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Previous research has demonstrated broad neurobehavioral abnormalities in bipolar affective disorder (cf. Cassens, Wolfe, & Zola, 1990). As yet however, there have been no comparisons of neuropsychological function across patients with manic, depressed, or mixed subtypes. Consequently, the effects of current disease manifestation upon higher cognitive function is poorly understood. In the present study, 31 manic, 23 mixed, and 18 depressed dextral bipolar inpatients and 22 control subjects were administered the CVLT, Trailmaking Tests, Grooved Pegboard Test, and MMPI-2. Groups were equivalent for age and race. Education served as a covariate in the MANCOVA due to fewer years of education in the depressed group (M = 12.88; SD. = 2.24) relative to the control (M = 15.14; SD =1.74) and manic groups (M = 14.41; SD = 2.68). The multivariate and univariate effects of participant group were uniformly significant (p<.05) on the cognitive measures. Tukey LSD comparisons revealed that depressed bipolar showed performance more commensurate with controls than with the other patient groups. In contrast, manic and mixed bipolar patients performed worse than the controls and depressed bipolars. Additionally, the manic and mixed bipolars had moderately-severely impaired performance, whereas the depressed patients showed normal performance. These differences were not attributable to differences in psychiatric symptomatology, as the patient groups did not differ on MMPI-2 scales. These findings imply that mania yields more pronounced neurobehavioral dysfunction than depression among bipolar patients. Although limited by a cross-sectional design, these data suggest that neuropsychological impairment in bipolar affective illness may be transiently related to manic episodes rather than chronically present.
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