Cognitive reserve in neuropsychiatry

Background. The idea that superior cognitive function acts as a protective factor against dementia and the consequences of head injury is well established. Here we suggest the hypothesis that cognitive reserve is also important in neuropsychiatric disorders including schizophrenia, bipolar disorder and depression.Method. We review the history of passive and active models of reserve, and apply the concept to neuropsychiatric disorders. Schizophrenia is used as an exemplar because the effects of premorbid IQ and cognitive function in this disorder have been extensively studied.Results. Cognitive reserve may impact on neuropsychiatric disorders in three ways: by affecting the risk for developing the disorder, in the expression of symptoms within disorders, and in patients' functional outcome. Cognitive failure below a certain threshold may alone, or in combination with common psychiatric symptoms, produce neuropsychiatric syndromes.Conclusions. Consideration of cognitive reserve may considerably improve our understanding of individual differences in the causes and consequences of neuropsychiatric disorders. For these reasons, the concept of cognitive reserve should be incorporated in future studies of neuropsychiatric disorder. It may be possible to enhance cognitive reserve through pharmacological or non-pharmacological means, such as education, neurocognitive activation or other treatment programmes.

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Affective Temperaments and Illness Severity in Patients with Bipolar Disorder

Medicina ◽

10.3390/medicina57010054 ◽

2021 ◽

Vol 57 (1) ◽

pp. 54

Author(s):

Mario Luciano ◽

Luca Steardo ◽

Gaia Sampogna ◽

Vito Caivano ◽

Carmen Ciampi ◽

...

Keyword(s):

Quality Of Life ◽

Bipolar Disorder ◽

Protective Factor ◽

Psychiatric Symptoms ◽

Control Group ◽

Term Outcome ◽

Long Term Outcome ◽

Affective Temperaments

Background and objectives: Bipolar disorder (BD) is one of the most burdensome psychiatric illnesses, being associated with a negative long-term outcome and the highest suicide rate. Although affective temperaments can impact on BD long-term outcome, their role remains poorly investigated. The aims of the present study are to describe the clinical characteristics of patients with BD more frequently associated with the different affective temperaments and to assess the relation between affective temperaments and severity of clinical picture in a sample of patients with BD. Materials and Methods: A total of 199 patients have been recruited in the outpatients units of two university sites. Patients’ psychiatric symptoms, affective temperaments, and quality of life were investigated through validated assessment instruments. Results: Predominant cyclothymic and irritable temperaments are associated to higher number of relapses, poorer quality of life, higher rates of aggressive behaviors, and suicide attempts. Conversely, the predominant hyperthymic disposition was a protective factor for several outcome measures, including relapse rate, severity of anxiety, depressive and manic symptoms, suicidality, and earlier age at onset. One limitationo of the present study is that the recruitment took place in two university sites; therefore, our findings cannot be fully generalized to the whole community of BD patients. Other limitations are the lack of a control group and the cross-sectional design of the study. Conclusions: The early identification of affective temperaments can help clinicians to identify those BD patients who are more likely to show a poor long-term outcome. An early screening of affective temperaments can be useful to develop targeted integrated pharmacological and psychosocial interventions.

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T27. COGNITIVE RESERVE IN CHILD AND ADOLESCENT OFFSPRING OF PATIENTS DIANOSED WITH SCHIZOPHRENIA OR BIPOLAR DISORDER

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa029.587 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S241-S242

Author(s):

Elena De la Serna ◽

Patricia Camprodon-Boadas ◽

Gisela Sugranyes ◽

Carla Torrent ◽

Brisa Sole ◽

...

Keyword(s):

