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Depression Research and Treatment
Volume 2012 (2012), Article ID 275957, 11 pages
http://dx.doi.org/10.1155/2012/275957
Review Article

Bipolar Disorder: Clinical Perspectives and Implications with Cognitive Dysfunction and Dementia

1Psychiatry Service, Hospital de São João (HSJ), EPE, 4200-319 Porto, Portugal
2Faculty of Medicine, University of Porto (FMUP), 4200-319 Porto, Portugal

Received 15 September 2011; Revised 13 March 2012; Accepted 27 March 2012

Academic Editor: Bernhard Baune

Copyright © 2012 R. Lopes and L. Fernandes. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Cognitive dysfunction as a core feature in the course of bipolar affective disorder (BPD) is a current subject of debate and represents an important source of psychosocial and functional burden. Objectives. To stand out the connection and clinical implications between cognitive dysfunction, dementia, and BPD. Methods. A nonsystematic review of all English language PubMed articles published between 1995 and 2011 using the terms “bipolar disorder,” “cognitive dysfunction,” and “dementia”. Discussion. As a manifestation of an affective trait or stage, both in the acute phases and in remission, the domains affected include attention, executive function, and verbal memory. The likely evolution or overlap with the behavioural symptoms of an organic dementia allows it to be considered as a dementia specific to BPD. This is named by some authors, as BPD type VI, but others consider it a form of frontotemporal dementia. It is still not known if this process is neurodevelopmental or neurodegenerative in nature, or both simultaneously. The assessment should consider the iatrogenic effects of medication, the affective symptoms, and a neurocognitive evaluation. Conclusion. More specific neuropsychological tests and functional imaging studies are needed and will assume an important role in the near future for diagnosis and treatment.