Initial usability and feasibility evaluation of the SIMPLe Smartphone application to monitor and psychoeducate bipolar patients

BackgroundThe SIMPLe project was designed with the aim of developing a smartphone application (i.e. app) to monitor and psychoeducate subjects with bipolar disorder through highly personalized messages from both passive and active data. The project was based on a face-to-face group program, which has an increasing scientific evidence of its efficacy and cost-effectiveness reducing bipolar disorder relapses.AimsAn initial feasibility study was conducted to evaluate the usability and satisfaction of an Android version of the SIMPLe app 1.0.MethodsThe SIMPLe feasibility study was conducted from March 2015 to June 2015. The participation in the study was offered to a consecutive sample of adult patients diagnosed of bipolar disorder I, II or NOS (not otherwise specified) attending the outpatient mental health clinic of the Hospital Clinic of Barcelona, Spain.ResultsThe participation in the study was offered to 72 stable bipolar patients. Forty-three subjects were enrolled in the study. Since the day the patients were enrolled in the study, the rate of completed tests was 0.74 per day and 1.13 per week. Nine emergency alerts were received through the application and notified to the reference patients’ psychiatrists. Ninety-five percent of the initial participants remained actively using the app and no relapses were identified during the 3 months of the study.ConclusionThese preliminary results suggest a high feasibility of the SIMPLE app based on the rates of tasks completed and retention.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Thought overactivation as a marker of bipolar disorder

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.547 ◽

2016 ◽

Vol 33 (S1) ◽

pp. s222-s223 ◽

Cited By ~ 2

Author(s):

M. Ferrari ◽

P. Ossola ◽

V. Lucarini ◽

V. Accardi ◽

C. De Panfilis ◽

...

Keyword(s):

Bipolar Disorder ◽

Mood Disorders ◽

Subjective Experience ◽

Small Sample Size ◽

Mental States ◽

Small Sample ◽

Bipolar Spectrum ◽

Global Functioning ◽

Competing Interest ◽

Bipolar Patients

IntroductionRecent studies have underlined the importance of considering the form of thoughts, beyond their content, in order to achieve a better phenomenological comprehension of mental states in mood disorders. The subjective experience of thought overactivation is an important feature of mood disorders that could help in identifying, among patients with a depressive episode, those who belong to the bipolar spectrum.ObjectivesPatients with a diagnosis of bipolar disorder (BD) were compared with matched healthy controls (HC) on a scale that evaluates thought overactivation.AimsValidate the Italian version of a scale for thought overactivation (i.e. STOQ) in a sample of bipolar patients.MethodsThirty euthymic BD and 30 HC completed the Subjective Thought Overactivation Questionnaire (STOQ), the Ruminative Responses Scale (RRS), the Beck Depression Inventory-II (BDI-II) and global functioning (VGF).ResultsThe 9-items version of the STOQ has been back translated and its internal consistency in this sample was satisfactory (alpha = .91). Both the brooding subscore of RRS (b-RRS) (r = .706; P < .001) and STOQ (r = .664; P < .001) correlate significantly with depressive symptoms whereas only the first correlate with VGF (r = –.801; P < .001). The two groups did not differed in the b-RRS (HC = 8.41 vs BD = 9.72; P = .21), whereas BD where significantly higher in the STOQ total score (HC = 6.62 vs. BD = 14.9; P = .007).ConclusionOur results, although limited by the small sample size, confirm the validity of the STOQ and suggest that this scale could grasp a feature characteristic of BD, independently from their tendency to ruminate. The latter seems to impact more on global functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The emotional intelligence in severe mental disorders: A comparative study in schizophrenia and bipolar disorder

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1146 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S330-S331

Author(s):

E. Chapela ◽

M. Félix-Alcántara ◽

J. Quintero ◽

I. Morales ◽

J. Gómez-Arnau ◽

...

