Cognitive Function in Older Euthymic Bipolar Patients

ObjectivesTo assess cognitive function in older euthymic bipolar patients. To investigate the relationship between cognitive disorders and clinical features in this population.MethodsWe conducted a cross-sectional study during the period from August to November 2015. It included 34 stable bipolar outpatients, aged at least 65 years. We used the Montreal Cognitive Assessment (MoCA) to screen for cognitive disorders. Our patients were clinically euthymic, as checked by the Hamilton depression scale and the Young mania scale.ResultsThe sex ratio was 1. The mean age of our patients was 68.2 years. Most of them were married (82.4%), unemployed (55.8%), living in urban area (82.4%), had low educational level (58.8%) and low income (64.7%).The majority was bipolar type 1 (67.6%). The most recent episode was manic in 55.9% of cases, including psychotic features in 50% of cases. Subsyndromal affective symptoms were noted between episodes in 23.5% of them. The average MoCA score was 23.6. Cognitive disorders were found in 61.5% of patients, who showed impairments across all cognitive domains. The most frequent deficits were found in attention (100%) and executive functions (85.3%).Cognitive dysfunction correlated to psychotic features during the last episode (P = 0.005), subsyndromal affective symptoms between episodes (P = 0.13), high number of mood episodes (P = 0.007) and hospitalisations (P = 0.014).ConclusionOur study confirmed that cognitive dysfunction was frequent in older bipolar patients in Tunisia. Preventing mood episodes, screening for addictive and somatic comorbidities, as well as cognitive rehabilitation, are suitable strategies for improving cognitive functioning among these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Depressive Mixed States: Symptomatology, Prevalence and Principles of Treatment

European Psychiatry ◽

10.1016/s0924-9338(09)70808-9 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

W. Drozdz ◽

A. Borkowska

Keyword(s):

Affective Disorders ◽

Rating Scale ◽

Depressive Symptomatology ◽

Depression Scale ◽

Assessment Tools ◽

The Other ◽

Mood Stabilizers ◽

Hamilton Depression Scale ◽

Principles Of Treatment ◽

Bipolar Patients

Current diagnostic systems (DSM-IV-TR and ICD-10) do not include depressive mixed state (DMS) as a separate category. However, both historical descriptions and data from recent research clearly indicate that cooccurrence of (hypo)maniacal and depressive symptoms is standard in clinical picture of affective disorders. Most frequently employed criterion for DMS is the presence of at least three symptoms of (hypo)mania for 7 days during a major depressive episode. Not only formal diagnostic criteria for DMS are lacking but also psychometric assessment tools (for example the Hamilton Depression Scale or the MADRS) were designed around the features of “classical” depression. The other obstacles to recognize DMS could be lack of insight into the (hypo)maniacal symptoms in patients and cognitive dysfunctions present during an episode. On the other hand, newly created instrument, the Bipolar Depression Rating Scale, may assist clinical evaluation of DMS. Despite predominating depressive symptomatology, the principles of treatment of DMS suggest avoidance of antidepressant monotherapy in favor of mood stabilizers' administration. Actually DMS may emerge as a complication of antidepressant monotherapy in some bipolar patients or may be induced with interferon-alpha treatment in some chronic hepatitis C patients. Important consequences of both spontaneous and drug-induced DMS could be the roughening of affective symptomatology, resistance to antidepressants and the increase of suicidality. Thorough appraisal of symptoms seen in patients with affective disorders for indicators of DMS could have critical consequences for functional outcomes.

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Subjective experience of cognitive function in affective disorders

European Psychiatry ◽

10.1016/s0924-9338(11)71944-7 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 234-234

Author(s):

K. Miskowiak ◽

M. Vinberg ◽

E.M. Christensen ◽

L.V. Kessing

Keyword(s):

