Associations between cognitive functioning, mood symptoms and coping styles in older age bipolar disorder.

Background: Older age patients with bipolar disorder (OABD) have often passive coping styles, generally considered as detrimental for functioning. The aim of the current study is to identify the contribution of cognitive functioning, subjective cognitive complaints and mood symptoms to passive and active coping styles in older age BD.
Methods: In 90 euthymic patients (age > 60) with BD I or II, we examined coping, neuropsychological profile including memory, attention, executive function and fluency, subjective cognitive complaints and mood symptoms.
Results: Better executive functioning and fewer depressive symptoms were associated with more active coping (p = .02 and p = .001 respectively). Associations between executive functioning and coping styles turned nonsignificant when combined with depressive symptoms in one model, indicating the importance of mood on coping styles. No associations were found between subjective cognitive complaints and coping styles.
Limitations: Cross-sectional data were used and no conclusions about causality can be made.
Conclusions: Even in euthymic patients, subclinical depressive symptoms may influence active coping negatively. Subjective cognitive complaints and objectified cognitive functioning seem to be of less importance for coping styles. Important implications are on the one hand optimizing treatment on reducing depressive symptoms and on the other hand focusing therapeutic interventions on coping in bipolar patients.
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