Metacognitive knowledge and experience in recently diagnosed patients with bipolar disorder.
OBJECTIVE Even in remission, cognitive deficits are frequently observed in bipolar disorder. Because these deficits are assessed with complex and comprehensive tests, they seem to be neglected in routine daily practice; however, assessing them with short self-rated questionnaires could be beneficial. This study aimed to investigate the correlation between objective and subjective cognitive assessment in bipolar disorder. METHOD The study included 38 patients with bipolar disorder that were in remission for at least 6 months and 19 healthy controls. The Stroop Test and Auditory Verbal Learning Test were used for the objective assessment of cognitive functioning, and the cognitive functioning subscale of the Bipolar Disorder Functioning Questionnaire was used for the subjective assessment of cognitive functioning. Mood symptoms were assessed using the Hamilton Depression Rating Scale and Young Mania Rating Scale. RESULTS Based on objective assessment there were significant differences in all domains of the Auditory Verbal Learning Test between the bipolar patients and healthy controls, whereas there weren't any significant difference in Stroop Test results. Based on subjective assessment there were significant differences between the bipolar patients and healthy controls in terms of cognitive functioning subscale total score and first item score, but not in terms of the other items. When the correlation between the objective and subjective cognitive assessments was investigated, total score of the cognitive functioning subscale and 2 items--1. to run simple calculations in one's mind and 2. gathering and performing what one is asked to do--were moderately to weakly correlated with immediate recall, verbal learning, recognition, retrieval, and reading shape color. No correlation was observed between the other items of the cognitive functioning subscale. CONCLUSION Based on subjective assessment of cognitive functioning, the bipolar patients tended to over-estimate themselves. Furthermore, bipolar patients tended to report more deficits correlated with objective cognitive assessment when they had to display active performance, whereas they did not report cognitive deficits at this level when such a condition was not present.