Cognitive Function ◽

Cognitive Dysfunction ◽

Subjective Experience ◽

Unipolar Depression ◽

University Hospital ◽

Attention And Memory ◽

Cognitive Difficulties ◽

Affective Symptoms ◽

Patients Experience ◽

The Impact

IntroductionCognitive dysfunction in unipolar depression (UD) and bipolar disorder (BD) may persist into periods of remission and affect psychosocial function. Attention and memory deficits may be more pronounced during remission in BD compared with UD. However, patients’ subjective experience of cognitive difficulties is poorly understood, and it is unclear whether this differs between BD and UD.Aims and objectivesTo examine self-reported cognitive function in remitted patients with BD and UD.MethodsPatients with BD (n = 54) and UD (n = 45) were referred to the outpatient clinic at Department of Psychiatry, Copenhagen University Hospital, following hospital discharge.Affective symptoms and patients’ experience of cognitive symptoms were assessed at their initial consultation at the clinic.ResultsPatients in remission experienced mild to moderate impairment of cognitive function with greatest difficulties in motivation, energy, attention and memory. Subjective experience of cognitive function were similar for BD and UD and were predicted by affective symptoms rather than by diagnosis, age, gender or comorbid alcohol misuse.ConclusionsThe absence of differences between UD and BD in the subjective experience of cognitive difficulties contrasts with evidence of greater objective cognitive dysfunction in BD. This highlights a potential discord between subjective and objective measures of cognitive function. The impact of affective symptoms on the subjectively experienced cognitive difficulties suggests that they reflect mood symptoms rather than objective cognitive deficits. Further investigation of the relation between objective and subjective measures of cognitive function and the influence of affective symptoms is warranted.

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Increased Psychopathology and Maladaptive Personality Traits, But Normal Cognitive Functioning, In Patients after Long-Term Cure of Acromegaly

Endocrine Reviews ◽

10.1210/edrv.31.5.9993 ◽

2010 ◽

Vol 31 (5) ◽

pp. 778-779

Author(s):

Jitske Tiemensma ◽

Nienke R. Biermasz ◽

Roos C. van der Mast ◽

Moniek J. E. Wassenaar ◽

Huub A. M. Middelkoop ◽

...

Keyword(s):

Cognitive Function ◽

Personality Traits ◽

Cognitive Dysfunction ◽

Short Form ◽

Depression Scale ◽

Cross Sectional Study ◽

Cross Sectional ◽

Personality Changes ◽

Irreversible Effects

ABSTRACT Objective Active acromegaly is associated with psychopathology, personality changes, and cognitive dysfunction. It is unknown whether, and to what extent, these effects are present after long-term cure of acromegaly. Aim The aim of the study was to assess psychopathology, personality traits, and cognitive function in patients after long-term cure of acromegaly. Design This was a cross-sectional study. Patients and Methods We studied 68 patients after long-term cure (13 ± 1 yr) of acromegaly and 68 matched controls. We compared these data with 60 patients treated for nonfunctioning pituitary macroadenomas (NFMAs) and 60 matched controls. Psychopathology was assessed using the Apathy Scale, Irritability Scale, Hospital Anxiety and Depression Scale, and Mood and Anxiety Symptoms Questionnaire short-form and personality by the Dimensional Assessment of Personality Pathology short-form (DAPP). Cognitive function was assessed by 11 tests. Results Compared with matched controls, patients cured from acromegaly scored significantly worse on virtually all psychopathology questionnaires and on several subscales of the DAPP. Compared with NFMA patients, patients cured from acromegaly scored worse on negative affect (P = 0.050) and somatic arousal (P = 0.009) and seven of 18 subscales of the DAPP (P < 0.05). Cognitive function in patients cured from acromegaly did not differ from matched controls or patients treated for NFMA. Conclusion Patients with long-term cure of acromegaly show a higher prevalence of psychopathology and maladaptive personality traits but not cognitive dysfunction, compared with matched controls and patients treated for NFMA. These results suggest irreversible effects of previous GH excess, rather than effects of pituitary adenomas per se and/or their treatment, on the central nervous system.

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NQPC-15 COGNITIVE FUNCTION AND ACTIVITY OF DAILY LIFE AFTER TUMOR REMOVAL FOR PATIENTS WITH BIFRONTAL GLIOBLASTOMA

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz039.144 ◽

2019 ◽

Vol 1 (Supplement_2) ◽

pp. ii32-ii32

Author(s):

Akiko Kakuta ◽

Masayuki Nitta ◽

Takashi Maruyama ◽

Yoshihiro Muragaki ◽

Tetsuo Ikai

Keyword(s):

