Verbenko G. Cognitive impairments in patients with bipolar affective disorder (clinical features, diagnosis, therapy)

In this dissertation a theoretical generalization was performed and a new solution was presented for an actual scientific task of improvement of efficacy of diagnosis and therapy of bipolar affective disorder (BAD) on the base of investigations of peculiarities of cognitive impairments and their social-demographic, clinical-psychopathological, and pathopsychological correlates depending on a BAD phase. It was determined that cognitive impairments in BAD were manifested as a wide range of psychopathological phenomena which were more prevalent in patients with BAD-M and BAD-D and were less prevalent in patients with BAD-E. Peculiarities of the BAD phenomenological structure for different phases of the disease were detected. Patients with BAD-M had such manifestations of cognitive impairments as a increased self-esteem (56.7 %) and speed of thoughts (86.7 %), an exaggeration of their achievements and abilities (73.3 %), impairments of executive functions, first of all, in problems with a decision making (83.3 %). In patients with BAD-D cognitive impairments were registered as rigidity of thinking (52.5 %), impairments with concentration (95.0 %) and executive functions (planning and decision making) (85.0 %). Patients with BAD-E had impairments of concentration (64.0 %), decreased executive functions (planning and decision making) (46.0 %), decreased levels of interests and critics regarding attitude to the disease (38.0 %). Peculiarities of cognitive impairments in different BAD phases were important criteria for diagnosis of this pathology and should be taken into account in therapeutic processes and rehabilitation of such patients. A consideration of characteristics of cognitive functioning depending on BAD phase allows improving efficacy of treatment for this category of patients.