Greater executive and visual memory dysfunction in comorbid bipolar disorder and substance use disorder

David F. Marshall, Sara J. Walker, Kelly A. Ryan, Masoud Kamali, Erika F.H. Saunders, Anne L. Weldon, Kenneth M. Adams, Melvin G. McInnis, Scott A. Langenecker

    Research output: Contribution to journalArticlepeer-review


    Measures of cognitive dysfunction in Bipolar Disorder (BD) have identified state and trait dependent metrics. An influence of substance abuse (SUD) on BD has been suggested. This study investigates potential differential, additive, or interactive cognitive dysfunction in bipolar patients with or without a history of SUD. Two hundred fifty-six individuals with BD, 98 without SUD and 158 with SUD, and 97 Healthy Controls (HC) completed diagnostic interviews, neuropsychological testing, and symptom severity scales. The BD groups exhibited poorer performance than the HC group on most cognitive factors. The BD with SUD exhibited significantly poorer performance than BD without SUD in visual memory and conceptual reasoning/set-shifting. In addition, a significant interaction effect between substance use and depressive symptoms was found for auditory memory and emotion processing. BD patients with a history of SUD demonstrated worse visual memory and conceptual reasoning skills above and beyond the dysfunction observed in these domains among individuals with BD without SUD, suggesting greater impact on integrative, gestalt-driven processing domains. Future research might address longitudinal outcome as a function of BD, SUD, and combined BD/SUD to evaluate neural systems involved in risk for, and effects of, these illnesses.

    Original languageEnglish (US)
    Pages (from-to)252-257
    Number of pages6
    JournalPsychiatry research
    Issue number2-3
    StatePublished - Dec 30 2012


    • Alcohol
    • Cognition
    • Dual diagnosis
    • Mood disorders
    • Neuropsychology

    ASJC Scopus subject areas

    • Psychiatry and Mental health
    • Biological Psychiatry


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