Cognitive Function ◽

Cognitive Dysfunction ◽

Social Life ◽

Cognitive Disorders ◽

Tumor Location ◽

Tumor Removal ◽

Disturbance Of Consciousness ◽

Before And After ◽

Active Rehabilitation ◽

The Right

Abstract INTRODUCTION Glioblastomas often grow in a butterfly shape in the bifrontal lobes. The aggressive removal of these contrast-enhanced lesions may cause serious cognitive dysfunction. In this study, we have analyzed changes of cognitive function, effects on ADL, as well as rehabilitation methods for patients with bifrontal glioblastoma before and after tumor removal. SUBJECTS In this study, 6 patients including 2 males and 4 females with a mean age of 39.8 were reviewed. All patients exhibited bifrontal glioblastoma that was surgically removed. The primary tumor location was lower-left frontal gyrus for four of the patients, the right preSMA-SMA region for one patient, and the lower-right frontal gyrus for the remaining patient. METHOD Patients’cognitive function and ADL evaluated after the tumor removal and at the end of postoperative chemoradiotherapy, were retrospectively analyzed. We compared and verified the features and EOR. An evaluation was performed using MMSE-J, FAB, TMT, RCPM, RBMT, BADS, and FIM. RESULT After completion of chemoradiotherapy, 3 patients returned home, 2 were transferred to the hospital, and 1 returned to work. MMSE score was worsen in two patients, and their tumor were located in the lower-right frontal gyrus and the lower-left frontal gyrus. Two cases in the right frontal lobe and two cases in the lower left frontal gyrus scored lower average on the TMT. In our final evaluation, ADL was not worsening after surgery. DISCUSSION Many patients with bifrontal glioblastoma exhibited disturbance of consciousness due to strong edema before surgery, but they recovered in about two months after the tumor removal and many of them considered back to work. Involvement of prefrontal cortex may be related to severe cognitive dysfunction. Active rehabilitation should be started as soon as possible after surgery to acquire a compensation functions for the cognitive disorders and simulation for social life and work.

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Efficacy of hyperbaric oxygen combined with escitalopram in depression and its effect on cognitive function

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.4.3993 ◽

2021 ◽

Vol 37 (4) ◽

Author(s):

Kun Mi ◽

Qiang Guo ◽

Bao-yan Xu ◽

Man Wang ◽

Hao Bi

Keyword(s):

Cognitive Function ◽

Hyperbaric Oxygen ◽

Depression Scale ◽

Control Group ◽

Hamilton Depression Scale ◽

Observation Group ◽

Creative Commons ◽

Significant Difference ◽

Hamd Score ◽

Icd 10

Objective: To investigate the efficacy of hyperbaric oxygen (HBO) combined with escitalopram in patients with depression and its effect on cognitive function. Methods: From 2016 to 2018, seventy patients with depression aged 18-65 years treated in Affiliated Hospital of Hebei University were selected. Seventy patients with depression meeting the diagnostic criteria of ICD-10 were selected and randomly divided into control group and observation group using a random number table, with 35 patients in each group. The control group was treated with escitalopram, while the observation group was additionally treated with HBO on this basis. The patients were assessed using the Hamilton Depression Scale (HAMD) and Montreal Cognitive Assessment Scale (MoCA) before treatment and two, four and six weeks after treatment. Results: Two weeks after treatment, HAMD score showed a statistically significant difference between the two groups (P < 0.05). No statistically significant differences were found in HAMD score between the two groups four and six weeks after treatment (P > 0.05). Four and six weeks after treatment, MoCA score presented statistically significant differences between the two groups (P < 0.05). Conclusion: Escitalopram combined with HBO in the treatment of depression presents rapid efficacy and a certain effect in improving cognitive function. doi: https://doi.org/10.12669/pjms.37.4.3993 How to cite this:Mi K, Guo Q, Xu BY, Wang M, Bi H. Efficacy of hyperbaric oxygen combined with escitalopram in depression and its effect on cognitive function. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.3993 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Effects of Paroxetine on Motor and Cognitive Function Recovery in Patients with Non-Depressed Ischemic Stroke: An Open Randomized Controlled Study

Brain Impairment ◽

10.1017/brimp.2018.6 ◽

2018 ◽

Vol 19 (3) ◽

pp. 228-234

Author(s):

Xiao-Ling Pan ◽

Hong-Fang Chen ◽

Xing Cheng ◽

Chuan-Chen Hu ◽

Jian-Wei Wang ◽

...

