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(a) RVP total hits and (b) SOC NM4M across groups. (a) RVP total hits: HC (mean = 47.0, SD = 9.3), Udep (mean = 41.1, SD = 11.7), Beuth (mean = 38.1, SD = 12.6), Bdep (mean = 32.8, SD = 9.8). Four-group ANOVA: F(3,76) = 6.04, p = 0.001. Post hoc Bonferroni tests: Bdep < HC, p = 0.001, Beuth < HC, p = 0.045, for all other post hoc comparisons p > 0.1. (b) SOC NM4M: HC (mean = 4.8, SD = 0.8), Udep (mean = 5.6, SD = 1.0), Beuth (mean = 5.3, SD = 1.0), Bdep (mean = 5.7, SD = 1.3). Four-group ANOVA: F(3,76) = 3.56, p = 0.016. Post hoc Bonferroni tests: Udep > HC, p = 0.045, Bdep > HC, p = 0.046, all other post hoc comparisons p > 0.1. *p < 0.05 for post hoc comparisons vs HC.
Source publication
To identify neurocognitive measures that could be used as objective markers of bipolar disorder.
We examined executive function, sustained attention and short-term memory as neurocognitive domains in 18 participants with bipolar disorder in euthymic state (Beuth), 14 in depressed state (Bdep), 20 with unipolar depression (Udep) and 28 healthy contr...
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Citations
... It is possible that the relationship observed between mind wandering and sustained attention performance is driven by an unobserved construct. Specifically, prior work has suggested that both neuroticism (Crow, 2019;Robison et al., 2017) and depression (Maalouf et al., 2010;Seli et al., 2019) are related to sustained attention performance and mind wandering. Thus, it is important to examine how these constructs may impact both sustained attention and mind wandering. ...
The construct of mind wandering has notoriously been characterized as heterogenous which may mean that not all types of mind wandering produce the same pattern of results. One operationalization of mind wandering, task-unrelated thoughts (TUTs), can also itself vary in many dimensions, including the emotional valence of TUTs. The current study summarizes several years of work examining the impact that the emotional valence of TUTs has on different aspects of sustained attention. Participants in several studies reported whether their TUTs were negative, neutral, or positive in emotional valence during a sustained attention-to-response task (SART). The first major focus was a meta-analysis where we examined correlations between each TUT valence and SART performance measures. For the second major focus, we tested how different TUT valences changed over the course of the task. The results suggest that negative TUTs typically show stronger associations with SART performance measures, although all TUT valences have numerically similar correlations. Regarding time-on-task effects, across the studies, there was consistent evidence for a linear increase in negative TUTs across blocks. Evidence for this linear increase was not consistent for neutral and positive TUTs. The results of the current study suggest that the relationships between TUTs and performance, and their likelihood of occurring during a task, are not necessarily the same for every type of TUT. These results highlight the importance of continuing to investigate different types of TUTs and different forms of mind wandering, in general, to better understand how this phenomenon occurs.
... Interestingly, symptom fluctuations do not seem to explain such cognitive deficits [34]. Such cognitive deficits are persistent and stable over time, especially impaired sustained attention [35][36][37]. Consistent with this extant evidence, our results showed that BD patients exhibited more pronounced dysfunction in attention domain, in terms of the number and effect size of neuropsychological measures. ...
Background
The neural correlate of cognitive deficits in bipolar disorder (BD) is an issue that warrants further investigation. However, relatively few studies have examined the intrinsic functional connectivity (FC) underlying cognitive deficits involving sustained attention and executive function at both the region and network levels, as well as the different relationships between connectivity patterns and cognitive performance, in BD patients and healthy controls (HCs).
Methods
Patients with BD (n = 59) and HCs (n = 52) underwent structural and resting-state functional magnetic resonance imaging and completed the Wisconsin Card Sorting Test (WCST), the continuous performance test and a clinical assessment. A seed-based approach was used to evaluate the intrinsic FC alterations in three core neurocognitive networks (the default mode network [DMN], the central executive network [CEN] and the salience network [SN]). Finally, we examined the relationship between FC and cognitive performance by using linear regression analyses.
Results
Decreased FC was observed within the DMN, in the DMN-SN and DMN-CEN and increased FC was observed in the SN-CEN in BD. The alteration direction of regional FC was consistent with that of FC at the brain network level. Decreased FC between the left posterior cingulate cortex and right anterior cingulate cortex was associated with longer WCST completion time in BD patients (but not in HCs).
Conclusions
These findings emphasize the dominant role of the DMN in the psychopathology of BD and provide evidence that cognitive deficits in BD may be associated with aberrant FC between the anterior and posterior DMN.