Keyword(s):

Bipolar Disorder ◽

Emotional Intelligence ◽

Mental Disorders ◽

Clinical Care ◽

Descriptive Analysis ◽

Assessment Tools ◽

Severe Mental Disorders ◽

Assessment Protocol ◽

Competing Interest ◽

Bipolar Patients

IntroductionSevere mental disorders have deficits in different aspects of social cognition, which seem to be more pronounced in patients with schizophrenia compared to those with bipolar disorder. Emotional intelligence, defined as the ability to process, understand and manage emotions, is one of the main components of the sociocognition. Both in schizophrenia and bipolar disorder have been described changes in emotional intelligence, but only few studies compare both disorders.ObjectivesThe objective of this research is to increase knowledge about the differences between schizophrenia and bipolar disorder.AimsTo compare emotional intelligence in patients with schizophrenia versus bipolar patients.MethodsSeventy-five adult patients with schizophrenia and bipolar disorder were evaluate.The assessment protocol consisted of a questionnaire on socio-demographic and clinical-care data, and a battery of assessment scales (BPRS, PANSS, SCID-I-RV, YMRS, HDRS, CGI-S, EEAG, MSCEIT). Among the assessment tools of emotional intelligence, we select MSCEIT as the most validated.Statistical analysis was performed using SPSS 23 version. After the descriptive analysis of the data, we compare the results of the scales.ResultsBoth disorders show a deterioration of emotional intelligence compared to the general population. There were no statistically significant differences in the comparison of emotional intelligence between schizophrenia and bipolar disorder.ConclusionSchizophrenia and bipolar disorder have deficits in emotional intelligence, while it is difficult to show differences between them. These changes in emotional intelligence are part of a set of cognitive, social and non-social skills, which are altered in these severe mental disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Bipolar disorder and co-occurring cannabis use disorders

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.522 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S466-S466

Author(s):

S. Ben Mustapha ◽

W. Homri ◽

L. Jouini ◽

R. Labbane

Keyword(s):

Bipolar Disorder ◽

Suicide Attempts ◽

Term Treatment ◽

Cannabis Use ◽

Family Dynamic ◽

Long Term Treatment ◽

Cannabis Use Disorders ◽

Competing Interest ◽

Bipolar Patients ◽

Psychotic Features

AimsAssess the prevalence of cannabis use disorders (CUD) in patients with bipolar disorder, describe the demographic and clinical profile socio bipolar patients with comorbid addictive and assess the implications of this comorbidity on prognosis and evolution of bipolar disorder.MethodsA case-control study, 100 euthymic patients treated for bipolar disorder, recruited in the department of psychiatry C of Razi hospital. Two groups were individualized by the presence or not of cannabis use disorders comorbidity. The two groups were compared for sociodemographic, clinical, therapeutic and historical characteristics.ResultsThe prevalence of CUD was 27.53% (n = 19) in our sample. Comparing bipolar patients according to the presence or absence of CUD, we found the following results with patients with CUD comorbidity: younger, mostly male, a disturbed family dynamic, low educational level, poor socio-economic conditions, more time abroad history, more suicide attempts in history, more criminal record, more psychiatric family history, an earlier onset of the disease, a longer duration of undiagnosed bipolar disorder, more personality disorder, more frequent presence of a triggering factor for bipolar disorder, more psychotic features during mood episodes, more need of antipsychotic long-term treatment.ConclusionsThe frequency of CUD in BD is higher than the prevalence in the general population and CUD is a factor in the evolution and prognosis of bipolar disorder and promotes the development of mood disorders in predisposed patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Social functioning and social cognition in bipolar disorder: Is there a connection?

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1175 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S336-S336

Author(s):

V. Maria Iulia ◽

R.C. Delphine ◽

H. Audrey ◽

K. Arthur

Keyword(s):

