Background:
Nearly all information during cognitive processing takes place during periods of sustained attention, yet, sustained attention deficit was among the most commonly reported impairments in bipolar disorder (BP). The majority of previous studies only focused on bipolar I disorder (BP I), owing to underdiagnosing or misdiagnosing of bipolar II disorder (BP II). With the shaping up of bipolar spectrum paradigm, the goal of this study was to compare the sustained attention of inter-episode patients with BP I to those with BP II.
Methods:
Fifty-one inter-episode BP patients (22 BP I and 29 BP II) and 20 healthy controls participated in this study. The severity of psychiatric symptom was assessed by the 17-item Hamilton Depression Rating Scale and the Young Mania Rating Scale. All participants received Conners' Continuous Performance Test-II (CPT) to evaluate sustained attention.
Results:
After controlling for the severity of symptoms, age and years of education, BP I patients had a significantly longer reaction time (F(2, 68) = 7.648, p = 0.001), worse d' (F(2, 68) = 6.313, p = 0.003) and more commission errors (F(2, 68) = 6.182, p = 0.004) than did BP II patients and healthy controls. BP II patients and controls scored significantly higher than did BP I patients on detectability (d') (F = 6.313, p = 0.003). No significant difference was found among the three groups in omission errors and no significant correlations were observed between CPT performance and clinical characteristics in the three groups.
Conclusions:
These findings suggested that impairments in sustained attention might be more representative of BP I than BP II, after controlling for the severity of symptoms, age, years of education and reaction time performed on the attentional test. A longitudinal follow-up study design with larger sample size might be needed to provide more information on chronological sustained attention deficit in BP patients and illustrate clearer differentiations between the three groups.

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