Patterns of Impairment in Executive Functions within Unipolar and Bipolar Depression

2017 ◽  
Vol 41 (S1) ◽  
pp. S212-S212
Author(s):  
B. Suciu ◽  
R. Paunescu ◽  
I. Miclutia
Keyword(s):  
Bipolar Disorder ◽  
Executive Functions ◽  
Cognitive Deficits ◽  
Cognitive Abilities ◽  
Bipolar Depression ◽  
Cognitive Effort ◽  
Unipolar Disorder ◽  
Depressed Patients ◽  
Competing Interest ◽  
Executive Impairment

IntroductionThe majority of studies revealed that cognitive deficits are an important aspect in many psychiatric illnesses, such as bipolar disorder and major depressive disorder. In the past, cognitive impairment was considered part of depression and it was expected to diminish as other mood symptoms improved with treatment.MethodThis study is based on the review of recent literature, performed in order to understand the dimension of executive impairment in unipolar and bipolar depression.ResultsBoth unipolar and bipolar depressed patients display cognitive deficits in several cognitive domains within executive functions. Different subcomponents of executive functions are altered in both types of patients, but impairments in sustained attention appear specific in bipolar depression while dysfunctional divided attention is reported in unipolar disorder. Studies describe deficits in planning strategies and monitoring processes that are characteristically impaired in unipolar depressed patients. Also these subjects tend to make more perseverative responses suggesting set shifting deficits and moreover they require longer time and more cognitive effort in order to accomplish tasks involving inhibitory control or cognitive flexibility. Other findings suggest that bipolar I depressed patients perform worse than bipolar II depressed patients and unipolar depressed patients across all executive functions especially in the decision making process that is considered to be a trait marker for bipolar disorder with no differences between the two types of bipolar subjects.ConclusionsExecutive functions represent a term that includes a higher order of cognitive abilities with deficits that are present in both disorders but display slightly different patterns of impairment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Treatment of bipolar depression with supraphysiologic doses of levothyroxine: a randomized, placebo-controlled study of comorbid anxiety symptoms

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Maximilian Pilhatsch ◽  
Thomas J Stamm ◽  
Petra Stahl ◽  
Ute Lewitzka ◽  
Anne Berghöfer ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Phenotypic Expression ◽  
Anxiety Symptoms ◽  
Controlled Study ◽  
Double Blind ◽  
Comorbid Anxiety ◽  
Depressed Patients ◽  
Depressive Episodes

Abstract Background Symptoms of anxiety co-occur in a variety of disorders including in depressive episodes of bipolar disorder and in patients with thyrotoxicosis. Treatment of refractory bipolar disorder with supraphysiologic doses of levothyroxine (L-T4) has been shown to improve the phenotypic expression of the disorder and is associated with an increase of circulating thyroid hormones. However, it might be associated with somatic and mental adverse effects. Here we report the investigation of the influence of treatment with supraphysiologic doses of L-T4 on symptoms of anxiety in patients with refractory bipolar depression. Methods Post-hoc analysis from a 6-week, multi-center, randomized, double-blind, placebo-controlled study of the effects of supraphysiologic L-T4 treatment on anxiety symptoms in bipolar depression. Anxiety symptoms were measured weekly with the Hamilton anxiety/somatization factor (HASF) score of the Hamilton Depression Rating Scale (HAMD) and the State- and Trait Anxiety Inventory (STAI). Results Treatment of both groups was associated with a significant reduction in anxiety symptoms (p < 0.001) with no statistical difference between groups (LT-4: from 5.9 (SD = 2.0) at baseline to 3.7 (SD = 2.4) at study end; placebo: from 6.1 (SD = 2.4) at baseline to 4.4 (SD = 2.8) at study end; p = 0.717). Severity of anxiety at baseline did not show a statistically significant correlation to the antidepressive effect of treatment with supraphysiologic doses of L-T4 (p = 0.811). Gender did not show an influence on the reduction of anxiety symptoms (females: from 5.6 (SD = 1.7) at baseline to 3.5 (SD = 2.4) at study end; males: from 6.1 (SD = 2.3) at baseline to 4.0 (SD = 2.4) at study end; p = 0.877). Conclusions This study failed to detect a difference in change of anxiety between bipolar depressed patients treated with supraphysiologic doses of L-T4 or placebo. Comorbid anxiety symptoms should not be considered a limitation for the administration of supraphysiologic doses of L-T4 refractory bipolar depressed patients. Trial registration ClinicalTrials, ClinicalTrials.gov identifier: NCT01528839. Registered 2 June 2012—Retrospectively registered, https://clinicaltrials.gov/ct2/show/study/NCT01528839

