Chapter 1 30 ‘Bipolar disorder’: Bipolar disorder is a mood disorder characterised by well-recognizable episodes of extreme mood swings that include at least one episode of mania or hypomania (one week or longer of being euphoric, full of energy, or unusually irritable) and possibly depression. During a manic episode, there can be problems with attention and distraction that can translate into cognitive deficits. Cognitive difficulties are prone to exist due to distraction (hypervigilance and hypo-tenacity), high association, and other core features of mania, or in the case of a depressive episode, the opposite symptoms: apathy, low association, and disturbed vigilance and tenacity. There are several types of bipolar disorder and its related disorders. These may include mania, hypomania, and depression. Symptoms can cause unpredictable changes in mood and behaviour, resulting in significant distress and difficulty in life. Table 6. Different Bipoar disorder types. Type Description Bipolar I disorder The patient has had at least one manic episode, which may be preceded or followed by hypomanic or depressive episodes. In some cases, mania can lead to a break from reality (psychosis). Bipolar II disorder. The patient has had at least one depressive episode and at least one hypomanic episode, but never a manic episode. Cyclothymic disorder The patient has had at least two years (or one year for children and teenagers) of many periods of hypomania symptoms and periods of depressive symptoms (although less severe than depression). Other types These include bipolar and related disorders caused by certain medications (prednisone is the most notorious), drugs or alcohol or as a result of a medical condition, such as Cushing’s disease, brain trauma, or stroke. To date, no differences in cognitive impairment have been found between the clinical bipolar disorder subtypes bipolar type I and II (Bora, 2018). Hospitalisation, number of episodes, or psychosis do not seem, although debated, (significantly) associated with any particular cognitivedomain inunipolar depression, as it seems toworsenexecutive function, working and verbal memory, and processing speed in bipolar depression (Bortolato et al., 2015; Cardoso et al., 2015; Bora, 2018). However, there is inconsistent or no evidence in longitudinal studies that cognitive impairment is progressive (Bortolato et al., 2015). The cognitive profile of bipolar disorder is similar to that of schizophrenia, but to a lesser extent (Van Rheenen et al., 2017). The cognitive domains affected are widespread, and one cannot speak of a specific neuropsychological signature to differentiate the two (Bortolato et al., 2015). As for euthymic patients compared to controls, there are noticeable differences
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