Neurocognition and emotional processing in bipolar offspring

Abstract

Background/aims: Recent evidence suggests that the psychosocial function for patients with Bipolar Disorder (BD) may not always be as favorable as originally proposed by Emil Kraeplin. This dysfunction has been statistically associated with neurocognitive measures (on tasks assessing working memory, learning and executive function) and emotional processing (on tasks assessing facial emotion labeling). Studies of Offspring of Bipolar Parents (OBP) in comparison with Offspring of Healthy Controls (OHC) demonstrate elevated risk for development of BD and limited evidence of impairment in neurocognitive function and emotional processing. The identification of an endophenotype for BD could help in early identification of BD, institution of early appropriate intervention and thereby perhaps limit this psychosocial dysfunction. The aims included the recruitment of a matched sample of OBP and OHC and investigation of neurocognitive function and facial emotion labelling in these two groups. The hypotheses were: OBP will show impairment in the domains of memory, learning and executive function, OBP will demonstrate more errors on facial emotion labeling tasks and the deficits in facial emotion labelling will not be related to impairments demonstrated on the domains of memory, learning and executive function. Results: OBP showed deficits in IQ, spatial working memory, visual and auditory working memory as compared to OHC. OBP also made more errors on tasks of facial emotion labeling; particularly on ‘fearful faces’ in comparison to OHC. The novel finding from this project was the lack of significant association between the reported neurocognitive deficits and facial emotion labeling deficits in OBP. Conclusion: The study identified deficits in neurocognitive function and facial emotion labeling in OBP which appear to be independent. These deficits met some criteria for being considered an endophenotype for BD. The study was limited by a small sample size, lack of blinding and low specificity of these deficits for BD. Further longitudinal research to study the evolution of these deficits would be the next step in confirmation of these deficits as a potential candidate endophenotype for BD. In addition research should focus on factors that might contribute to these deficits such as severity of parental BD (‘nature’) and family environment (‘nurture’).