Bipolar Disorder ◽

Social Cognition ◽

Social Functioning ◽

Social Cognitive ◽

Situational Factors ◽

Global Functioning ◽

Literature Searches ◽

The Social ◽

Competing Interest ◽

Bipolar Patients

IntroductionThe research interest in social cognition in bipolar disorder has increased in a significant way in the last decade showing major impairments, especially in mental state reasoning, even during euthymia (Samamé et al., 2012; Samamé et al., 2015). Social cognitive processes in humans describe the ways individuals draw inferences about other people's beliefs and the ways they weigh social situational factors in making these inferences (Green et al., 2008). A causal relationship between social cognition deficits and global functioning has been already established in schizophrenic populations (Green et al., 2015). But there is still little information regarding the relation between social cognition and social functioning in bipolar disorder.AimsTo review the relationship between general/social functioning and social cognitive impairments in bipolar patients.MethodsA systematic review of literature was conducted. Relevant articles were identified through literature searches in PubMed/Medline, EBSCOHost and Google Scholar databases dating from 2000 to 2015 using the keywords “bipolar”, “social cognition”, “theory of mind”, “mentalizing”, “emotion recognition”, “emotion processing”, “functioning” and “quality of life”.ResultsThe findings of the review will be discussed, regarding the specificity of the thymic state of the patients and the social cognition instruments used.ConclusionsTo the best of our knowledge, the present review is the first to explore specifically the relation between the social cognition deficits and the general/social functioning of bipolar patients. This exploration is of interest for a better comprehension of this disorder to improve the outcome of the patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Telemedicine and bipolar disorder

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.148 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S121-S121

Author(s):

A. García-Alocén ◽

C. Bermudez-Ampudia ◽

M. Martínez-Cengotitabengoa ◽

I. González-Ortega ◽

S. Ruiz de Azua ◽

...

Keyword(s):

Bipolar Disorder ◽

Psychoeducational Intervention ◽

Treatment As Usual ◽

Patient Functioning ◽

Manic Symptoms ◽

Intervention Treatment ◽

Competing Interest ◽

Additional Support ◽

Bipolar Patients ◽

Web Platform

Show the efficacy of an innovate telemedicine psyeducational invention based on a psychoeducational intervention treatment with a group of bipolar patients.ObjetivesTo assess the efficacy of an innovate telemedicine psyeducational treatment (TPT) based on a psychoeducational intervention (21 sessions) with an additional support through telemedicine which has 12 videos versus treatment as usual (TAU) based on psychiatry reviews. Specifically, the objective was to evaluate patients’ efficacy of psyeducational treatment with telemedicine (TPT) in the fuctionalitity, depressive symptoms and manic symptoms.MethodsThirty-eight patients with bipolar disorder were included in the study and randomly distributed in the two groups. The telemedine treatment is performed through a www.puedoser.es web platform provided by Astra Zeneca. In the web platform is available forums, emails and digital-course with the sessions worked as a reminder. In order to assess the effectiveness of treatments, FAST scale was administered at baseline and 6 months after the intervention. To obtain the results we used coparative data analysis.ResultsIn patients, we found a low daily functionality. The main issues were: interpersonal cognitive area (t = –2.611; P = 0.014) and interpersonal-area (t = –2.617; P = 0.014). We found, at baseline, that TPT group had worse overall results in daily functionality (t = –2.876; P = 0.008). After intervention, there is an improvement in the daily functionality of the TPT group. This improvement occurred in cognitive area (z = –3.24; P < 0.001), leisure area (z = –1.85; P = 0.065) and interpersonal area (z = –1.72; P = 0.086).ConclusionsThe psychoeducational program combined with telemedicine shows to be more effective than TAU in the improvement of general patient functioning in bipolar disorder patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Psychosocial functioning impairment in euthymic patients with bipolar disorder II: The role of clinical factors

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1164 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S333-S333

Author(s):

R.S. Ilhan ◽

V. Senturk-Cankorur

Keyword(s):