Bipolar Disorder ◽

High Risk ◽

Verbal Memory ◽

Cognitive Reserve ◽

Protective Factor ◽

Rating Scale ◽

Structured Interview ◽

Psychotic Symptoms ◽

Prodromal Symptoms ◽

Neuropsychological Variables

Abstract Background Cognitive Reserve (CR) is defined as the ability of the brain to cope and deal with physiological or pathological brain injuries. In the field of psychiatry, higher levels of CR have been associated with lower levels of psychotic symptoms, higher psycho-social functioning and higher cognitive performance, suggesting that CR should be considered as a protective factor (Barnett et al., 2006; Amoretti et al., 2016). This study aims to compare CR levels in a sample of adolescents and young adult offspring of patients with schizophrenia or bipolar disorder who are at high risk of developing these disorders (HR) and compared them with a group of healthy controls (HC). We also assess the utility of CR in predicting clinical and cognitive variables. Methods Participants were 85 HR and 45 HC. A CR proxy was calculated based on premorbid IQ, socio-occupational attainment and social activities. Clinical assessment included: the Structured Interview for Prodromal Symptoms (SOPS), the Young Mania Rating Scale (YMRS) and the Hamilton Depression Rating Scale (HDRS). Neuropsychological assessment included: Working Memory, Processing Speed, Verbal Memory, attention and executive functioning. A factorial analysis was conducted in order to obtain a single CR measure. Differences between groups in CR were assessed via MANCOVA and linear regressions were conducted to check the effectiveness of CR in predicting clinical and neuropsychological variables. Results No significant differences were observed in age or gender between HR and HC groups. Socioeconomic status was lower in HR subjects (F=8.100, p=0.005).CR was significantly lower in the HR group than in the HC group (F=17.522; p<0.001). Moreover, the CR proxy was able to correctly classify 72.7% of the sample as either HR or HC. Our proxy was able to predict the following clinical variables in the HR group: negative (F=9.269; p=0.002), and total (F=7.290; p=0.009) prodromal symptoms, the YMRS (F=11.597; P<0.001) and the HDRS (F=12.761; p<0.001). In terms of neuropsychological variables, RC predicted WM (F=9.738; p=0.003), PS (F=4.557; p=0.037) and verbal memory [immediate (F=6.999; p=0.010) and delayed recall (F=10.990; P=0.002)] in the HR sample. Discussion HR subjects have lower CR than controls. CR is associated with clinical and neuropsychological variables. To our knowledge no previous studies have assessed CR in high risk samples. Nevertheless, studies conducted in adult first episode psychotic samples have shown an association between CR and the severity of symptoms.

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ADHD and bipolar disorder challenge in diagnosis in children and adolescents

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1228 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S347-S347

Author(s):

P. Cano Ruiz ◽

A. Gómez Peinado ◽

S. Cañas Fraile ◽

P. Sanmartin Salinas

Keyword(s):

Bipolar Disorder ◽

Children And Adolescents ◽

Attention Deficit Disorder ◽

Psychiatric Symptoms ◽

Family Factors ◽

Bipolar Spectrum ◽

Hyperactivity Disorder ◽

Bipolar Disease ◽

History Of ◽

Competing Interest

IntroductionThe professionals in charge of children and adolescents with attention deficit disorder and hyperactivity disorder (ADHD) should be prepared to treat a wide variety of psychiatric symptoms, as most have at least one comorbid psychiatric disorder.Sometimes the differential diagnosis between ADHD and bipolar disease is difficult because of overlapping symptoms between the two disorders (Geller et al., 1997; Biederman et al., 2000; Singh et al., 2006).MethodologyA literature review about the comorbidity between ADHD and bipolar disorder in children and adolescents was performed.ResultsAccording to different studies, between 60 and 90% of children and adolescents with ADHD have comorbid bipolar disorder. However, the percentage of children and adolescents with ADHD that has comorbid bipolar disorder varied from 10 to 22% (puedes poner from 60 to 90% si no quieres repetir el and).ConclusionsThe prevalence of bipolar disease, particularly among adolescents, is between 1 and 7%. This percentage is higher if all forms of bipolar spectrum are included. Some personal and family factors increase the probability of a patient having ADHD present bipolar disease: decreased IQ, delayed development, family history of ADHD or bipolar disease, and the combined subtype.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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A case of neurosyphilis in a patient presenting with bipolar mixed episode suggestive symptoms

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.318 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S347-S347

Author(s):

M. Martins ◽

R. Fernandes

Keyword(s):

Bipolar Disorder ◽

Mental Illness ◽

Psychiatric Symptoms ◽

Transmitted Disease ◽

Previous History ◽

Clinical Manifestations ◽

Presenting Symptoms ◽

History Of ◽

Clinical Records ◽

First Admission

IntroductionSyphilis is a sexually transmitted disease caused by Treponema pallidum. Early invasion of the central nervous system might occur early in the course of the disease. Clinical manifestations may include acute meningeal syphilis, meningovascular syphilis, paretic neurosyphilis and tabetic neurosyphilis. Psychiatric symptoms are often the presenting symptoms of this illness and the correct diagnosis involves both a high degree of suspicion and adequate diagnostic tests.ObjectivesThe authors report a case of a patient, with no previous history of mental illness, initially admitted in a psychiatric unit with a clinical picture suggestive of a mixed bipolar disorder episode who has been diagnosed with neurosyphilis a year after.MethodsReview of clinical records and complementary exams.ResultsBy the first admission, the patient presented with depressed and irritable mood, emotional lability, aggressiveness, grandiose and racing thoughts. Upon discharge, he was diagnosed with bipolar disorder and referred to ambulatory unit. The following year he starts presenting cognitive deficits and a progressive loss of autonomy in daily living activities, being referred to neurology evaluation. A year after the first admission, he is admitted in a neurology unit and diagnosed with neurosyphilis.ConclusionsCurrent prevalence of symptomatic neurosyphilis in Western Europe is unknown. Atypical cases presenting with heterogeneous psychiatric and neurologic symptoms, with no previous history of mental illness, should raise a high index of clinical suspicion, since consequences for the patient's health might be severe if not properly diagnosed and treated.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Cognitive function in euthymic bipolar disorder (BP I) patients with a history of psychotic symptoms vs. schizophrenia