Keyword(s):

Ischemic Stroke ◽

Cognitive Function ◽

Depression Scale ◽

Controlled Study ◽

Hamilton Depression Scale ◽

Randomized Controlled ◽

Function Recovery ◽

Random Number Table ◽

And Control

Introduction: To investigate the effects of paroxetine (PAR) on motor and cognitive function recovery in patients with non-depressed ischemic stroke (nD-AIS).Methods: One hundred sixty-seven patients hospitalized for non-depressed acute ischemic stroke were selected and divided into treatment (T) and control (C) groups using a random number table. All patients received conventional secondary ischemic stroke prevention and rehabilitation training; patients in Group T additionally received treatment with PAR (10 mg/day during week 1 and 20 mg/day thereafter) for 3 months. The follow-up observation lasted 6 months. The Fugl–Meyer motor scale (FMMS), Montreal cognitive assessment (MoCA), and Hamilton depression scale (HAMD) were used on D0, D15, D90, and D180 (T0, 1, 2, and 3, respectively; D180 = 90 days after treatment cessation) after study initiation, and scores were compared between the groups.Results: The FMMS and MoCA scores differed significantly between Groups T and C at T2 and T3 (p < .05); by contrast, these scores did not differ significantly between the groups at T1 (p > .05). Furthermore, the HAMD scores differed significantly between the two groups at T3 (p < .05), but not at T1 and T2 (p > .05).Conclusions: PAR treatment may improve motor and cognitive function recovery in patients with nD-AIS. Moreover, PAR may reduce the occurrence of depression after stroke.

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Cognitive impairment in multiple sclerosis does not affect reliability and validity of self-report health measures

Multiple Sclerosis Journal ◽

10.1191/1352458503ms927oa ◽

2003 ◽

Vol 9 (4) ◽

pp. 404-410 ◽

Cited By ~ 83

Author(s):

Stefan M Gold ◽

Holger Schulz ◽

Andrea Mönch ◽

Karl-Heinz Schulz ◽

Christoph Heesen

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Dysfunction ◽

Depression Scale ◽

Reliability And Validity ◽

Self Report ◽

Poor Correlation ◽

Health Measures ◽

Health Status Measures

Patient self-report health measures have received increasing recognition as supplementar y outcome parameters in multiple sclerosis (MS). G iven the high prevalence of cognitive problems in this population, reliability and validity of self-report instruments in patient groups with cognitive impairment is essential, especially when using such scales longitudinally. A sample of 80 MS patients with cognitive dysfunction according to Symbol Digit Modalities Test (SDMT) score and 107 unimpaired patients were included in the analyses. Data was available from the Hamburg Q uality of Life Q uestionnaire in Multiple Sclerosis (HAQ UA MS), the Hospital A nxiety and Depression Scale (HA DS), clinical rating scores [Expanded Disability Status Scale (EDSS) and FS (Functio nal Status) scales, C A MBS (Cambridge MS Basic Score)] and objective tests of upper and lower limb function [Timed 8 Meter Walk (T8) and Nine Hole Peg Test (9HPT)). Both self-report questionnaires showed satisfactory internal consistencies and retest reliability. Pattern and magnitude of correlations with other health status measures supported the validity of both instruments. However, there was a marked discrepancy between subjective and objective measures of cognitive function. C ognitively impaired patients furthermore showed significantly higher depression and anxiety as well as lower quality of life (Q oL). The report provides evidence that Q oL and affective symptomatology can be reliably assessed in MS patients with cognitive dysfunction. The common pattern of poor correlation between self-rated and objective cognitive function thus appears to be a result of the patients’ (adaptive or maladaptive) coping mechanisms rather than being due to inaccurate measurement.

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Obesity and quality of life in bipolar disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.389 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S423-S424

Author(s):

R. Jouini ◽

H. Ben Ammar ◽

G. Hamdi ◽

N. Smari ◽

A. Aissa ◽

...

Keyword(s):

Quality Of Life ◽

Bipolar Disorder ◽

Scale Score ◽

Rating Scale ◽

Short Form ◽

Depression Scale ◽

Overweight And Obesity ◽

Hamilton Depression Scale ◽

Bipolar Patients

IntroductionOverweight and obesity, despite their comorbidities and mortality, could deteriorate the quality of life of people with bipolar disorder.ObjectivesThe objective of this study is to evaluate the quality of life among patients with bipolar disorder and investigate a possible interaction between obesity and deterioration of the quality of life.AimsThis study aims to highlight the importance of preventing overweight and obesity in people with bipolar disorder to obtain an adequate quality of life subsequently an acceptable control of the illness.MethodsFifty euthymic bipolar patients (Hamilton Depression Scale score ≤ 8, and Young Mania Rating Scale score ≤ 6) received the Medical Outcomes Study 36-Item Short-Form Health Survey in Arabic validated version in order to investigate the quality of life.ResultsWe examined 50 euthymic bipolar patients (60% men, 40% women). The average age was 46, 5 years (23–70). Most patients (69%) were over weighted (BMI ≥ 25.0 kg/m2) (body mass index), of whom 40% were obese (BMI ≥ 30.0 kg/m2). Seventy-two percent of the investigated patients had an affected quality of life (score < 66.7). The mental items were deteriorated in 80% of the cases. An affected quality of life was correlated with obesity. The BMI was significantly and negatively correlated with the scores of dimensions D4 (mental health) and D8 (perceived health) (P < 0.01).ConclusionThe investigation of quality of life in people with mental disorder enables to reveal the social handicap caused by these illnesses consequently emphasizes health care in mental affections.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Demographic Factors and Cognitive Function Assessments Associated with Mild Cognitive Impairment Progression for the Elderly

