Neuropsychological Function in Manic-Depressive Psychosis Evidence for Persistent Deficits in Patients with Chronic, Severe Illness

While neuropsychological deficits are recognised to occur in manic-depressive psychosis during episodes of depression and to reverse with clinical recovery, it is uncertain whether they can ever be seen outside episodes of illness. Forty-five patients meeting DSM-III-R criteria for major depression or bipolar disorder were screened using tests of memory, executive function and overall intellectual function. All testing was carried out during remission of affective symptoms. None of 24 young patients and 11 elderly patients scored in the impaired range on any of the tests. However, five of ten patients with chronic, severe affective disorder were impaired on one or more of the measures. On more detailed neuropsychological investigation, these five patients were found to show a variable pattern of impairment, ranging from memory and executive deficits in relative isolation, to widespread poor performance. Enduring neuropsychological deficits may be a feature of chronic, severe manic-depressive illness.