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Annals of General Psychiatry
Published in: Annals of General Psychiatry 1/2020

Open Access 01-12-2020 | Review

Neurocognitive impairment and evidence-based treatment options in Bipolar disorder

Author: Konstantinos N. Fountoulakis

Published in: Annals of General Psychiatry | Issue 1/2020

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Abstract

Background

The current paper briefly summarizes the literature on the neurocognitive deficit and its treatment in BD patients.

Methods

The material was chosen on the basis of previous systematic reviews the author has taken part in.

Results

The data so far suggest that the deficit is qualitatively similar but quantitatively milder in comparison to schizophrenia, it is present already since the first episode, is weakly related to mood symptoms and somewhat stronger to psychotic symptoms, it probably determines much of the disability and treatment is problematic. This deficit is also present during periods of euthymia. The possible adverse effect of psychotropic medication is rather small if any at all and is confounded by the specific clinical symptoms, for which medication is used for their treatment. This is especially true concerning antipsychotics and psychotic symptoms. The origin and the etiopathogenesis of the core neurocognitive impairment remain elusive. The presence of a neurodegenerative and of a neurodevelopmental component has both data in favor and against and they are both the focus of debate.

Conclusions

Treatment of the neurocognitive deficit and restoration of functioning is problematic. The data are limited and treatment options are few and with a weak overall effect. Pharmacological treatments, ECT and rTMS present some hard data, while the literature is inconclusive concerning psychotherapeutic interventions.
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Metadata
Title
Neurocognitive impairment and evidence-based treatment options in Bipolar disorder
Author
Konstantinos N. Fountoulakis
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Annals of General Psychiatry / Issue 1/2020
Electronic ISSN: 1744-859X
DOI
https://doi.org/10.1186/s12991-020-00304-4

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