HOFF, ANNE L. PHD; SHUKLA, SASHI MD; HELMS, PAUL MD; ARONSON, THOMAS A. MD; LOGUE, CAMILLE PHD; OLLO, CHRISTINE PHD; COOK, BRIAN DO Author Information

30 inpatients diagnosed with schizophrenia were compared to 35 inpatients with bipolar affective disorder, manic type, on a large group of neuropsychological measures. Separate factor analyses were performed on measures of verbal, spatial, and speed variables in order to generate summary scales. Controlling for the effects of age, education, sex, duration of illness, number of previous hospitalizations, and medications at time of testing, there were no significant differences between diagnostic groups on the three factors or on individual test variables. Patients on medication performed more poorly on speed variables than those off medication. These findings call into question the notion of differential patterns of cognitive deficit among psychotic diagnoses.

Forty patients from an outpatient lithium clinic were studied who had a clear history of organic abnormalities which predated their affective symptomatology. In the course of reviewing the clinical histories regarding these patients, it was observed that only 37.5% of the patients had ever received a clinical diagnosis of organic affective syndrome. Variables associated with a failure to consider a diagnosis of organic affective syndrome were investigated.

Researchers studying cognition in mania have assumed that mania is a homogeneous entity. Recent preliminary evidence indicates that some manic syndromes may be preceded by medical, pharmacological, and neurologic antecedents. While DSM-III suggests that mild cognitive impairment may be associated with these manic syndromes, studies to date have not documented this assertion. We compared bipolar patients with antecedent neurologic factors (neurologic manics, NM) to bipolar patients without such histories (primary manics, PM) on standard neuropsychological measures and clinical parameters to ascertain whether cognitive testing could be used as an adjunctive diagnostic tool in defining this subgroup of patients. Results indicated that the NM group was more dysfunctional in intellectual functioning and course of psychiatric illness than the PM group.

Thirty-nine patients with bipolar illness preceded by organic factors were compared to age and sex matched bipolar controls. The patients with pre-existing organic factors were older at onset of their bipolar illness, had fewer depressive episodes, less family history of affective disorder, and were symptomatically different in a number of respects. The nosology of such disorders is discussed and the literature reviewed.

Forty-six patients with bipolar illness were evaluated with scalp-recorded electroencephalograms. Familial pattern of psychopathology was evaluated between groups with clinically normal and abnormal EEG tracings. Those with abnormal EEGs were noted to have a significantly negative family history of effective disorder when compared to the EEG normal group. These results may support the concept of some patients with mania having an acquired illness which occurs independent from its genetic loading.