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Table 4 Summary of findings for the FEM remission studies

From: Cognitive impairment in first-episode mania: a systematic review of the evidence in the acute and remission phases of the illness

Cognitive function Controls FEM Statistics Study
Domain Test Specific n Mean (SD) n Mean (SD) p value Effect size First author (year)
Processing speed Colour-word interference (D-KEFS) Colour naming 110 28.2 (4.8) 34 31.6 (7.3) 0.002b,e 0.08g Hellvin et al. (2012)
21a 32.2 (9.2)
Word naming 110 21.5 (3.3) 34 22.1 (3.5) 0.161b 0.02g
21a 23.1 (4.4)
Grooved pegboard N/A 110 64.0 (7.7) 34 74.7 (16.0) <0.001b,e 0.20g
21a 77.4 (16.6)
Stroop Word naming 25 103.2 (13.7) 45 100.2 (12.9) >0.05c,f 0.09h Torres et al. (2010)
Colour naming 25 73.7 (12.3) 45 72.5 (11.8) >0.05c,f 0.07h
Trail Making Test A 50 83.70 (4.21) 50 94.00 (7.72) <0.001c NR Elshahawi et al. (2011)
66 55.89 (19.99) 24 52.50 (18.27) >0.05d <0.2i Lopez-Jaramillo et al. (2010)
25 20.8 (6.4) 45 26.0 (7.8) >0.05c,f 0.55h Torres et al. (2010)
WAIS/WAIS-III Digit symbol coding 50 11.02 (2.48) 50 7.36 (0.53) <0.001b NR Elshahawi et al. (2011)
66 40.92 (12.92) 24 38.63 (12.37) >0.05d <0.2i Lopez-Jaramillo et al. (2010)
110 78.1 (14.6) 34 66.8 (14.8) <0.001b,e 0.11g Hellvin et al. (2012)
21a 67.6 (14.3)
Attention CANTAB RVIP 25 0.92 (0.04) 45 0.89 (0.05) 0.008c,e,f 0.62h Torres et al. (2010)
CVLT Trial 1 25 7.0 (1.6) 45 6.5 (1.9) >0.05c,f 0.28h Torres et al. (2010)
WAIS-III/WMS/WMS-Revised Digit span forward 110 6.2 (1.1) 34 5.9 (1.2) 0.33b 0.01g Hellvin et al. (2012)
21a 6.0 (1.3)
66 5.39 (1.14) 24 5.42 (0.97) >0.05d <0.2i Lopez-Jaramillo et al. (2010)
50 6.44 (0.54) 50 4.14 (0.35) <0.001c NR Elshahawi et al. (2011)
Learning and memory CANTAB Pattern recognition 25 97.0 (3.3) 45 94.6 (7.0) >0.05c,f 0.27h Torres et al. (2010)
Spatial recognition 25 83.2 (11.8) 45 76.8 (15.2) >0.05c,f 0.40h
Paired associates 25 4.9 (5.4) 45 9.1 (6.5) >0.05c,f 0.45h
CVLT Total trials 1 to 5 110 57.2 (9.2) 34 53.8 (13.7) 0.158b 0.02g Hellvin et al. (2012)
21a 54.0 (10.6)
25 58.7 (7.7) 45 51.6 (11.6) 0.004c,e,f 0.61h Torres et al. (2010)
Delayed recall 110 13.2 (2.4) 34 11.3 (4.2) 0.007b,e 0.06g Hellvin et al. (2012)
21a 12.5 (3.0) >0.05b
25 12.7 (2.7) 45 10.9 (3.0) >0.05c,f 0.57h Torres et al. (2010)
Rey Complex Figure Delayed recall 109 22.8 (6.1) 34 20.8 (7.5) 0.030b 0.04g Hellvin et al. (2012)
21a 19.1 (6.0)
Immediate recall 66 18.33 (10.98) 24 14.79 (5.09) >0.05d <0.4i Lopez-Jaramillo et al. (2010)