Interictal dysphoric disorder – the bridge between epilepsy and bipolar disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S126-S127
Author(s):  
R. Sousa ◽  
M. Salta ◽  
B. Barata ◽  
J. Nogueira ◽  
J. Vieira ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Depression ◽  
Classical Antiquity ◽  
Biological Processes ◽  
Bipolar Ii Disorder ◽  
Bipolar Ii ◽  
Episodic Course ◽  
Competing Interest ◽  
Patients With Epilepsy ◽  
Pituitary Adrenal Axis

IntroductionPsychiatric disorders are frequent among patients with epilepsy. The association between epilepsy and mood disorders is recognized since the classical antiquity. Recent studies demonstrated that the prevalence of bipolar symptoms in epilepsy patients is more significant than previously expected. In the first half of the twentieth century, Kraeplin and Bleuler were the first to describe a pleomorphic pattern of symptoms claimed to be typical of patients with epilepsy and recently Blumer coined the term interictal dysphoric disorder to identify this condition. Although for some authors, the existence of this condition as a diagnostic entity is still doubtful, for others, it represents a phenotypic copy of bipolar disorder.ObjectivesIn this work, we start from the phenomenological similarities between the interictal dysphoric disorder and the bipolar disorder, to explore the neurobiological underpinnings that support a possible link between epilepsy and bipolar disorder.MethodsResearch of articles published in PubMed and other databases.ResultsInterictal dysphoric patients have features that resemble the more unstable forms of bipolar II disorder and benefit from the same therapy used in bipolar depression. Epilepsy and bipolar disorder share features like episodic course, the kindling phenomenon as possible pathogenic mechanisms and the response to antiepileptic drugs. The study of possible common biological processes like neurogenesis/neuroplasticity, inflammation, brain-derived-neurotrophic-factor, hypothalamus pituitary adrenal axis, provided promising but not consensual results.ConclusionsFurther efforts to understand the link between epilepsy and bipolar disorder could provide the insight needed to find common therapeutic targets and improve the treatment of both illnesses.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Concordance and Discrepancy Between Subjective and Objective Cognitive Assessment in Bipolar Disorder: What is Influencing this Discrepancy?

2017 ◽  
Vol 41 (S1) ◽  
pp. S207-S207
Author(s):  
F. Lima ◽  
T. Cardoso ◽  
C. Bonnin ◽  
A. Martinez-Aran ◽  
E. Vieta ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Abilities ◽  
Cognitive Assessment ◽  
Rating Scale ◽  
False Negative ◽  
Cognitive Difficulties ◽  
Full Remission ◽  
Cognitive Measure ◽  
Competing Interest ◽  
Congruent Group

IntroductionEvidence has shown that some patients with bipolar disorder have a relatively accurate sense of their cognitive abilities, whereas others may overreported or underreported cognitive difficulties, which causes a discrepancy in this measures.ObjectivesTo investigate concordance and discrepancy between subjective and objective cognitive measures, as well as to identify factors that could influence this discrepancy.MethodsPatients who met DSM IV-TR criteria for bipolar disorder in partial or full remission (HDRS-17 score ≤ 12; YMRS score ≤ 7) were recruited from outpatient clinic at Barcelona and Porto Alegre. Objective cognitive assessment was performed by the Letter-Number Sequencing (LNS-WAIS III). Cognitive Complaints in Bipolar Disorder Rating Scale (COBRA) was used as a subjective cognitive measure.ResultsWere included 179 patients. We found a concordance between COBRA and LNS in 62 cases, and discrepancy in 117 cases (Fig. 1). The incongruent group (COBRA–and LNS + ) have less years of study (8.10 ± 4.01) than the incongruent group (COBRA+ and LNS–) (13.44 ± 4.05, P = 0.001), and than congruent group (COBRA–and NLS–) (13.75 ± 4.04, P = 0.003). Finally, the congruent group (COBRA+ and LNS + ) was the group with higher functioning impairment.ConclusionsA few number of false-negative cases were detected, suggesting that COBRA can be used as a screening instrument. A special attention should be provided for subjects with a few years of study, because possibly these subjects presents more difficulty in express its cognitive difficulties.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Peripheral Uric Acid as a Biomarker in Individuals With Bipolar Disorder: A Case Control Study

