LTA and Cognitive impairment: which have documented involvement in both bipolar disorder and cognitive impairments, with effects in the reverse direction.15,26,28 Despite this, TNF-β has previously been reported as attenuated in the presence of inflammatory signals in those with severe depressive episodes,62 and we highlight that the association we identified with this marker was not robust (i.e. did not persist to a significant extent after exclusion of participants whose inflammatory activity was likely influenced by a health condition or medication).