Internet-Based Cognitive Assessments During Remission in Bipolar Disorder: Subjective Cognitive Function and Clinical Severity.

Introduction: Cognitive impairment is well-established in bipolar disorder and significantly impacts daily functioning. However, the relationship between self-evaluated cognitive functions and objective cognitive tests is inconsistent. This heterogeneity in cognitive function necessitates flexible and accessible testing methods. An Internet-based test platform can address this need. This study examines cognitive function in individuals with bipolar disorder in full or partial remission using an Internet-based test platform. It explores associations with subjective cognitive function and clinical severity.

Methods: In this cross-sectional study, the Memoro Internet-based cognitive test platform was used to assess objective cognitive functions. We recruited 84 participants with bipolar disorder type I or II in full or partial remission at the time of assessment, aged 18 to 65 years, from a bipolar outpatient clinic at a university hospital. We examined the completion rates of cognitive tests, reported technical issues, and differences between cognitively normal and impaired groups. Subjective cognition was measured using Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA).

Results: A total of 84 participants completed the Memoro assessment of objective cognitive performance. No significant differences were observed in the completion rates of cognitive subtests or reported technical issues across groups. Of the participants, 61.9% were classified as cognitively normal, while 38.1% had cognitive impairments. 86.9% reported cognitive complaints. Correlation analysis indicated relationships between cognitive complaints (COBRA), symptoms of anxiety, and verbal memory. Multiple regression analyses identify symptoms of anxiety and age as significant predictors of verbal immediate recall and cognitive complaints.

Conclusion: Objective measurements showed fewer cognitive problems than subjective reports. Additionally, anxiety symptoms may contribute to overreporting cognitive complaints.

Clinical Registration: ClinicalTrials.gov identifier: NCT04454073.