Mood disorders are characterized by considerable cognitive heterogeneity. However, little is known about high cognitive performance and its associations with relevant clinical outcomes. High cognitive performance in persons with mood disorders and high-risk unaffected relatives (UR) may be an expression of resilience to illness-related neuropathology. Cross-sectional data from persons with mood disorders (n = 212), unaffected relatives (UR) (n = 96), and healthy controls (HC) (n = 152) were pooled from two cohort studies, during which participants completed neuropsychological test batteries comprising both non-emotional and emotional cognition. Participants were grouped into ‘high’ or ‘normal cognitive performance’ subgroups based on their global cognitive performance. Groups were compared to investigate high-performing persons with mood disorders and relatives, respectively, in demographic and clinical variables and emotional cognition. Resulting subgroups were persons with mood disorders with high (P-HP = 67) and normal cognitive performance (P-NP = 135), UR with high (UR-HP = 41) and normal cognitive performance (UR-NP = 52) and HC with high (HC-HP = 86) and normal cognitive performance (HC-NP = 66). P-HP were characterized by fewer experiences of physical abuse, fewer mood episodes and improved functioning compared to P-NP. Both P-HP and UR-HP experienced more overall childhood trauma, compared to HC-HP. All cognitively high-performing subgroups exhibited faster recognition of emotional faces compared to their corresponding normally performing group. High cognitive performance was associated with favorable clinical outcomes and improved functioning in persons with mood disorders and high-risk UR. Given this association, above-average enhancement of cognition beyond normalization may aid functional recovery.
Kjaerstad et al. (Tue,) studied this question.