... 40 Poor mental health may decrease cognitive performance, such as an individual's capacity to focus and process information, leading to poor performance, according to the literature. 41,42 In the workplace, these effects can result in decreased alertness and job performance, which could put lives in danger and raise the risk of adverse medical events. 43,44 Interventions that aim to improve working conditions and reduce the personal and occupational stress of faculty to assist in reducing and/or preventing symptoms of depression, stress, and anxiety must be considered due to the associations between highly stressful work and its impact on mental wellbeing. ...
Objective: To assess depression level in work force of a Teaching hospital. Study Design: Experimental study. Setting: Al-Tibri Medical College and Hospital. Period: June 2021 to August 2021. Material & Methods: Total 250 faculty members of 7 different medical colleges and teaching hospital across the Sindh, Pakistan participates in the survey from 7 different medical colleges. Survey was conducted thorough online google form. Data was statistically analyzed by SPSS and Chi-square was performed to analyze the relationship between the professional environment and mental health. Results: It was observed that the 10% clinical faculty members and only 1% basic science faculty were statistically significant at p level p<0.005 and p<0.001 respectively. While other demographic factors were also found to be statistically significant at p<0.001. Conclusion: The results revealed the clinical faculty is at higher risk mental health issues then the faculty of the basic sciences. Since the clinical environment is to relate to the public dealing and handling or listening the traumatic cases on regular basis which might affect the mental health of the working personnel.
... Affective symptoms also tend to co-occur with deficits in sustained attention and thus would theoretically benefit from yoga training (Maalouf et al., 2010). Even if both forms of yoga produced equivalent benefits, differences in attentional and interoceptive mechanisms would help clarify the putative distinction between Interoception-Focused and Movement-Focused yoga and may inform future treatment selection for affective disorders such as anxiety and depression. ...
... Interoception-Focused yoga enhanced several metrics of sustained attention over the Movement-Focused yoga group. This finding has important clinical implications, as sustained attention deficits are reliable biomarkers for depression and anxiety disorders (Maalouf et al., 2010), and greater attentional control predicts greater treatment response (Alexopoulos et al., 2000;Julian & Mohr, 2006), with accompanying reductions in rumination and intrusive thoughts (Papageorgiou & Wells, 2000). Haukaas, Gjerde, Varting, Hallan, and Solem (2018) have even found that in both attention training and Mindful Self-Compassion interventions aimed at reducing anxiety and depressive symptoms, attentional performance was the only unique predictor of treatment response. ...
... Diversely, in BD, cognitive deficits influenced social and professional skills, with an overall negative impact on quality of life [19,21], episodic memory [22], attention [23], fine motor skills [24], reduced psychosocial functioning (negatively affected by memory and depressed mood [25], and executive functions [26,27]). Psychosocial health of BD patients was also impaired by psychomotor agitation, irritability, insomnia, and emotional lability [19,28,29]. ...
The purpose of this study is to use a dynamic network approach as an innovative way to identify distinct patterns of interacting symptoms in patients with Major Depressive Disorder (MDD) and patients with Bipolar Type I Disorder (BD). More precisely, the hypothesis will be testing that the phenotype of patients is driven by disease specific connectivity and interdependencies among various domains of functioning even in the presence of underlying common mechanisms. In a prospective observational cohort study, hundred-forty-three patients were recruited at the Psychiatric Clinic "Villa dei Gerani" (Catania, Italy), 87 patients with MDD and 56 with BD with a depressive episode. Two nested sub-groups were treated for a twelve-week period, which allowed us to explore differences in the pattern of symptom distribution (central vs. peripheral) and their connectedness (strong vs weak) before (T0) and after (T1) treatment. All patients underwent a complete neuropsychological evaluation at baseline (T0) and at T1. A network structure was computed for MDD and BD patients at T0 and T1 from a covariance matrix of 17 items belonging to three domains-neurocognitive, psychosocial, and mood-related (affective) to identify what symptoms were driving the networks. Clinically relevant differences were observed between MDD and BD, at T0 and after 12 weeks of pharmacological treatment. At time T0, MDD patients displayed an affective domain strongly connected with the nodes of psychosocial functioning, while direct connectivity of the affective domain with the neurocognitive cluster was absent. The network of patients with BD, in contrast, revealed a cluster of highly interconnected psychosocial nodes but was guided by neurocognitive functions. The nodes related to the affective domain in MDD are less connected and placed in the periphery of the networks, whereas in BD they are more connected with psychosocial and neurocognitive nodes. Noteworthy is that, from T0 to T1 the "Betweenness" centrality measure was lower in both disorders which means that fewer "shortest paths" between nodes pass through the affective domain. Moreover, fewer edges were connected directly with the nodes in this domain. In MDD patients, pharmacological treatment primarily affected executive functions which seem to improve with treatment. In contrast, in patients with BD, treatment resulted in improvement of overall connectivity and centrality of the affective domain, which seems then to affect and direct the overall network. Though different network structures were observed for MDD and BD patients, data suggest that treatment should include tailored cognitive therapy, because improvement in this central domain appeared to be fundamental for better outcomes in other domains. In sum, the advantage of network analysis is that it helps to predict the trajectory of future phenotype related disease manifestations. In turn, this allows new insights in how to balance therapeutic interventions, involving different fields of function and combining pharmacological and non-pharmacological treatment modalities.
