Summary: Poor verbal memory may increase the risk of psychiatric hospitalization for patients diagnosed with bipolar disorder or depression. It was previously thought that the severity of the disease had an impact on poor memory, but the study shows that poor memory can also impact the risk of being hospitalized.
The results reveal that there is an approximately 84% increased risk of being admitted to a psychiatric ward if a patient has previously had clinically significant verbal memory impairment.
- Verbal memory can determine whether psychiatric patients diagnosed with bipolar disorder or depression are at risk of being hospitalized or readmitted to a psychiatric ward, a new study has found.
- The study followed 518 patients over a number of years and found that poor verbal memory in itself increases the risk of psychiatric hospitalization, with an approximately 84% increased risk of being admitted to a psychiatric ward. if you have ever had a clinically significant impairment in the ability to learn and remember verbal information.
- The researchers recommend that greater attention be paid to memory impairment in psychiatric treatment and that new therapeutic approaches are needed to help address the persistent memory and cognitive problems experienced by approximately half of patients with recurrent depression. or bipolar disorder.
Source: University of Copenhagen
Memory plays a crucial role in people’s social and professional lives. Now, new research shows that verbal (i.e. linguistic) memory also determines whether psychiatric patients diagnosed with bipolar disorder or depression are at risk of being hospitalized or readmitted to a psychiatric ward.
“It has long been known that patients who have previously been hospitalized for major depression or bipolar disorder often have memory problems. But it was believed that it was the severity of the disease itself that played a role in poor memory. Now we can see that the arrow is also pointing the other way,” says Kamilla Miskowiak, a professor in the Department of Psychology at the University of Copenhagen.
In the new study, Kamilla Miskowiak, working closely with lead researcher Anjali Sankar and a number of other researchers from the Neurobiological Research Unit at Rigshospitalet and UCPH, followed 518 patients over several years, who all already undergone the same cognitive tests in other studies.
Combined with data from Statistics Denmark, the researchers used the previous studies to see to what extent patients’ verbal memory and so-called executive functions, such as the ability to plan and solve problems, affect the risk of being hospitalized in a psychiatric service.
The conclusion is clear:
“A poor verbal memory in itself increases the risk of hospitalization in psychiatry. This is evident when we adjust for past hospitalizations, disease severity, symptoms of depression, and other factors that we know are important,” explains Kamilla Miskowiak.
Nearly double the risk of hospitalization
The study concludes that there is an approximately 84% increased risk of being admitted to a psychiatric ward if you have ever had a clinically significant impairment in the ability to learn and remember verbal information.
The study cannot say for sure why this impairment in verbal memory increases the risk. But according to Kamilla Miskowiak, it may be linked to the fact that patients often have a harder time remembering their medications and coping with the demands of their daily lives, which can lead to stress.
“We know that stress is a major risk factor for relapse. And many people with mental health issues are already struggling to stay afloat. Thus, being exposed to the additional stress of impaired verbal memory may increase the risk of further depression or severe mania requiring hospitalization.
Conversely, the study finds no significant association between impaired executive function and an increased risk of hospitalization. And patients with impaired cognitive functions do not appear to fare significantly worse on social parameters such as employment, cohabitation, and marital status.
However, the researchers found that poor executive function was associated with a 51% reduced likelihood of having attained the highest level of education (polytechnic and university). According to Kamilla Miskowiak, a reduced ability to plan and implement problem-solving strategies during studies can hinder academic success and vice versa.
Call for new treatment methods
But above all, it is essential to know that poor verbal memory itself increases the risk of psychiatric hospitalization in people with mental illness. According to Kamilla Miskowiak, this means that more attention should be paid to memory disorders in psychiatric treatment, which currently focuses in a limited way on cognitive skills.
“It is not enough 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 their symptoms are stable,” she says.
“About half of patients with recurrent depression or bipolar disorder have persistent problems with memory and other cognitive functions. This calls for both more systematic cognitive screening and new treatment approaches.
About the study
The study, the largest of its kind to date, includes a total of 518 patients diagnosed with bipolar disorder or depression. Studies track patient outcomes from 2009 to 2020, using registry data on hospitalizations and including a range of demographic and socioeconomic variables such as age, gender, education and employment .
As all participants underwent the same cognitive tests before entering the study, statistical analyzes can assess the extent to which verbal memory and impaired executive functions (including planning and problem solving) increase the risk of psychiatric hospitalization and worsening social conditions.
First author Anjali Sankar, senior researcher at the NRU Research Unit at Rigshospitalet, was the main force behind most of the analyzes in collaboration with project leader Kamilla W. Miskowiak. In addition, eight other researchers affiliated with the University of Copenhagen and Rigshospitalet participated in the study: Simon C. Ziersen, Brice Ozenne, Emily E. Beaman, Vibeke H. Dam, Patrick M. Fisher, Gitte M. Knudsen , Lars V. Kessing and Vibe Frøkjær.
Funding: The study is part of a larger project, BrainDrugs, which is led by Professor Gitte Moos Knudsen and has received funding from the Lundbeck Foundation.
About this memory and mental health research news
Author: Soren Bang
Source: University of Copenhagen
Contact: Søren Bang – University of Copenhagen
Picture: Image is credited to Neuroscience News
Original research: Free access.
“Association of neurocognitive function with psychiatric hospitalization and socio-demographic conditions in people with bipolar and major depressive disorders” by Kamilla Miskowiak et al. ECMedicineClinical
Association of neurocognitive function with psychiatric hospitalization and sociodemographic conditions in people with bipolar and major depressive disorders
Neurocognitive disorders are associated with poor clinical and occupational outcomes in people with affective disorders. However, little is known about their associations with long-term clinical outcomes such as psychiatric hospitalizations and with sociodemographic indicators other than employment. In the largest longitudinal study of neurocognition in affective disorders to date, we investigate the role of neurocognitive disorders on psychiatric hospitalizations and socio-demographic conditions.
The study included 518 people with bipolar or major depressive disorder. Neurocognitive assessments covered executive functions and verbal memory domains. Longitudinal data on psychiatric hospitalization and sociodemographic conditions (employment, cohabitation and marital status) up to 11 years were obtained using national population registers. The primary and secondary endpoints were psychiatric hospitalizations (n = 398) and worsening of sociodemographic conditions (n = 518), in the follow-up period since study inclusion, respectively. Cox regression models were used to examine the association of neurocognition with future psychiatric hospitalizations and worsening sociodemographic conditions.
Clinically significant impairment in verbal memory (z-score ≤ −1; defined by the ISBD Cognition Task Force), but not executive function, was associated with a higher risk of future hospitalization, after adjusting for age, sex and hospitalization in the year prior to inclusion, severity of depression, diagnosis and type of clinical trial (HR = 1.84, 95% CI: 1.05 –3.25, p=0.034; n=398). The results remained significant even after taking into account the duration of the disease. Neurocognitive disorders were not associated with worsening sociodemographic conditions (p ≥ 0.17; n = 518).
Promoting neurocognitive function, particularly verbal memory, may mitigate the risk of future psychiatric hospitalization in people with affective disorders.
The Lundbeck Foundation (R279-2018-1145).