2021 ◽  
Author(s):  
Zhe Lu ◽  
Yingtan Wang ◽  
Guanglei Xun
Keyword(s):  
Bipolar Disorder ◽  
Uric Acid ◽  
Drug Use ◽  
Bipolar Depression ◽  
Acute Stage ◽  
Free Subgroup ◽  
Continuous Variables ◽  
Chi Square ◽  
Unipolar Disorder ◽  
Drug Naïve

Abstract Background: At present, no well-established biomarkers were ever found to distinguish unipolar disorder (UD) and bipolar disorder (BD). This study aimed to explore whether uric acid (UA) could be a biomarker to distinguish UD and BD. Methods: Peripheral UA of 119 patients with BD in acute stage (AS) and 77 in remission stage (RS), and 95 patients with UD in AS and 61 in RS were measured, so were 180 healthy controls. Differences in continuous variables among groups were assessed by the independent samples t-test and one-way analysis of variance. The chi-square test was applied to categorical data such as gender. Results: UA levels in BD group were higher than UD and HC groups regardless of the AS or RS, while differences in UA levels between UD group and HC group were not significant. Differences of UA levels between BD-M (bipolar mania/hypomania) and BD-D (bipolar depression) subgroups were not significant, and UA levels of BD-M and BD-D subgroups were higher than UD and HC groups. Only in UD group, UA levels of drug-use subgroup were higher than drug-naïve/free subgroup, but differences disappeared when analyzed stratified by sex; whether in drug-use or drug-naïve/free subgroup, differences of UA levels between BD-M and BD-D groups were not significant.Conclusion: The study suggests UA levels may be a biomarker of BD to distinguish from UD.

scholarly journals Neuropsychological profile of patients with bipolar depression in remission

2005 ◽  
Vol 62 (7-8) ◽  
pp. 543-550 ◽  
Author(s):  
Sanja Totic-Poznanovic ◽  
Dragan Marinkovic ◽  
Dragan Pavlovic ◽  
Vladimir Paunovic
Keyword(s):  
Bipolar Disorder ◽  
Executive Functions ◽  
Learning And Memory ◽  
Bipolar Depression ◽  
Verbal Learning ◽  
Bipolar Affective Disorder ◽  
Control Group ◽  
State Variables ◽  
Neuropsychological Profile ◽  
Clinical Measures

Aim. To determine if the patients with bipolar affective disorder, after the depressive phase, would exhibit cognitive impairment in remission. Methods. Twenty three euthymic patients with bipolar disorder were matched, on a case-by-case basis, to twenty-one healthy subjects in the control group, for the presence of the symptoms of depression. The patients and the control group were tested with a battery of neuropsychological tests. Results. Impairments were found in the patients compared with the control group in tests of verbal learning and memory and in tests of executive function. Verbal learning and memory, as well as executive functions, did not correlate either with the clinical indices of patients, or with the demographic and baseline clinical measures of depression. Conclusion. Impaired verbal learning and memory and executive functions may represent a trait rather than the state variables in bipolar disorder.

Euthymic bipolar disorder: Are there cognitive dysfunctions?