... Affective symptoms also tend to co-occur with deficits in sustained attention and thus would theoretically benefit from yoga training (Maalouf et al., 2010). Even if both forms of yoga produced equivalent benefits, differences in attentional and interoceptive mechanisms would help clarify the putative distinction between Interoception-Focused and Movement-Focused yoga and may inform future treatment selection for affective disorders such as anxiety and depression. ...
... Interoception-Focused yoga enhanced several metrics of sustained attention over the Movement-Focused yoga group. This finding has important clinical implications, as sustained attention deficits are reliable biomarkers for depression and anxiety disorders (Maalouf et al., 2010), and greater attentional control predicts greater treatment response (Alexopoulos et al., 2000;Julian & Mohr, 2006), with accompanying reductions in rumination and intrusive thoughts (Papageorgiou & Wells, 2000). Haukaas, Gjerde, Varting, Hallan, and Solem (2018) have even found that in both attention training and Mindful Self-Compassion interventions aimed at reducing anxiety and depressive symptoms, attentional performance was the only unique predictor of treatment response. ...
Yoga is increasingly recognized for both its physical and mental health benefits, yet its central mechanisms of action remain unclear. In addition to benefits generally associated with physical exercise, yoga may also cultivate interoception, the sense of the body's internal state, the ability to notice and respond adaptively to physiological cues. Complicating matters, yoga training varies in the relative emphasis on physical movement and the cultivation of interoceptive awareness, yet few studies have explored whether differences in emphasis impact yoga's benefits. A randomized trial explored the effects of interoceptive emphasis in yoga training on attention and subjective wellbeing. Over a 10-week period featuring classes twice each week, community-dwelling adult participants with moderate depressive symptoms (N = 58) were randomized to attend either more Movement-Focused yoga or Interoception-Focused yoga. Assessments were conducted at baseline, post-intervention, and at a one-month follow-up, which included both self-reports of mood and interoception, and task-performance on a Sustained Attention to Response Task. Relative to Movement-Focused yoga, Interoception-Focused yoga practitioners showed greater improvements in sustained attention, but no differences in self-reported mood or interoception. Yet sustained attention improvements in the Interoception-Focused group were greatest for those endorsing high levels of interoception, an effect that was absent in the Movement-Focused group. Despite an exploratory sample size, these findings support the potential for an interoceptive focus to extend yoga's attentional benefits, particularly for those who report high interoceptive awareness.
... Two other studies' results regarding the RBANS domain attention were inconsistent [18,31]. Unimpaired performance was shown in attention switching [39] sustained attention [38,51], and in attention span (WAIS digit span forward) [27,35]. ...
... Jia [31] showed that first episode drug-naïve depressive patients had deficits in delayed, but not in immediate [18] found differences just in the immediate memory (RBANS). Three other authors failed to show differences in visual memory [16], verbal and visual memory [39], and immediate and delayed visual memory [38]. ...
... Also, Lyche [37] using the Attentional Network Test, found no significant deficits for the domain EF. Deficits for the depressed sample for EF was shown using the tasks "Stockings of Cambridge" (SOC) [38] and "intra-extradimensional set shift" [20]. The Wisconsin Card Sorting Test (WCST) also revealed deficits [41,54]. ...
Previous research suggests a broad range of deficits in major depressive disorder. Our goal was to update the current assumptions and investigate the extent of cognitive impairment in depression in the acute and remitted state. A systematic review of the existing literature between 2009 and 2019 assessing the risk of bias within the included studies was performed. Of the 42 articles reviewed, an unclear risk of bias was shown overall. The risk of bias mainly concerned the sample selection, inadequate remedial measures, as well as the lack of blinding the assessors. In the acute phase, we found strong support for impairment in processing speed, learning, and memory. Follow-up studies and direct comparisons revealed less pronounced deficits in remission, however, deficits were still present in attention, learning and memory, and working memory. A positive correlation between the number of episodes and cognitive deficits as well as depression severity and cognitive deficits was reported. The results also demonstrate a resemblance between the cognitive profiles in bipolar disorder and depression. Comparisons of depression with schizophrenia led to unclear results, at times suggesting an overlap in cognitive performance. The main findings support the global deficit hypothesis and align with results from prior meta-analyses and reviews. Recommendations for future research are also presented.
