Neuropsychiatric Disease and Treatment (Oct 2018)

The correlation between longitudinal changes in hypothalamic–pituitary–adrenal (HPA)-axis activity and changes in neurocognitive function in mixed-state bipolar II disorder

  • Lee HH,
  • Chang CH,
  • Wang LJ,
  • Wu CC,
  • Chen HL,
  • Lu T,
  • Lu RB,
  • Lee SY

Journal volume & issue
Vol. Volume 14
pp. 2703 – 2713

Abstract

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Hsuan-Han Lee,1 Cheng-Ho Chang,1 Liang-Jen Wang,2 Chih-Ching Wu,3,4 Hsing-Ling Chen,5 Ti Lu,1 Ru-Band Lu6,7 Sheng-Yu Lee1,6,8,9 1Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; 2Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 3Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; 4Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan; 5Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; 6Department of Psychiatry, National Cheng Kung University Hospital, Tainan, Taiwan; 7Institute of Behavioral Medicine Sciences, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan; 8Department of Psychiatry, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; 9Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan Introduction: In this study, we aim to determine 1) the differences in cortisol in patients with bipolar II disorder (BD-II) and control subjects and 2) the correlation between cortisol levels and cognitive function in patients with BD-II during a 24-week follow-up period.Methods: We recruited a total of 32 BD-II patients and 30 healthy control subjects. The BD-II patients were assessed for clinical severity and serum cortisol level at baseline and at weeks 8, 16, and 24. The Brief Assessment of Cognition in Affective Disorders (BACA) was adopted to evaluate cognitive function at baseline and endpoint (week 24). Meanwhile, we assessed the controls for serum cortisol level and BACA at baseline.Results: We observed that the BD-II group had a higher serum cortisol level and lower BACA composite scores compared with the healthy controls at baseline. A significant correlation was found between changes in Verbal Fluency, a subset of BACA, and changes in serum cortisol level after the 24-week follow-up, controlling for age, gender, years of education, and clinical severity (P<0.001).Conclusion: We propose that serum cortisol may be involved in the psychopathological mechanisms of cognitive decline in BD-II. Keywords: bipolar II disorder, cognitive function, cortisol level, correlation

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