System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Epublish

PubMed: 42936543 DOI: 10.1155/da/9918396

Is It Possible to Establish Thresholds for Depressive Symptom Severity Associated With Cognitive Impairments in Bipolar Disorders? Findings From the FACE-BD Cohort.

Depress Anxiety 2026:9918396

Authors: Nathan Vidal, Eric Brunet-Gouet, Alexandre Billard, Solène Frileux, Raoul Belzeaux, Anamaria Bogdan, Philippe Courtet, Thierry D'Amato, Caroline Dubertret, Bruno Etain, Emmanuel Haffen, Dominique Januel, Marion Leboyer, Antoine Lefrere, Pierre-Michel Llorca, Emeline Marlinge, Katia M'Bailara, Emilie Olié, Mircea Polosan, Raymund Schwan, Michel Walter, Christine Passerieux, Paul Roux

Affiliations

  • Fondation FondaMental Créteil France.
  • DisAP MOODS Team INSERM UMR1018 CESP Université de Versailles Saint-Quentin-En-Yvelines Université Paris-Saclay Le Chesnay France universite-paris-saclay.fr.
  • Centre Hospitalier de Versailles Service Universitaire de Psychiatrie d'Adultes et d'Addictologie Le Chesnay France.
  • CHU Montpellier France chru-strasbourg.fr.
  • IGF University of Montpellier CNRS INSERM Montpellier France inserm.fr.
  • Pôle de Psychiatrie Centre Hospitalier Princesse Grace Monaco Monaco chpg.mc.
  • Department of Emergency Psychiatry and Acute Care Lapeyronie Hospital CHU Montpellier Montpellier France chu-montpellier.fr.
  • INSERM U1028 CNRS UMR5292 Lyon Neuroscience Research Center Psychiatric Disorders: From Resistance to Response Team University Lyon 1 Villeurbanne Lyon France univ-lyon1.fr.
  • Université de Paris Inserm UMR1266 Sorbonne Paris Cité Faculté de Médecine Paris France sorbonne-paris-cite.fr.
  • AP-HP Groupe Hospitalo-Universitaire AP-HP Nord DMU ESPRIT Service de Psychiatrie et Addictologie Hôpital Louis Mourier Colombes France aphp.fr.
  • Optimisation Thérapeutique en Neuropharmacologie OPTEN U1144 INSERM Université Paris Cité Paris 75006 France u-paris.fr.
  • Département de Psychiatrie et de Médecine Addictologique Hôpitaux Lariboisière-Fernand Widal GHU APHP Nord Université Paris Cité Paris F-75010 France u-paris.fr.
  • UMR INSERM 1322 LINC Université Marie et Louis Pasteur Besançon France.
  • Service de Psychiatrie de l'adulte CIC-1431 INSERM CHU de Besançon Besançon F-25000 France.
  • Université Sorbonne Paris Nord Bobigny Cedex 93017 France univ-paris13.fr.
  • Département de Recherche Clinique Pôle Universitaire 03 G03 EPS Ville Evrard Neuilly sur Marne France.
  • Inserm U 955 Neuropsychiatrie Translationnelle DMU IMPACT (AP-HP) Département de Psychiatrie, Fondation FondaMental Université Paris Est Créteil (UPEC) Créteil 94000 France u-pec.fr.
  • Pôle de Psychiatrie Assistance Publique Hôpitaux de Marseille Marseille France ap-hm.fr.
  • NT-UMR7289 CNRS Aix-Marseille Université Marseille France.
  • Centre Hospitalier et Universitaire Département de Psychiatrie EA 7280 Université d'Auvergne Clermont-Ferrand France u-clermont1.fr.
  • Centre Hospitalier Charles Perrens Pôle de Psychiatrie Générale et Universitaire Bordeaux France.
  • LabPsy UR 4139 Université de Bordeaux Bordeaux F-33000 France u-bordeaux.fr.
  • Université Grenoble Alpes Inserm U1216 CHU Grenoble Alpes Grenoble Institut Neurosciences Grenoble France univ-grenoble-alpes.fr.
  • Centre Psychothérapique de Nancy Inserm U1254 Université de Lorraine Nancy France univ-lorraine.fr.
  • Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale 29G01 et 29G02 CHRU de Brest Hôpital de Bohars Brest France.
  • Service de Psychiatrie du Secteur 78G18 Centre Hospitalier de Plaisir Plaisir France.

Abstract

Individuals with bipolar disorders (BDs) with depressive symptoms exhibit poorer cognitive performance and are often excluded from procognitive interventions and cognitive research. Threshold values on depression severity scales, based on cutoffs defining depressive episodes, have traditionally been used to exclude patients suspected of having depression-associated cognitive impairment. Identifying a threshold value for depression-associated cognitive impairment on these scales could help guide patient selection and treatment. We assessed neuropsychological performance in outpatients with BD with varying levels of depressive symptom severity measured by the Montgomery-Åsberg Depression Rating Scale (MADRS). The sample was divided based on the total MADRS score or subscores in MADRS theoretical domains. We then compared average cognitive performance between groups while adjusting for relevant covariates to determine a MADRS score above which cognition is significantly impaired. We included 2532 individuals with BD. The composite cognitive score was significantly lower in individuals with a MADRS score ≥ 12 than in those with a score ≤ 1 but did not differ from that of individuals with scores between 2 and 11. Symptoms of detachment and sadness were more strongly associated with cognitive impairment than other symptoms. Individuals with type I BD with MADRS detachment subscores higher than 4 and individuals with type II BD with nonzero sadness subscores had significant cognitive impairment compared to individuals with lower subscores. Excluding individuals with BD whose cognition may be affected by depressive symptoms would require omitting those with MADRS detachment subscores higher than 4 or nonzero sadness subscores. Our findings question the existence of a total depression severity threshold for cognitive impairment, as specific depressive symptoms seem more strongly associated with cognitive impairment than total symptom severity.

MeSH

Depression, Bipolar Disorder, Sadness, Cognitive Dysfunction, Signs And Symptoms, Cognition Disorders, Anxiety Disorders, Cognition