WMS Logical memory (LM) 66 10.05 (3.64) 24 8.92 (2.78) >0.05d <0.4i Lopez-Jaramillo et al. (2010)
Visual reproduction 66 8.70 (2.83) 24 7.71 (3.38) >0.05d <0.4i
Associated pairs 66 14.86 (3.46) 24 13.69 (4.15) >0.05d <0.4i
LM recognition 66 17.29 (3.13) 24 18.53 (2.14) >0.05d <0.6i
WMS-Revised Information 50 5.98 (0.14) 50 5.32 (0.47) <0.001c NR Elshahawi et al. (2011)
Mental control 50 5.78 (0.76) 50 4.78 (1.27) <0.001c NR
Logical memory 50 13.93 (1.72) 50 11.91 (1.19) <0.001c NR
Visual reproduction 50 10.66 (0.96) 50 10.80 (1.01) 0.479c NR
Total memory 50 74.51 (4.08) 50 62.93 (3.30) <0.001c NR
WMS-III LM, learning 110 26.5 (6.5) 34 24.9 (7.9) 0.381b 0.01g Hellvin et al. (2012)
21a 24.9 (4.5)
LM, recall 110 23.8 (7.2) 34 20.9 (8.2) 0.084b 0.03g
21a 21.4 (5.3)
Visuospatial processing Benton Judgement of line orientation 25 29.0 (2.0) 45 27.4 (3.0) >0.05c,f 0.45h Torres et al. (2010)
Executive functions CANTAB Stockings 25 10.4 (1.6) 45 9.0 (2.4) 0.002c,e,f 0.64h Torres et al. (2010)
I/E-D 25 3.1 (5.2) 45 7.8 (8.9) 0.002c,e,f 0.61h
Colour-word interference (D-KEFS) Inhibition 110 49.4 (10.5) 34 59.9 (26.6) <0.001b,e 0.09g Hellvin et al. (2012)
21a 61.1 (18.9)
Inhibition/switching 110 55.6 (12.5) 34 60.9 (25.4) 0.033b 0.04g
21a 65.1 (20.6)
Letter-number sequencing N/A 109 11.2 (2.3) 34 9.6 (3.1) <0.001b,e 0.09g
20a 9.4 (2.4)
25 12.0 (3.1) 45 10.8 (2.6) >0.05c,f 0.37h Torres et al. (2010)
Spatial working memory N/A 25 9.2 (16.7) 45 21.0 (20.1) <0.001c,e,f 0.72h Torres et al. (2010)
Stroop Conflict time 66 62.91 (13.78) 24 65.04 (11.91) >0.05d <0.2i Lopez-Jaramillo et al. (2010)
Conflict errors 66 2.02 (2.00) 24 2.25 (2.95) >0.05d <0.2i
Interference 25 49.7 (12.4) 45 47.0 (9.3) >0.05c,f 0.20h Torres et al. (2010)
Trail Making Test B 50 232.50 (23.24) 50 264.50 (40.19) <0.001c NR Elshahawi et al. (2011)
66 106.95 (55.88) 24 127.67 (90.48) >0.05d <0.4i Lopez-Jaramillo et al. (2010)
25 46.1 (12.6) 45 58.5 (23.8) >0.05c,f 0.58h Torres et al. (2010)
WAIS-III Digit span backward 110 4.8 (1.2) 34 4.1 (1.1) 0.009b,e 0.06g Hellvin et al. (2012)
21a 4.3 (1.2) >0.05b
WCST Perseveration errors 50 10.52 (3.73) 50 26.14 (6.92) <0.001c NR Elshahawi et al. (2011)
Perseveration responses 72 7.1 (3.7) 34 7.8 (3.5) 0.703b <0.01g Hellvin et al. (2012)
15a 7.5 (3.3)
Category completion 50 5.84 (0.42) 50 4.40 (1.44) <0.001c NR Elshahawi et al. (2011)
72 3.7 (1.2) 34 3.8 (1.2) 0.962b <0.01g Hellvin et al. (2012)
15a 3.7 (1.3)
Total errors 72 14.4 (6.4) 26 15.4 (7.2) 0.713b <0.01g
15a 15.6 (6.2)
