Recovery of cognitive functioning in patients with co-occurring bipolar disorder and alcohol dependence during early remission from an acute mood episode

OBJECTIVE: This study aimed to examine cognitive recovery in patients with co-occurring bipolar disorder (BD) and alcohol dependence (AD) during remission from an acute mood disturbance. METHOD: Fifty-five adult inpatients with bipolar I disorder (BD I) completed a neuropsychological battery, mood measures, and substance abuse measures upon discharge from the hospital and at a 3-month follow-up. Analyses provided group comparisons on these measures between patients who presented with co-occurring AD (n = 21) in the year prior to hospital admission and patients without a substance use disorder (SUD; n = 34). RESULTS: Multivariate analyses of variance detected group differences on measures of visual memory, verbal memory, and executive functioning, using previous number of psychiatric admissions and age of onset of BD as covariates. These differences occurred both at discharge and follow-up. Between discharge and follow-up, the group without SUD exhibited more substantial gains than the group of dually diagnosed patients on free recall of verbal and visual materials and on a measure of cognitive flexibility. CONCLUSIONS: Patients with co-occurring BD and AD may suffer from more severe cognitive dysfunction and less favorable recovery of cognitive deficits than patients without SUD over the course of remission from a mood episode.