Psychiatry Research ◽

10.1016/j.psychres.2015.08.012 ◽

2015 ◽

Vol 230 (1) ◽

pp. 65-69 ◽

Cited By ~ 14

Author(s):

Igor Nenadic ◽

Kerstin Langbein ◽

Maren Dietzek ◽

Anne Forberg ◽

Stefan Smesny ◽

...

Keyword(s):

Bipolar Disorder ◽

Cognitive Function ◽

Psychotic Symptoms ◽

History Of

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Temporal tumor as a cause of bipolar-like disorder?

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.538 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S471-S471

Author(s):

S. Domingues ◽

M. Cotter ◽

I. Amado ◽

R. Massano

Keyword(s):

Bipolar Disorder ◽

Psychiatric Symptoms ◽

Sudden Onset ◽

Psychomotor Agitation ◽

Temporal Epilepsy ◽

Co Morbidity ◽

History Of ◽

Competing Interest ◽

History Of Epilepsy ◽

Clinical Records

IntroductionThe relationship between brain tumours, temporal epilepsy and psychiatric symptoms are historically known.ObjectivesTo report a case of mania in a patient with previous diagnosis of bipolar disorder, temporal tumour and temporal epilepsy.MethodsClinical records. Research on PubMed, using “lateral temporal epilepsy” or “brain tumour” and “mania”.ResultsA 52 years old man was conducted to the emergency department by the police. He was found with psychomotor agitation at the Sanctuary of Fátima. He was apparently hyperthimic with flight of ideas. He had a history of epilepsy and temporal tumour and two previous manic episodes. It was assumed as a maniac episode.During inpatient evaluation, patient had memory for the occurrence. He described a sudden onset on the day before, after drinking wine. He described delirant atmosphere, persecutory and mystic delusional beliefs “this is the third secret of Fátima being revealed”, followed by ecstasy and psychomotor agitation. Remission was obtained in one week on psychotropics. MRI documented the lesion. Electroencephalography performed one month later revealed “slow waves.”ConclusionsOrganic causes should be excluded before consider a psychiatric disorder. The hypothesis of epilepsy-related psychosis or mania and other effects of a temporal tumour should be considered in etiology. However, co morbidity with bipolar disorder cannot be excluded.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Does bilingualism protect against cognitive aging?

Linguistic Approaches to Bilingualism ◽

10.1075/lab.15043.wat ◽

2016 ◽

Vol 6 (5) ◽

pp. 590-604 ◽

Cited By ~ 5

Author(s):

Caitlin Wei-Ming Watson ◽

Jennifer J. Manly ◽

Laura B. Zahodne

Keyword(s):

Cognitive Function ◽

Study Design ◽

Cognitive Aging ◽

Cognitive Reserve ◽

Protective Factor ◽

Cognitive Change ◽

Confounding Factors ◽

Cognitive Level ◽

Structural Variables ◽

Level Versus

Abstract Recent studies of bilingualism as a protective factor in cognitive aging have reported conflicting findings, and researchers have begun to explore the methodological complications that may explain differences across studies. This article details the current research landscape and addresses several issues relevant to the study of bilingualism and late-life cognitive function: study design, establishing causal relationships, confounding factors, operationalizing bilingualism, predicting cognitive level versus cognitive change, and incorporating brain structural variables to interrogate cognitive reserve.

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Bipolar Disorder Associated with Primary Generalised Epilepsy

The British Journal of Psychiatry ◽

10.1192/bjp.162.5.699 ◽

1993 ◽

Vol 162 (5) ◽

pp. 699-700 ◽

Cited By ~ 4

Author(s):

Robert H. Howland

Keyword(s):

Bipolar Disorder ◽

Family History ◽

Psychiatric Illness ◽

Psychiatric Symptoms ◽

Absence Seizures ◽

Epileptic Discharges ◽

History Of ◽

Temporally Correlated

A patient with bipolar disorder and primary generalised epilepsy, and a family history of psychiatric illness and epilepsy, is described. The episodic psychiatric symptoms were temporally correlated with epileptic discharges and absence seizures observed during repeated EEGs.

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