Bipolar Disorder ◽

Psychosocial Functioning ◽

Rating Scale ◽

Healthy Individuals ◽

Young Mania ◽

Clinical Variables ◽

Hamilton Anxiety Rating Scale ◽

Short Test ◽

Competing Interest ◽

Bipolar Patients

IntroductionGrowing body of evidence have showed that euthymic bipolar patients have poor psychosocial functioning. Most of the studies have focused on the psychosocial functioning in euthymic bipolar disorder (BD)-I patients. On the contrary, there have been limited researches investigating psychosocial functioning in euthymic BD-II patients. Moreover, the factors associated with psychosocial functioning in euthymic patients with BD II have been also understudied.Objectives/aimsAim of our study was to investigate the association between clinical variables and poor psychosocial functioning in euthymic BD-II patients. Hypothesis of this study was that euthymic BD-II patients would have low level of psychosocial functioning compared with healthy individuals.MethodsBD-II (n = 37) and healthy subjects (n = 35) were compared in terms of their psychosocial functioning which were assessed by Functional Assessment Short Test (FAST). The euthymic state was confirmed by low scores both on the Hamilton Depression Rating Scale (HDRS) and the Young Mania Rating Scale (YMRS). Anxiety symptoms were also assessed by Hamilton Anxiety Rating Scale (HARS) in both groups. Clinical variables were taken as independent variables and FAST scores were taken as dependent variable in order to run correlation analysis in BD-II group.ResultsNo socio-demographic differences were found between two groups. Euthymic BD-II patients had significantly higher FAST, HARS, HDRS YMRS scores compared with healthy individuals. Only HDRS scores correlated with FAST scores of BD-II patients.ConclusionsThis study indicated that euthymic BD-II patients had poorer psychosocial functioning. And subclinical depressive symptoms were associated with poor psychosocial functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Akathisia: Prevalence and risk factors in patients with psychosis and bipolar disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.271 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S330-S331

Author(s):

L. Jouini ◽

U. Ouali ◽

S. Ouanes ◽

Z. Rania ◽

R. Jomli ◽

...

Keyword(s):

Risk Factors ◽

Bipolar Disorder ◽

Schizoaffective Disorder ◽

Antipsychotic Drugs ◽

Total Dosage ◽

Drug Compliance ◽

Tunisian Patients ◽

Competing Interest ◽

Bipolar Patients ◽

Barnes Akathisia Scale

IntroductionAkathisia is probably the most common and one of the most distressing of the movement disorders associated with antipsychotic drugs. Little is known about its prevalence and its risk factors in real-world psychotic and bipolar patients to date.ObjectivesThe main objective of this study was to determine the prevalence of akathisia and to determine the risk factors and the treatments associated with it in a sample of Tunisian patients with schizophrenia, schizoaffective or bipolar disorder.MethodsSeventy-four patients with schizophrenia, schizoaffective or bipolar disorder were included and assessed with a validated scale: the Barnes Akathisia scale (BAS). Ongoing psychotropic treatments were recorded.ResultsThe global prevalence of akathisia (as defined by a score ≥ 2 on the global akathisia subscale of the BAS) was 20.5%. Akathisia was significantly more common in patients with schizophrenia or schizoaffective disorder than in patients with Bipolar disorder (27.5% vs 9.4%; P = 0.049). However, the prevalence of akathisia did not differ according to sex, age, the illness duration, the presence of a comorbid anxiety disorder, the number of antipsychotics used, the type of the used antipsychotic (first vs second-generation), the antipsychotic chlorpromazine-equivalent total dosage, the use of benzodiazepines or anticholinergics, or the reported drug compliance.ConclusionsAkathisia seems to be more common in some psychiatric disorders than in others such as schizophrenia or schizoaffective disorder. Longitudinal studies would be required to draw any firm conclusions concerning the factors involved in the emergence of akathisia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Economic impact of suicidality in manic patients with depressive features

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2255 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S603-S603

Author(s):

U. Ösby ◽

E. Jonas ◽

J. Hällgren ◽

M. Pompili

Keyword(s):

