Intermediate: Cognitive phenotypes in bipolar disorder

Scott A. Langenecker, Erika F.H. Saunders, Allison M. Kade, Michael T. Ransom, Melvin G. McInnis

Research output: Contribution to journalArticlepeer-review


Background: Intermediate cognitive phenotypes (ICPs) are measurable and quantifiable states that may be objectively assessed in a standardized method, and can be integrated into association studies, including genetic, biochemical, clinical, and imaging based correlates. The present study used neuropsychological measures as ICPs, with factor scores in executive functioning, attention, memory, fine motor function, and emotion processing, similar to prior work in schizophrenia. Methods: Healthy control subjects (HC, n = 34) and euthymic (E, n = 66), depressed (D, n = 43), or hypomanic/mixed (HM, n = 13) patients with bipolar disorder (BD) were assessed with neuropsychological tests. These were from eight domains consistent with previous literature; auditory memory, visual memory, processing speed with interference resolution, verbal fluency and processing speed, conceptual reasoning and set-shifting, inhibitory control, emotion processing, and fine motor dexterity. Results: Of the eight factor scores, the HC group outperformed the E group in three (Processing Speed with Interference Resolution, Visual Memory, Fine Motor Dexterity), the D group in seven (all except Inhibitory Control), and the HM group in four (Inhibitory Control, Processing Speed with Interference Resolution, Fine Motor Dexterity, and Auditory Memory). Limitations: The HM group was relatively small, thus effects of this phase of illness may have been underestimated. Effects of medication could not be fully controlled without a randomized, double-blind, placebo-controlled study. Conclusions: Use of the factor scores can assist in determining ICPs for BD and related disorders, and may provide more specific targets for development of new treatments. We highlight strong ICPs (Processing Speed with Interference Resolution, Visual Memory, Fine Motor Dexterity) for further study, consistent with the existing literature.

Original languageEnglish (US)
Pages (from-to)285-293
Number of pages9
JournalJournal of Affective Disorders
Issue number3
StatePublished - May 2010
Externally publishedYes


  • Bipolar disorder
  • Cognition
  • Depression
  • Emotion
  • Executive function
  • Intermediate phenotype
  • Mania
  • Phenotype

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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