... In the clinical population, greater awareness of the present moment is evident in improving mood disorders symptoms by enhancing attentional regulation (Brown et al., 2011). Through MM, the training on present-centered awareness may thus be targeted to improve mental illnesses that relate to attentional deficit such as attention deficit hyperactivity disorder (ADHD) and bipolar disorder (Maalouf et al., 2010;Passarotti et al., 2010). ...
Different forms of mindfulness meditation are increasingly integrated in the clinical practice in the last three decades. Previous studies have identified changes in the neurophysiology and neurochemistry of the brain resulting from different mindfulness meditation practices in the general population. However, research on neural correlates of different types of meditation, particularly on the clinical outcomes, is still very sparse. Therefore, the aim of this article is to review the neural impact of mindfulness meditation interventions on different mental disorders via the classification of main components of mindfulness meditation. The clearer classification of mindfulness meditation may inform future clinical practice and research directions.
... Within BD, decrements in cognition are consistently reported, notably dysfunction in attention, executive functioning, learning and memory, emotion perception, and psychomotor speed. 7,16,[19][20][21] These reports primarily examine the euthymic state, consistent with cognitive dysfunction as an endophenotypic marker of BD. 22,23 Few studies have focused on cognition during active mood episodes, though reports that specifically address this question suggest cognitive deficits are more pronounced during depressive and manic/ hypomanic mood states compared to euthymia, [24][25][26] in congruence with aforementioned research showing depression impacts cognition in unipolar depressed samples. [8][9][10][11][12][13][14][15][16][17][18] However, the analysis of the relationship between cognition and mood symptoms in BD has relied upon between-subject, cross-sectional comparisons and smaller samples sizes. ...
Objectives:
Previous research suggests that cognitive performance worsens during manic and depressed states in bipolar disorder (BD). However, studies have often relied upon between-subject, cross-sectional analyses and smaller sample sizes. The current study examined the relationship between mood symptoms and cognition in a within-subject, longitudinal study with a large sample.
Methods:
Seven hundred and seventy-three individuals with BD completed a neuropsychological battery and mood assessments at baseline and 1-year follow-up. The battery captured eight domains of cognition: fine motor dexterity, visual memory, auditory memory, emotion processing, and four aspects of executive functioning: verbal fluency and processing speed; conceptual reasoning and set shifting; processing speed with influence resolution; and inhibitory control. Structural equation modeling was conducted to examine the cross-sectional and longitudinal relationships between depressive symptoms, manic symptoms, and cognitive performance. Age and education were included as covariates. Eight models were run with the respective cognitive domains.
Results:
Baseline mood positively predicted 1-year mood, and baseline cognition positively predicted 1-year cognition. Mood and cognition were generally not related for the eight cognitive domains. Baseline mania was predictive in one of eight baseline domains (conceptual reasoning and set shifting); baseline cognition predicted 1-year symptoms (inhibitory control-depression symptoms, visual memory-manic symptoms).
Conclusions:
In a large community sample of patients with bipolar spectrum disorder, cognitive performance appears to be largely unrelated to depressive and manic symptoms, suggesting that cognitive dysfunction is stable in BD and is not dependent on mood state in BD. Future work could examine how treatment affects relationship between cognition and mood.
... Evidence suggests that distractibility could be a core deficit of bipolar disorder, 40,41 a trait less closely associated with unipolar depression. 42,43 This evidence suggests that increased central executive function in bipolar participants could be required to attend to F I G U R E 2 Magnetic resonance imaging research comparing bipolar and unipolar depression by year and imaging type. There were 88 neuroimaging publications included in this figure. ...
Bipolar disorder is defined by the onset of mania; however, most of the bipolar disorder illness course is spent struggling with depression. Patients presenting with depression in the context of bipolar disorder describe similar symptoms to unipolar depression, and the two disorders are not currently distinguishable by clinical presentations. This similarity results in half of individuals with bipolar disorder being misdiagnosed for up to 10 years with unipolar depression and thus provided with inappropriate treatments. This chapter describes the neural networks believed to be related to mood disorder pathology and methods for acquiring these neural measures. It also examines neuroimaging findings from studies directly comparing bipolar disorder and unipolar depression to understand network dysfunctions that may aid in early diagnosis. Studies comparing neural measures of white matter structure, grey matter structure, neural activity, and connectivity will be reviewed. Finally, to identify neural abnormalities that are evident early in the development of the pathology, comparisons of youth with bipolar disorder versus unipolar depression and comparisons of youth at familial risk for the development of mood disorders will be reviewed.
