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Data-driven cognitive phenotypes in subjects with bipolar disorder and their clinical markers of severity
- Source :
- Psychological medicine. 52(9)
- Publication Year :
- 2020
-
Abstract
- BackgroundSubjects with bipolar disorder (BD) show heterogeneous cognitive profile and that not necessarily the disease will lead to unfavorable clinical outcomes. We aimed to identify clinical markers of severity among cognitive clusters in individuals with BD through data-driven methods.MethodsWe recruited 167 outpatients with BD and 100 unaffected volunteers from Brazil and Spain that underwent a neuropsychological assessment. Cognitive functions assessed were inhibitory control, processing speed, cognitive flexibility, verbal fluency, working memory, short- and long-term verbal memory. We performed hierarchical cluster analysis and discriminant function analysis to determine and confirm cognitive clusters, respectively. Then, we used classification and regression tree (CART) algorithm to determine clinical and sociodemographic variables of the previously defined cognitive clusters.ResultsWe identified three neuropsychological subgroups in individuals with BD: intact (35.3%), selectively impaired (34.7%), and severely impaired individuals (29.9%). The most important predictors of cognitive subgroups were years of education, the number of hospitalizations, and age, respectively. The model with CART algorithm showed sensitivity 45.8%, specificity 78.4%, balanced accuracy 62.1%, and the area under the ROC curve was 0.61. Of 10 attributes included in the model, only three variables were able to separate cognitive clusters in BD individuals: years of education, number of hospitalizations, and age.ConclusionThese results corroborate with recent findings of neuropsychological heterogeneity in BD, and suggest an overlapping between premorbid and morbid aspects that influence distinct cognitive courses of the disease.
- Subjects :
- Bipolar Disorder
Neuropsychological Tests
03 medical and health sciences
0302 clinical medicine
Cognition
Discriminant function analysis
medicine
Verbal fluency test
Humans
Bipolar disorder
Neuropsychological assessment
Applied Psychology
medicine.diagnostic_test
business.industry
Cognitive flexibility
Neuropsychology
medicine.disease
030227 psychiatry
Psychiatry and Mental health
Phenotype
Verbal memory
business
030217 neurology & neurosurgery
Biomarkers
Clinical psychology
Subjects
Details
- ISSN :
- 14698978 and 00332917
- Volume :
- 52
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Psychological medicine
- Accession number :
- edsair.doi.dedup.....682ac859b5038bc4ee8376cd744f2b9b