BioMed Research International ◽

10.1155/2020/3054373 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Hong-yun Qin ◽

Xu-dong Zhao ◽

Bing-gen Zhu ◽

Cheng-ping Hu

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Function ◽

Demographic Data ◽

Depression Scale ◽

Demographic Factors ◽

The Elderly ◽

Income Level ◽

Hamilton Depression Scale ◽

Clinical Dementia Rating

Objectives. In this study, we aimed to conduct a 6-year follow-up and acquire a large sample dataset to analyze the most important demographic factors and cognitive function scale variables associated with mild cognitive impairment (MCI) progression for an elderly cohort (age ≥ 60 years old). Patients and Methods. We analyzed the subjects who had participated in a survey in 2011 and were successfully contacted in the later survey in 2017. For each subject, the basic demographic information was recorded, including sex, age, education level, marital status, working status, income level, and physical mental illness history. Cognitive assessments were performed using the following scales if possible: (1) the mini-mental state examination (MMSE) scale, (2) Montreal cognitive assessment (MoCA), (3) the clinical dementia rating (CDR) scale, and (4) Hamilton Depression Scale (HAMD-17). Results. The progression outcomes were different between sexes, among age brackets, education degrees, occupations types, and income levels; different progression groups had distinct children numbers (p<0.001), heights (p<0.05), and body weights (p<0.01); the positive ends six years later were positively related to better performance in the MoCA and MMSE scales (progressed vs stable p<0.01). Moreover, we constructed some indicators using age, MoCA, and MMSE scores, which showed an efficiency in predicting the progression outcomes. Conclusions. In conclusion, the MCI progression outcomes were associated with sex, age, education degrees, occupations types, income level, children number, height, and weight. MoCA and MMSE scales are supporting tools to predict the progression outcomes, especially combined with the demographic data.

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Efficacy of Acupuncture On Cognitive Function In Poststroke Depression: Study Protocol For A Randomized, Placebo-Controlled Trial

10.21203/rs.3.rs-76109/v1 ◽

2021 ◽

Author(s):

Ling Chen ◽

Yi Chen ◽

Lihua Wu ◽

Wen Fu ◽

Luanmian Wu ◽

...

Keyword(s):

Cognitive Function ◽

Acupuncture Treatment ◽

Negative Emotion ◽

Intervention Group ◽

Depression Scale ◽

Event Related Potentials ◽

Control Group ◽

Hamilton Depression Scale ◽

Poststroke Depression ◽

Related Potentials

Abstract Introduction: Poststroke depression (PSD) is the most common mental complication after stroke and has a serious impact on functional outcomes and quality of life. Antidepressants are the first-line treatment for PSD, but many reported side effects remain. Clinical research has shown that acupuncture has a positive effect on PSD. This trial aims to study the efficacy and safety of acupuncture for PSD and to explore its effect on cognitive function. It is hypothesized that acupuncture treatment improves depressive symptom, cognitive behavior and negative emotion processing bias in PSD.Methods: In this randomized, placebo-controlled, single-blinded trial, fifty-six people with PSD will be randomly allocated into the intervention (n=28) or control (n=28) groups. The intervention group will receive acupuncture treatment, and the control group will receive sham acupuncture treatment, in 20 sessions over 4 weeks. The primary outcome is the change from baseline in the Hamilton Depression Scale-17 (HAMD-17) scores at week 4. Secondary outcomes include the Wisconsin Card Sorting Test (WCST) and latency and amplitude of P1, N170 and P3 of the event-related potentials (ERPs) components to assess the changes in cognitive function and electroencephalography. Outcomes are assessed at baseline and post intervention.Discussion: Acupuncture therapy could become an alternative treatment for PSD, and it is expected that this trial will provide reliable clinical evidence for the future use of acupuncture for the treatment of PSD.Trial registration: Chinese Clinical Trial Registry: ChiCTR1900026948. Registered on 27 October 2019.

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