Features of changes in the cognitive sphere of patients with a primary episode of bipolar affective disorder

153 patients with primary episode of bipolar affective disorder were divided to three groups: with prevalence of depressive symptomatology (44 men and 75 women), with prevalence of manic symptoms (15 men and 8 women) and with simultaneous presence of depressive and manic symptomatology or with rapid or severe manic symptoms (6 men and 5 women) and were examined using the Rey–Osterrieth test. It was found that they had impaired cognitive functioning whose structure and severity were related to the clinical type of the primary episode. In patients with depressive variant revealed approximately equal deterioration of test performance across all assessment vectors, while reproduction (immediate and delayed) observed synchronous deterioration of indicators, with the degree of deterioration of characteristics between copying and immediate and retarded reproduction. In the manic variant the performance of test is significantly different from the depressive variant. Patients with a manic variant showed the lowest indicators in the presence of individual elements of the figure, accuracy and diligence. At the same time, indicators for most estimation vectors are unstable, varying with immediate and delayed reproduction without some systematicity. Such features reflect on the cognitive functions of the maniac state with its acceleration of the speed of thinking, its chaos, instability of attention, difficulties of concentration and inability to productive activity. In patients with mixed episode, the Ray–Osterrieth test scores reflect complex contradictory tendencies of changes in the affective area, related to the rapid phase change and the presence of opposite affective manifestations. Quantitative values of indicators in patients of this group has an intermediate position between indicators of patients with depressive and manic variants. Common disorders inherent in patients of all groups were distortion of the integrity and symmetry of the figure, contamination of the elements of the figure and the omission of minor details. The differences in the structure and severity of cognitive impairment between men and women are not statistically significant.