Examining the associations between manic symptoms and cognitive performance in bipolar disorders: evidence from a cross-sectional replication study in the FACE-BD cohort.

Studies examining the effect of mania on cognition in Bipolar Disorders (BD) have yielded contradictory results. Koenders and collaborators showed in 2014 that, among 189 adults with BD, adults with subclinical manic symptoms perform a task measuring divided attention significantly better than adults with less or more severe manic symptoms. We aimed to replicate this finding in a larger sample. We included adults from the FACE-BD cohort with a BD diagnosis based on the DSM-IV-R criteria. We excluded adults with a current characterized depressive or manic episode or with other possible sources of cognitive impairment. We assessed the associations between the YMRS score and cognitive functions involved in divided attention using linear regression models, adjusting for the same covariates as the original study. We found no significant linear or quadratic associations between the YMRS total score and attention, working memory, and executive performance in the bivariable models nor after adjusting for covariates in 2,739 adults with BD. We were unable to replicate the findings reported by Koenders and collaborators. The low variance and mean severity of manic symptoms in our sample may partly explain the absence of significant associations. Our results suggest that subclinical hypomanic symptoms neither enhance nor impair cognitive performance in adults with BD, calling into question the benefit of residual hypomanic symptoms on patients' cognitive functioning.