Characterisation of Deficits and Sex Differences in Verbal and Visual Memory/Learning in Bipolar Disorder

J Int Neuropsychol Soc. 2023 Jan;29(1):12-23. doi: 10.1017/S1355617721001442. Epub 2022 Jan 24.


Objective: Cognitive impairment is consistently reported in bipolar disorder (BD), but few studies have characterised which memory component processes are affected. Further, it is unknown whether the component processes underlying memory impairment are moderated by sex. The present study examined diagnosis and sex differences in both verbal and visual memory/learning domains in patients with BD and psychiatrically healthy controls.

Method: Verbal and visual memory/learning were measured using the Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R). 114 patients with BD (n = 50 males, n = 64 females), were compared to 105 psychiatrically healthy controls (n = 42 males, n = 63 females).

Results: Patients with BD had worse performance in verbal and visual immediate and total recall, verbal and visual delayed free recall, and verbal recognition discrimination scores, but there were no group differences in learning slopes and cumulative learning index scores. There were trends for BD females to outperform BD males in visual memory/learning free recall and cumulative learning, but these results did not survive multiple testing correction. These findings did not change in a secondary sensitivity analysis comparing only strictly euthymic BD patients to controls (n = 64).

Conclusion: The present study found trait-like verbal and visual memory/learning impairment in BD that was attributable to deficient encoding and/or consolidation processes rather than deficits in learning. We did not find marked sex differences in either visual or verbal memory/learning measures, although some trend level effects were apparent and deserve exploration in future studies.

Keywords: BVMT-R; Consolidation; Encoding; Female; HVLT-R; Learning; Male.

MeSH terms

  • Bipolar Disorder* / complications
  • Bipolar Disorder* / psychology
  • Cognition
  • Female
  • Humans
  • Male
  • Memory
  • Neuropsychological Tests
  • Sex Characteristics
  • Verbal Learning