Bipolar Disorder ◽

Cause Of Death ◽

Suicidal Behaviour ◽

Attempted Suicide ◽

Limited Information ◽

Mixed Features ◽

First Results ◽

Discharged Patients ◽

Competing Interest ◽

Bipolar Patients

IntroductionThere is limited information published on the specific financial costs of completed and/or attempted suicide in bipolar patients. In the last 15 years, only 6 studies were published. Their results vary considerably due to differences in methods used. Also, information on cost for pure manic versus mixed episodes is lacking. This is surprising, since studies have shown that suicidal behaviour is more common among patients with depressive symptoms than with pure mania, and this difference increases considerably when the mixed-features specifier is applied.ObjectivesWe conducted a registry study with the aim to expand the epidemiological information on suicidal behaviour by episode type in bipolar disorder, and its associated costs.MethodsHealth data were retrieved from the Swedish Patient Register. Data covered the period 1990–2014 and included the number of discharged patients with bipolar diagnosis, hospital re-admissions, and attempted and/or completed suicides. Moreover, we retrieved data on suicide and cause of death from the Swedish Cause of Death register. Analyses were done for the whole sample and stratified by subtypes (mania, depression and mixed forms).ResultsFirst results will be presented at the EPA meeting.ConclusionsThis is a nation-wide Swedish study of completed and attempted suicide in bipolar patients. The hypothesis we will test is that there is a substantial variation between different bipolar disorder subtypes, and that most of the expenditures due to suicidal behaviour in bipolar disorder are linked to mixed forms, mania in combination with depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Emotional intelligence in bipolar disorder

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1145 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S330-S330

Author(s):

E. Chapela ◽

J. Quintero ◽

M. Félix-Alcántara ◽

I. Morales ◽

C. Javier ◽

...

Keyword(s):

Bipolar Disorder ◽

Emotional Intelligence ◽

Mental Disorders ◽

Social Cognitive ◽

Type I ◽

Severe Mental Disorders ◽

Factors Affecting ◽

Principal Factors ◽

Competing Interest ◽

Bipolar Patients

IntroductionEmotional intelligence is defined as the ability to process, understand and manage emotions. In bipolar disorder seem to be more conserved, with less functional impairment than other severe mental disorders as schizophrenia. So far, there are few studies analyzing emotional intelligence in bipolar disorder.ObjectiveThe objective of this research is to better understand the different characteristics and the factors affecting these social-cognitive dysfunctions in bipolar disorder.AimsTo explore possible factors related to emotional intelligence in these severe mental disorders: symptoms, cognitive functioning, quality of life and psychosocial function.Material and methodsTwenty-six adults bipolar type I patients were examined using MSCEIT (the most validated test for emotional intelligence), BPRS, YMRS, HDRS, WAIS-IV, TMT and Rey Figure in order to determine the level of emotional intelligence and factors relate.ResultsBipolar patients show lack of emotional intelligence when compared with general population. Cognitive impairment and age are the principal factors related.DiscussionResults are discussed and compared with recent literature.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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From Obsessivity to Bipolarity and Vice Versa. A Literature Review

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1817 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S494-S494

Author(s):

P. Cano Ruiz ◽

S. Cañas Fraile ◽

A. Gómez Peinado ◽

P. Sanmartin Salinas

Keyword(s):

Bipolar Disorder ◽

Depressive Illness ◽

Bipolar Spectrum ◽

Manic Depressive Illness ◽

Bipolar Spectrum Disorders ◽

Increased Risk ◽

Spectrum Disorders ◽

Competing Interest ◽

Bipolar Patients ◽

Depressive Episodes

IntroductionThe prevalence of obsessive symptoms in bipolar patients is currently under discussion. Last years, different cases of antidepressant-induced mania and hypomania in patients with OCD have been described.Several authors have reported that patients with OCD and bipolar disorder have more depressive episodes than patients with only OCD.ObjectiveTo know the relationship between OCD and other bipolar spectrum disorders.MethodBibliographical review on comorbidity between obsessive symptoms and bipolarity.ResultsSome longitudinal analysis have shown that patients firstly diagnosed with OCD have an increased risk for subsequent diagnosis of all other conditions, especially for bipolar and schizoaffective disorder, for those whose risk is of up to 13 times higher. The handling of a patient with bipolar disorder and OCD implies some difficulty, because of the main treatment of anxiety disorders, the antidepressants, alters the course of manic-depressive illness, accelerating cycles.ConclusionsOCD is etiologically related to bipolar spectrum disorders and schizophrenia. Therefore, it is necessary to continue the investigation of possible involved genes and approaches for clinical practice.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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