2011 ◽  
Vol 26 (S2) ◽  
pp. 198-198
Author(s):  
G. Da Ponte ◽  
T. Neves ◽  
M. Lobo
Keyword(s):  
Bipolar Disorder ◽  
Executive Functions ◽  
Cognitive Dysfunction ◽  
Cognitive Deficits ◽  
Verbal Memory ◽  
Clinical Case ◽  
Relevant Literature ◽  
Psychological Tests ◽  
Drug Treatments ◽  
Depressive Episodes

IntroductionThe presence of cognitive dysfunction in bipolar disorder is well established, but in the euthymic phase appear a few studies that point to the absence of cognitive deficits.ObjectivesAlert to cases of euthymic bipolar disorder with no cognitive dysfunction.MethodsReview of relevant literature and description of a clinical case with psychological tests that assess memory and executive functions.ResultsDescription of a clinical case: FP is a middle age woman, early retired, with a bipolar disorder type 2, which begins at age 30.Her disease has several depressive episodes, and in the last 10 years, she spent most of the days lying in bed and repeatedly resorted to the emergency department for excessive voluntary drug intoxication or simply because she “wanted” to be hospitalized; her husband could not stand this situation. In September of 2009, in addition to the medical and psychological consultations, she starts attending group therapy; over the next 6 months her medication was changed and finally her disease goes into remission.The psychological tests, made at euthymic phase, show’s no significant deficits in verbal memory and executive functions.ConclusionsThis patient has a disease with prolonged course and multiple hospitalizations and drug treatments, but don’t present relevant cognitive deficits, which may point to the fact that cognitive impairment is determined by biological factors.

Work memory and inhibition in abused children

2017 ◽  
Vol 41 (S1) ◽  
pp. S688-S688
Author(s):  
M.C. Jimenez Martinez
Keyword(s):  
Child Abuse ◽  
Executive Functions ◽  
Cognitive Abilities ◽  
Previous History ◽  
Work Memory ◽  
Daily Activities ◽  
Abused Children ◽  
History Of ◽  
Competing Interest ◽  
The Relationship

IntroductionIt has been shown that children with a history of abuse tend to have a deficit in both their academic and cognitive abilities. Mesa-Gresa, P., & Moya-Albiol, L. (2011) [1]. This study aimed to identify the relationship between abuse (psychological, neglect, custody and abandonment) and the performance of executive functions of memory of verbal work and inhibition.MethodThe Executive Function battery (Gonzalez, M., & Ostrosky, F., 2012) [2] was applied to 38 preschoolers 4–5 year olds who have experience abuse and to 36 preschoolers who have not. Data was analysed using the test t for independent samples and the Chi-cuadrado from Pearson.ResultsInhibition was affected in children with psychological abuse and negligence. It means that children presented difficulty in controlling their behaviour. Children victim of abandonment showed lower performance of executive functions of memory of verbal work. Such function allows them to carry on daily activities efficiently. Conversely, children without previous history of abuse showed higher performance in both tests especially in inhibition.ConclusionFindings suggest that child abuse in preschoolers can influence the performance in their executive functions without difference in gender.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Cognitive characteristics of unipolar (major depressive disorder) and bipolar depression

2016 ◽  
Vol 33 (S1) ◽  
pp. S374-S374 ◽  
Author(s):  
B. Suciu ◽  
R. Paunescu ◽  
I. Miclutia
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Cognitive Deficits ◽  
Bipolar Depression ◽  
Cognitive Domain ◽  
Global Functioning ◽  
Major Depressive ◽  
Cognitive Domains ◽  
Depressive Episodes

IntroductionImpairment in cognitive performance is an important characteristic in many psychiatric illnesses, such as Bipolar Disorder and Major Depressive Disorder. Initially, cognitive dysfunctions were considered to be present only in acute depressive episodes and to improve after symptoms recovered. Reports have described persistent cognitive deficits even after significant improvement of depressive symptoms.Aims/ObjectivesWe wanted to understand the dimension of cognitive impairment in unipolar and bipolar depression and also to underline the differences between cognitive profiles of patients diagnosed within the two mentioned disorders.MethodThis review examined recent literature about unipolar and bipolar depression.ResultsBoth depressed patients presented cognitive deficits in several cognitive domains. Different aspects of attention were altered in both patients but impairment in shifting attention appeared specific to unipolar disorder while impaired sustained attention was particular for bipolar disorder. Both types of patients showed memory deficits that were associated with poor global functioning. Two recent studies described that bipolar depressed subjects were more impaired across all cognitive domains than unipolar depressed subjects on tests assessing verbal memory, verbal fluency, attention and executive functions. The most consistently deficits were displayed on measures of executive functioning – such as tasks requiring problem solving, planning, decision making – suggesting that this cognitive domain is a trait-marker for depression.ConclusionsCognitive deficits are present in both disorders during a depressive episode but they display slightly different patterns of impairment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals No relation of Need for Cognition to basic executive functions

