Psychological Bulletin, Vol 152(3), Mar 2026, 326-348; doi:10.1037/bul0000509
Cognitive impairment is a common, yet underrecognized, feature of bipolar disorder (BD). While cognition has emerged as a contributing factor to poor functioning in BD, previous reviews did not examine the role of cognitive domains (i.e., social cognition, nonsocial cognition) or the role of key potential moderators, including age and sex. A systematic literature search identified studies that included assessments of cognition and functioning in BD (103 reports, 2,200 effect sizes, 9,323 BD participants). Multilevel models tested the association between cognition and functioning, as well as moderation by cognitive domain, functional domain, biological factors, and clinical factors. Better overall cognitive performance was associated with better overall functioning (r = .20, p