Journal of the International Neuropsychological Society

Research Articles

Longitudinal Study of Sustained Attention in Outpatients with Bipolar Disorder

Alexandrea L. Harmella1a2, Brent T. Mausbacha1, Raeanne C. Moorea1a3, Colin A. Deppa1a3, Dilip V. Jestea1a3 and Barton W. Palmera1a3a4 c1

a1 University of California, San Diego, Department of Psychiatry, La Jolla, California

a2 San Diego State University, Department of Psychology, San Diego, California

a3 The Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California

a4 Veterans Medical Research Foundation, VASDHS, San Diego, California


Individuals with bipolar disorder (BD) may exhibit attentional deficits, however, the extent of impairment and long-term fluctuations in performance in attention are relatively unknown. We investigated the relationship between sustained attention and affective symptoms over time among BD patients. We also examined whether global differences in attentional capacity differed among BD versus normal comparison (NC) subjects. Participants included 106 outpatients with BD and 66 NC subjects who were administered symptom rating scales and a measure of sustained attention (Continuous Performance Test- Identical Pairs). Measures were repeated 6, 12, and 26 weeks post-baseline. Compared to NC subjects, participants with BD showed impairment in sustained attention across time. Within patient increases in manic symptoms were associated with increased false alarms; both manic and depressive symptoms were associated with worse discrimination. Neither manic nor depressive symptoms were related to hit rates. Our results indicate that the ability to inhibit a response to near miss stimuli (i.e., those that are close to but not identical to the target) is globally impaired among BD patients relative to NC subjects, as well as state-dependent, covarying with affective symptoms. Psychosocial interventions requiring high levels of attentional capacity may need to be adapted according to patients’ current symptomatology. (JINS, 2014, 20, 1–8)

(Received June 18 2013)

(Revised December 06 2013)

(Accepted December 09 2013)


  • Neuropsychology;
  • Intra-individual variability;
  • Cognition;
  • Continuous performance test;
  • Mood disorder;
  • Bipolar disorder