2019 ◽  
Author(s):  
Anne Gärtner ◽  
Julia Grass ◽  
Max Wolff ◽  
Thomas Goschke ◽  
Anja Strobel ◽  
...  
Keyword(s):  
Young Adults ◽  
Executive Functions ◽  
Inhibitory Control ◽  
Cognitive Abilities ◽  
Shape Matching ◽  
Need For Cognition ◽  
Conclusive Evidence ◽  
Cognitive Effort ◽  
Stop Signal ◽  
Self Control

Need for Cognition (NFC) refers to a personality trait describing the relatively stable intrinsic motivation of individuals to invest cognitive effort in cognitive endeavors. Higher NFC is associated with a more elaborated, central information processing style and increased recruitment of resources in cognitively demanding situations. To further clarify the association between cognitive resources and NFC, we examined in two studies how NFC relates to executive functions as basic cognitive abilities. In Study 1, 189 healthy young adults completed a NFC scale and a battery of six commonly used inhibitory control tasks (Stroop, antisaccade, stop-signal, flanker, shape-matching, word-naming). In Study 2, 102 healthy young adults completed the NFC scale and two tasks for each of the three executive functions inhibitory control (go-nogo, stop-signal), shifting (number-letter, color-shape) and working memory updating (two-back, letter-memory). Using a Bayesian approach to correlation analysis, we found no conclusive evidence that NFC was related to any executive function measure. Instead, we obtained even moderate evidence for the null hypothesis. Both studies add to more recent findings that shape the understanding of NFC as a trait that is less characterized by increased cognitive control abilities but rather by increased willingness to invest effort and exert self-control via motivational processes.

Dermal reactivity and resilience in a sample of depressed patients

2016 ◽  
Vol 33 (S1) ◽  
pp. S598-S598
Author(s):  
I. Coppola ◽  
E. Gattoni ◽  
C. Gramaglia ◽  
S. Di Marco ◽  
C. Delicato ◽  
...  
Keyword(s):  
Depressive Disorders ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Bipolar Depression ◽  
Response To Treatment ◽  
Depressed Patients ◽  
Resilience Scale ◽  
History Of ◽  
Competing Interest ◽  
The Impact

BackgroundMental disorders are considered a risk factor for suicide: for example, the lifetime risk of suicide is estimated to be 4%–8% in people with mood disorders. The literature suggests that a history of suicide attempts is significantly related to electrodermal hyporeactivity and that patients with violent suicide attempters exhibit faster habituation of the electrodermal response to repeated neutral tones than patients with non-violent attempts. The impact of depressive symptoms on suicidal ideation may be moderated by resilience. Resilience refers to the ability to maintain o regain mental health despite experiencing adversity. In bipolar and depressive disorders, resilience may influence severity of episodes, frequency of relapse and response to treatment.AimThe objective of our study was to assess the possible correlation among attempted suicide, resilience and dermal reactivity in a sample of depressed patients.MethodsWe recruited patients with depressive disorders and bipolar depression; data about socio-demographic, clinical features, severity of attempted suicide and suicidal risk were gathered. Patients filled in the Resilience Scale for Adult (RSA). Moreover, for each patient we performed the Edor test in order to assess dermal reactivity.ResultsData collection is still ongoing. We expect to find lower levels of resilience in those patients who are hyporeactive and attempted suicide. Moreover, we hypothesize that suicide attempts in the group of hyporeactive patients would be characterized by planning and greater severity. Clinical implications will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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