Project. Patients on treatment with antipsychotic drugs
had a lower current full scale IQ, lower general memory scores,
and lower working memory scores. A family history of affective
disorders was associated with a higher full scale IQ, but not
with either general or working memory measures. Duration of
illness was negatively associated with general memory scores, but
had no effect on either IQ or working memory measures.
Conclusion: Current antipsychotic medication,
duration of illness, and family history of affective disorder
were the most significant predictors of IQ and memory function in
bipolar I disorder patients.