Cognitive trajectories in high premorbid social functioning bipolar patients

Introduction: This study aimed to describe the differences in global functioning in BD type I and type II patients with high premorbid functioning. Methods: From a more extensive sample of 140 subjects, fifty euthymic bipolar outpatients with high level of premorbid social functioning measured by Premorbid Adjustment Scale were enrolled. 90 BD were excluded because they had a low premorbid social functioning. Current social and neuropsychological functioning was assessed. Results: Cluster analysis showed that some BD patients maintain a high functioning, while other patients suffer of a loss of global functioning. Multivariate analysis showed that a lower social functioning, independently from premorbid social functioning, can be associated with a loss of executive functions (p = .009). In this analysis the effects of bipolar type (I or II), age at onset, current social roles and duration of illness were absent or not significant (p > .05). Discussions: This is the first study to distinguish levels of global functioning in euthymic BD patients that had the same premorbid social functioning. These important differences in the course of the BD can be assessed through psychosocial and neuropsychological assessment tools for a more appropriate management of the variables able to modify the course of disorder, also in euthymic phase. This practice becomes crucial in the definition and implementation of specific psychosocial treatments in the short and long-term course of disease, providing a new and specific area of intervention for bipolar disorder: the cognition.