Domain-specific cognitive function in euthymic bipolar disorder: a systematic review and meta-analysis
Author(s)
Type
Journal Article
Abstract
Background
Euthymic bipolar disorder (BD) is associated with general and domain-specific cognitive impairment, which predicts poor occupational and social functioning.
Methods
We searched Embase, Medline, and PsycInfo for articles published between database inception and June 2024, examining cognitive domains in euthymic BD. We conducted meta-analysis, meta-regressions, including premorbid IQ, demographic, and clinical variables. Newcastle Ottawa Scale, I2 statistic, and funnel plots/Egger’s and Begg’s Test were used to assess quality, heterogeneity, and publication bias, respectively. The Benjamini-Hochberg (BH) procedure was utilised for multiple comparisons.
Results
We identified 95 groups from 75 studies (N = 4,404 BD & 4,037 HC). BD showed significant impairment in general cognitive functioning (Hedge’s g = −0.58, 95%CI: −0.79, −0.37, p <.01), verbal memory (Hedge’s g = −0.70, 95%CI: −0.79, −0.60, p <.01), executive function (Hedge’s g = −0.69, 95%CI: −0.78, −0.60, p <.01), visuo-spatial memory (Hedge’s g = −0.68, 95%CI: −0.83, −0.53, p <.01), attention/processing speed (Hedge’s g = −0.64, 95%CI: −0.75, −0.54, p <.01), working memory (Hedge’s g = −0.61, 95%CI: −0.74, −0.49, p <.01), and premorbid IQ (Hedge’s g = −0.24, 95%CI: −0.36, −0.12, p <.01). Demographic and clinical factors were not associated with cognitive performance, except for a statistically significant, but small positive correlation between years of education and lower impairment in verbal memory, β = .066, adjusted p <.05.
Conclusions
Our findings highlight cognitive domains impaired in euthymic BD, indicating targets for interventions. Substantial variance is unexplained, warranting focus on larger samples of individual-level data.
Euthymic bipolar disorder (BD) is associated with general and domain-specific cognitive impairment, which predicts poor occupational and social functioning.
Methods
We searched Embase, Medline, and PsycInfo for articles published between database inception and June 2024, examining cognitive domains in euthymic BD. We conducted meta-analysis, meta-regressions, including premorbid IQ, demographic, and clinical variables. Newcastle Ottawa Scale, I2 statistic, and funnel plots/Egger’s and Begg’s Test were used to assess quality, heterogeneity, and publication bias, respectively. The Benjamini-Hochberg (BH) procedure was utilised for multiple comparisons.
Results
We identified 95 groups from 75 studies (N = 4,404 BD & 4,037 HC). BD showed significant impairment in general cognitive functioning (Hedge’s g = −0.58, 95%CI: −0.79, −0.37, p <.01), verbal memory (Hedge’s g = −0.70, 95%CI: −0.79, −0.60, p <.01), executive function (Hedge’s g = −0.69, 95%CI: −0.78, −0.60, p <.01), visuo-spatial memory (Hedge’s g = −0.68, 95%CI: −0.83, −0.53, p <.01), attention/processing speed (Hedge’s g = −0.64, 95%CI: −0.75, −0.54, p <.01), working memory (Hedge’s g = −0.61, 95%CI: −0.74, −0.49, p <.01), and premorbid IQ (Hedge’s g = −0.24, 95%CI: −0.36, −0.12, p <.01). Demographic and clinical factors were not associated with cognitive performance, except for a statistically significant, but small positive correlation between years of education and lower impairment in verbal memory, β = .066, adjusted p <.05.
Conclusions
Our findings highlight cognitive domains impaired in euthymic BD, indicating targets for interventions. Substantial variance is unexplained, warranting focus on larger samples of individual-level data.
Date Issued
2025-11-05
Date Acceptance
2025-09-11
Citation
Psychological Medicine, 2025, 55
ISSN
0033-2917
Publisher
Cambridge University Press
Journal / Book Title
Psychological Medicine
Volume
55
Copyright Statement
© The Author(s), 2025. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
License URL
Identifier
10.1017/S0033291725101827
Subjects
À0.79, À0.37, p <.01), verbal memory (Hedge's g = À0.70, 95%CI: À0.79, À0.60, p <.01), executive function (Hedge's g = À0.69, 95%CI: À0.78, À0.60, p <.01), visuo-spatial memory (Hedge's g = À0.68, 95% CI: À0.83, À0.53, p <.01), attention/processing speed (Hedge's g = À0.64, 95%CI: À0.75, À0.54, p <.01), working memory (Hedge's g = À0.61, 95%CI: À0.74, À0.49, p <.01), and premorbid IQ (Hedge's g = À0.24, 95%CI: À0.36, À0.12, p <.01). Demographic Swidzinski, S., Tsapekos, D., Swidzinska, P., Zhang, W., Zheng, M., Millgate, E., Strawbridge, R., Short, R., Carter, B., Gallagher, P., Zanelli, J., Kravariti, E., Reichenberg, A., Young, A. H., Murray, R. M., & Jauhar, S. (2025). Domain-specific cognitive function in euthymic bipolar disorder: a systematic review and meta-analysis bipolar disorder
cognitive functioning
metaanalysis
systematic review
euthymia
Publication Status
Published
Article Number
ARTN e336
Date Publish Online
2025-11-05