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Psychol Med. 2017 Dec;47(16):2892-2905. doi: 10.1017/S003329171700143X. Epub 2017 Jun 7.

Neurocognitive subtypes in patients with bipolar disorder and their unaffected siblings.

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Department of Psychiatry,Icahn School of Medicine at Mount Sinai School of Medicine,New York, NY,USA.
Melbourne Neuropsychiatry Centre,Department of Psychiatry,University of Melbourne,Melbourne,Australia.
Zucker Hillside Hospital - Northwell Health System,Glen Oaks, NY,USA.



Our previous work revealed substantial heterogeneity in the cognitive profile of bipolar disorder (BD) due to the presence of three underlying cognitive subgroups characterized as: globally impaired, selectively impaired, or cognitively intact. In an effort to determine whether these subgroups are differentially related to genetic risk for the illness, we investigated whether cognitive deficits were more pronounced in unaffected siblings (UAS) of BD probands within identified clusters.


Cluster analysis was used to identify cognitive clusters in BD (N = 60). UAS (N = 49) were classified into groups according to their proband sibling's cluster assignment; comparisons were made across all clusters and healthy controls (HCs; N = 71).


Three cognitive clusters in BD emerged: a globally impaired (36.7%), a selectively impaired (30%), and a cognitively intact cluster (33.3%). UAS showed a qualitatively similar pattern to their BD siblings; UAS of the globally impaired BD cluster showed verbal memory and general cognitive impairments relative to HCs. In contrast, UAS of the other two clusters did not differ from HCs.


This study corroborates findings from prior work regarding the presence of cognitive heterogeneity in BD. UAS of subjects in the globally impaired BD cluster presented with a qualitatively similar cognitive profile to their siblings and performed worse than all other BD clusters and UAS groups. This suggests that inherited risk factors may be contributing to cognitive deficits more notably in one subgroup of patients with BD, pointing toward differential causes of cognitive deficits in discrete subgroups of patients with the disorder.


Bipolar disorder; cognition; heterogeneity; unaffected sibling; verbal memory

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