B-102: Bipolar Disorder Across a Neurocognitive Spectrum: A Literature Review

Abstract

Objective: Bipolar disorder (BD) is a chronic mood disorder characterized by recurrent affective episodes and significant functional impairment. Increasing evidence suggests that neurocognitive dysfunction is a core feature of BD, present across illness phases, including euthymia. However, the extent to which cognitive deficits reflect stable trait markers versus state-dependent fluctuations remains unclear. This meta-analysis examines neurocognitive functioning across the BD spectrum, with particular emphasis on processing speed (PS), executive functioning (EF), and attention (AT), and how these domains vary by symptom severity and illness course. Method/Data Selection: A comprehensive literature search under PRISMA guidelines was conducted using the EBSCO PsycINFO database for studies published between 2000 and 2026 using the terms “bipolar disorder” and “neurocognitive impairment,” yielding 668 articles. Inclusion criteria required empirical studies reporting performance on standardized neuropsychological measures across domains including EF, PS, AT, and memory. Results/Data Synthesis: Findings consistently indicate that neurocognitive impairment persists across BD, even during euthymia. Deficits in processing speed and executive functioning emerged as robust and stable impairments, suggesting trait-like dysfunction. In contrast, attention demonstrated a more variable pattern, with impairments present across phases but exacerbated during acute mood episodes, indicating state sensitivity. Verbal memory deficits were more pronounced in BD I relative to BD II and may reflect illness burden and neuroprogressive processes. Conclusions: Overall, results support a model in which BD is associated with both trait-related and state-dependent neurocognitive dysfunction, with processing speed and executive functioning representing core deficits and attention reflecting dynamic modulation by mood state.