Bipolar patients struggle with emotional distraction

By Eleanor McDermid, Senior medwireNews Reporter

Patients with bipolar disorder struggle with cognitive tasks in the face of emotional distractions, a study shows.

The effect was not seen in relatives of bipolar disorder patients or people with hypomanic personalities, suggesting “that this deficit is a consequence of the disorder rather than a vulnerability marker,” say lead researcher Philipp Kanske (Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany) and colleagues.

They believe that patients’ susceptibility to emotional distraction “could critically hinder functional recovery and thus should be a specific target of treatment.”

All study participants undertook a mental arithmetic test, while undergoing functional magnetic resonance imaging. The 22 bipolar I disorder patients in the study performed the task as fast and accurately as 22 mentally healthy controls, with similar brain activation. The same was true of 17 relatives and 17 controls, and 22 people with hypomanic personalities and 24 controls.

Presenting the mental arithmetic problem along with an emotionally distracting image resulted in a significant increase in the time taken for all participants to complete the task. However, the impact of emotional distraction was significant only among bipolar patients, whose average reaction time slowed from just over 3.6 to 4.0 seconds.

Inclusion of emotional images resulted in increased brain activation in all study participants, but only bipolar disorder patients had a significantly larger increase in activation than the controls, specifically in the right parietal cortex. The amount of activation in this region significantly correlated with the size of increase in reaction time.

Writing in the American Journal of Psychiatry, the researchers suggest that interventions to help bipolar disorder patients deal with emotional distraction “could include training of selective attention and emotion regulation, since this may be able to enhance sociofunctional integration in euthymic bipolar patients.”

They add: “Establishing such an intervention for improving neuropsychological performance in bipolar patients seems particularly important because these patients may attach emotional meaning even to nonemotional stimuli and tasks.”

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