Presenting Author: Dr. Eric Gee
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Patients with bipolar affective disorder (BAD) have neuropsychological deficits regardless of the phase of illness. 75% of euthymic BAD patients were found to score 1 standard deviation below controls in at least 4 cognitive domains. These deficits can be measured after 1 and 2 years of sustained remission and are associated with a lower global assessment of functioning score. Studies have measured cognition only after the diagnosis of BAD. It is unknown if cognitive deficits pre-exist diagnosis or are a consequence of BAD onset.
Our case study examines the formal cognitive testing done in a patient before and after the diagnosis of BAD. Forty-eight hours after the patient’s second cognitive test, the Young Mania Scale and Hamilton Rating Scale for Depression suggested the patient was not manic or depressed. Six domains were measured both before and after the diagnosis of BAD. The patient’s perceptual reasoning, processing speed and visual spatial abilities declined by more than 20 percentile points. A subjective experience around cognition was elicited from the patient and echoed the deficits found by testing. For this patient, it seems that the cognitive impairments were a consequence of BAD onset. The patient’s subjective experience and objective measures indicate cognitive deficits that impact the patient’s life and should be considered when treating patients with BAD.