{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:45:41Z","timestamp":1787021141422,"version":"build-2736575974"},"reference-count":51,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T00:00:00Z","timestamp":1604016000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec id=\"S2056472420001118_sec_a1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People with bipolar disorder have moderate cognitive difficulties that tend to be more pronounced during mood episodes but persist after clinical remission and affect recovery. Recent evidence suggests heterogeneity in these difficulties, but the factors underlying cognitive heterogeneity are unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472420001118_sec_a2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine whether distinct cognitive profiles can be identified in a sample of euthymic individuals with bipolar disorder and examine potential differences between subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472420001118_sec_a3\" sec-type=\"methods\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Cognitive performance was assessed across four domains (i.e. processing speed, verbal learning\/memory, working memory, executive functioning) in 80 participants. We conducted a hierarchical cluster analysis and a discriminant function analysis to identify cognitive profiles and considered differences in cognitive reserve, estimated cognitive decline from premorbid cognitive functioning, and clinical characteristics among subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472420001118_sec_a4\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Four discrete cognitive profiles were identified: cognitively intact (\n                      <jats:italic>n<\/jats:italic>\n                      = 25; 31.3%); selective deficits in verbal learning and memory (\n                      <jats:italic>n<\/jats:italic>\n                      = 15; 18.8%); intermediate deficits across all cognitive domains (\n                      <jats:italic>n<\/jats:italic>\n                      = 30; 37.5%); and severe deficits across all domains (\n                      <jats:italic>n<\/jats:italic>\n                      = 10; 12.5%). Cognitive decline after illness onset was greater for the intermediate and severe subgroups. Cognitive reserve scores were increasingly lower for subgroups with greater impairments. A smaller proportion of cognitively intact participants were using antipsychotic medications compared with all other subgroups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472420001118_sec_a5\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that individuals with cognitively impaired profiles demonstrate more cognitive decline after illness onset. Cognitive reserve may be one of the factors underlying cognitive variability across people with bipolar disorder. Patients in the intermediate and severe subgroups may be in greater need of interventions targeting cognitive difficulties.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2020.111","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T03:31:34Z","timestamp":1604028694000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":20,"title":["Role of cognitive reserve in cognitive variability in euthymic individuals with bipolar disorder: cross-sectional cluster analysis"],"prefix":"10.1192","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1972-4813","authenticated-orcid":false,"given":"Dimosthenis","family":"Tsapekos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2984-1124","authenticated-orcid":false,"given":"Rebecca","family":"Strawbridge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Mantingh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5701-0336","authenticated-orcid":false,"given":"Matteo","family":"Cella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Til","family":"Wykes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2291-6952","authenticated-orcid":false,"given":"Allan H.","family":"Young","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2020,10,30]]},"reference":[{"key":"S2056472420001118_ref11","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291714000439"},{"key":"S2056472420001118_ref31","doi-asserted-by":"publisher","DOI":"10.1186\/1745-0179-3-5"},{"key":"S2056472420001118_ref21","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12968"},{"key":"S2056472420001118_ref49","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12848"},{"key":"S2056472420001118_ref30","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53221.x"},{"key":"S2056472420001118_ref5","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbn044"},{"key":"S2056472420001118_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2016.08.018"},{"key":"S2056472420001118_ref19","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12485"},{"key":"S2056472420001118_ref27","volume-title":"Encyclopedia of Special Education","author":"Dumont","year":"2014"},{"key":"S2056472420001118_ref20","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-016-1472-4"},{"key":"S2056472420001118_ref50","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12890"},{"key":"S2056472420001118_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.01.123"},{"key":"S2056472420001118_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2016.04.002"},{"key":"S2056472420001118_ref29","volume-title":"Delis\u2013Kaplan Executive Function Scale (D-KEFS)","author":"Delis","year":"2001"},{"key":"S2056472420001118_ref16","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291719001417"},{"key":"S2056472420001118_ref45","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.07.015"},{"key":"S2056472420001118_ref26","volume-title":"Wechsler Memory Scale: WMS-IV; Technical and Interpretive Manual","author":"Wechsler","year":"2009"},{"key":"S2056472420001118_ref24","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.133.5.429"},{"key":"S2056472420001118_ref3","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12133"},{"key":"S2056472420001118_ref33","doi-asserted-by":"publisher","DOI":"10.1093\/arclin\/15.4.311"},{"key":"S2056472420001118_ref38","doi-asserted-by":"publisher","DOI":"10.1016\/j.cobeha.2015.05.003"},{"key":"S2056472420001118_ref40","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12535"},{"key":"S2056472420001118_ref42","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(20)30098-5"},{"key":"S2056472420001118_ref8","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717000307"},{"key":"S2056472420001118_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291714000774"},{"key":"S2056472420001118_ref48","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291718001836"},{"key":"S2056472420001118_ref2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2007.01055.x"},{"key":"S2056472420001118_ref14","doi-asserted-by":"publisher","DOI":"10.1080\/13803390902740643"},{"key":"S2056472420001118_ref15","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhh142"},{"key":"S2056472420001118_ref23","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.23.1.56"},{"key":"S2056472420001118_ref12","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617702813248"},{"key":"S2056472420001118_ref1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291707001675"},{"key":"S2056472420001118_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/S0028-3932(01)00094-X"},{"key":"S2056472420001118_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(12)70191-6"},{"key":"S2056472420001118_ref28","volume-title":"Wechsler Adult Intelligence Scale\u2013Fourth Edition (WAIS\u2013IV)","author":"Wechsler","year":"2014"},{"key":"S2056472420001118_ref34","unstructured":"34 Dolnicar, S . A review of unquestioned standards in using cluster analysis for data-driven market segmentation. In CD Conference Proceedings of the Australian and New Zealand Marketing Academy Conference 2002 (ANZMAC 2002), Deakin University, Melbourne, 2\u20134 December. Deakin University, 2002."},{"key":"S2056472420001118_ref4","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12904"},{"key":"S2056472420001118_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2016.10.012"},{"key":"S2056472420001118_ref32","unstructured":"32 Wechsler, D. Test of Premorbid Functioning \u2013 UK Version (TOPF UK). Pearson, 2011."},{"key":"S2056472420001118_ref36","doi-asserted-by":"publisher","DOI":"10.1017\/S003329171700143X"},{"key":"S2056472420001118_ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropharm.2019.03.028"},{"key":"S2056472420001118_ref39","doi-asserted-by":"publisher","DOI":"10.1176\/jnp.15.3.333"},{"key":"S2056472420001118_ref41","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbu198"},{"key":"S2056472420001118_ref43","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2014.09.007"},{"key":"S2056472420001118_ref44","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12821"},{"key":"S2056472420001118_ref47","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2012.01917.x"},{"key":"S2056472420001118_ref51","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2014.02.034"},{"key":"S2056472420001118_ref6","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2011.36"},{"key":"S2056472420001118_ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s11065-019-09422-7"},{"key":"S2056472420001118_ref22","first-page":"22","article-title":"The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10","volume":"59","author":"Sheehan","year":"1998","journal-title":"J Clin Psychiatry"},{"key":"S2056472420001118_ref46","doi-asserted-by":"publisher","DOI":"10.1177\/0706743716656607"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472420001118","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T03:31:47Z","timestamp":1604028707000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472420001118\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,30]]},"references-count":51,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,11]]}},"alternative-id":["S2056472420001118"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2020.111","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,30]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2020. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"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 in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e133"}}