WCST (short version) Perseverative responses 66 16.56 (6.74) 24 19.29 (8.61) >0.05d <0.4i Lopez-Jaramillo et al. (2010)
Perseverative errors 66 25.17 (7.42) 24 26.42 (8.37) >0.05d <0.2i
Categories 66 2.79 (1.21) 24 2.67 (1.24) >0.05d <0.2i
WMS/WMS-Revised Digit span backward 66 3.08 (1.06) 24 3.83 (1.02) 0. 005d 0.73i Lopez-Jaramillo et al. (2010)
50 5.30 (0.79) 50 3.66 (0.48) <0.001c NR Elshahawi et al. (2011)
Verbal fluency (DKEFS) Letter 110 43.0 (10.1) 34 41.3 (13.3) 0.755b <0.01g Hellvin et al. (2012)
21a 42.3 (13.6)
Category 110 48.9 (8.5) 34 44.9 (11.0) 0.208b 0.02g
21a 45.8 (11.7)
Category switching 110 14.9 (2.4) 34 14.0 (2.8) 0.199b 0.02g
21a 14.5 (3.6)
Verbal fluency Semantic 66 18.08 (3.53) 24 17.60 (3.21) >0.05d <0.2i Lopez-Jaramillo et al. (2010)
Phonological 66 12.31 (3.64) 24 11.23 (2.94) >0.05d <0.4h
FAS 25 41.4 (12.6) 45 38.5 (9.7) >0.05c,f 0.23h Torres et al. (2010)
Intelligence K-BIT Vocabulary score 25 103.5 (9.6) 45 102.3 (11.3) >0.05c,f 0.09h
Matrices 25 113.4(7.7) 45 106.6(11.6) 0.01c,e,f 0.59h
WAIS Verbal IQ 50 100.58 (9.71) 50 90.22 (6.02) <0.001b NR Elshahawi et al. (2011)
Performance IQ 50 104.06 (9.83) 50 84.86 (4.80) <0.001b NR
Full scale IQ 50 100.80 (8.87) 50 86.58 (4.62) <0.001b NR
66 99.53 (14.2) 24 96.24 (14.7) 0.002b 0.10i Lopez-Jaramillo et al. (2010)
WASI Vocabulary 110 60.6 (7.3) 34 60.3 (8.8) 0.902b <0.01g Hellvin et al. (2012)
21a 61.2 (6.6)
Similarities 110 38.5 (5.2) 34 37.4 (5.1) 0.555b <0.01g
21a 37.9 (4.1)
Block design 110 55.6 (10.2) 34 47.2 (15.9) <0.001b,e 0.11g
21a 46.0 (12.2)
Matrix reasoning 110 28.2 (3.3) 34 27.8 (5.8) 0.042b 0.04g
21a 25.7 (4.8)
Full scale IQ 110 111.6 (11.4) 34 108.6 (14.7) 0.159b 0.02g
21a 106.9 (9.6)
  1. FEM, first-episode mania; D-KEFS, Delis-Kaplan Executive System; WAIS, Wechsler Adult Intelligence Scale; CANTAB, Cambridge Neuropsychological Test Automated Battery; CVLT, California Verbal Learning Test; WMS, Wechsler Memory Scale; K-BIT, Kaufman Brief Intelligence Test; WASI, Wechsler Abbreviated Scale of Intelligence; RVIP, Rapid Information Visual Processing; I/E-D, intra/extra-dimensional test; NR, not reported. aFEM participants with previously untreated manic symptoms; bone-way ANOVA or univariate ANOVA; ctwo-tailed, independent-samples t-test, univariate t-test or student t-test; dMann-Whitney U test; esignificant difference after Bonferroni correction, ANOVA and t-test; fz-scores used in main analysis and effect size; geta squared; hCohen’s d with Hedges’ correction; ieffect size (ES) calculation for Mann-Whitney U, ES > 0.70 was considered significant.