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Neuropsychology of bipolar disorder
MURPHY, F.C. & Sahakian, B.J.
British Journal of Psychiatry, 178, (suppl 41) s120-s127
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Background. Although the presence of wide-ranging neuropsychological deficits in individuals suffering from major depression is well established, few studies have investigated the nature of cognitive impairment in patients with bipolar disorder. Aims. To review research of the neuropsychology of bipolar disorder, with special attention to the relationship between mood and cognitive functioning. Method. Literature review. Results. Findings generally demonstrate mania-related impairments on conventional neuropsychological tests, with direct comparisons of manic and depressed patients failing to find group differences. More recent work has sought to differentiate these disorders by employing tasks with affective components. This research has demonstrated biases for processing positive and negative stimuli in patients with mania and depression, respectively. Conclusions. Future studies, employing tasks that require cognitive and emotional processing, should improve our understanding of the deficits observed in depression and mania. Neuroimaging studies of the neural regions that underlie cognitive processing of affective meaning suggest that the medial and orbitofrontal prefrontal cortex may be particularly involved.