Previous research has established that in those with affective disorders, neurocognitive impairments are correlated with poor clinical outcomes and poor employment outcomes.

In a recent publication in eClinicalMedicine, researchers conducted the largest longitudinal study to examine neurocognitive impairments’ role in psychiatric hospitalizations and sociodemographic conditions.

The study involved 518 patients with major depressive disorder (MDD) or bipolar disorder (BD). The researchers conducted neurocognitive evaluations that assessed executive function and verbal memory domains. Using national population–based registers, longitudinal data on psychiatric hospitalization and sociodemographic conditions (employment, cohabitation, and marital status) for up to 11 years were also compiled. The authors indicated that the primary and secondary outcomes were psychiatric hospitalizations (n = 398) and deteriorating sociodemographic conditions (n = 518) in the follow-up period since study inclusion, respectively. To assess the correlation of neurocognition with future psychiatric hospitalizations and the deterioration of sociodemographic conditions, researchers employed Cox regression models.

Based on their findings, the authors specified that clinically significant impairment in verbal memory, but not in executive function, was correlated with a greater risk of impending hospitalization when adjusted for age, gender, hospitalization in the year preceding inclusion, depression severity, diagnosis, and type of clinical trial (HR 1.84; 95% CI, 1.05-3.25, P = .034; n = 398). They also noted that even after considering the duration of illness, the results continued to be considerable, and neurocognitive impairments were not correlated with the deteriorating of sociodemographic conditions.

The researchers also indicated that there is nearly an 84% augmented risk of psychiatric hospitalization if the patient has had clinically substantial impairment in learning and remembering verbal information.

The authors concluded, “In the largest longitudinal study of neurocognition in affective disorders, we show for the first time that clinically significant verbal memory impairment is associated with an increased risk of future psychiatric hospitalization in those diagnosed with BD or MDD. However, there is no evidence to indicate that neurocognitive impairments are associated with the worsening of sociodemographic conditions.”

The authors also indicated that additional studies conducted in individuals with affective disorders without a history of psychiatric hospitalizations would aid in establishing if impairments to verbal memory transpire before psychiatric hospitalizations and are predictive of first hospital admission.

Finally, they noted that their findings imply that fostering neurocognitive functioning in individuals with affective disorders as promptly during the course of the disease as possible could lessen the risk of future psychiatric hospitalization.

Kamilla Miskowiak, professor at the Department of Psychology, University of Copenhagen, stated, “Poor verbal memory in itself increases the risk of psychiatric hospitalization. This is evident when we adjust for previous hospitalization, severity of illness, depression symptoms, and other factors that we know are important. We know that stress is a major risk factor for relapse. And many people with mental health problems are already struggling to stay afloat. So being exposed to the additional stress of verbal memory impairment can increase the risk of new severe depressions or manias that require hospitalization.”

Dr. Miskowiak added, “It is not enough just to treat patients’ symptoms of depression or mania, for example. We also need to work on strengthening their memory and other cognitive functions as soon as they are symptom stable.”

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