scholarly journals The functional impairment of different subtypes and occupational states in euthymic patients with bipolar disorder

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xinyu Liu ◽  
Xiaojuan Ma ◽  
Wenchen Wang ◽  
Jian Zhang ◽  
Xia Sun ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Social Functioning ◽  
Rating Scale ◽  
Verbal Learning ◽  
Occupational Status ◽  
Learning Performance ◽  
Neurocognitive Functioning ◽  
Type I ◽  
Speed Of Processing ◽  
Occupational Functioning

Abstract Background The aim was to explore the associations between clinical symptoms, demographic variables, social and neurocognitive functioning in euthymic patients with bipolar disorder (BD) stratified by subgroups of DSM-IV BD (type I (BD-I) and type II (BD-II)) and occupational status (employed/unemployed), and to highlight the significance of occupational status when assessing social and neurocognitive functioning in euthymic BD patients. Methods A total of 81 euthymic BD patients were participated in the study. The severity of the depressive and manic/hypomanic symptoms was measured using the 17-item Hamilton Depression Rating Scale (HDRS-17) and the Young Mania Rating Scale (YMRS), respectively. Social functioning and neurocognitive functioning were evaluated by the Functioning Assessment Short Test (FAST) and neurocognitive measures, respectively. Results Employed BD patients displayed greater social functioning (autonomy, occupational functioning, interpersonal relationship domain) and better verbal learning performance and speed of processing than unemployed BD patients. The correlation between neurocognitive functioning and social functioning was stronger in the employed group than in the unemployed group. There were no significant differences in neurocognitive and social functioning between the BD-I and BD-II groups, and the correlation between neurocognitive functioning and social functioning was similar between the BD-I and BD-II groups. Conclusion Employed BD patients may present greater occupational functioning and interpersonal relationships, as well as better verbal learning performance and speed of processing.

The Functional Impairment of Different Subtypes and Occupational States in Euthymic Patients With Bipolar Disorder

2021 ◽  
Author(s):  
Xinyu Liu ◽  
Xiaojuan Ma ◽  
Wenchen wang ◽  
Jian Zhang ◽  
Xia Sun ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Social Functioning ◽  
Rating Scale ◽  
Verbal Learning ◽  
Occupational Status ◽  
Learning Performance ◽  
Neurocognitive Functioning ◽  
Type I ◽  
Speed Of Processing ◽  
Occupational Functioning

Abstract Background The aim was to explore the associations between clinical symptoms, demographic variables, social and neurocognitive functioning in euthymic patients with bipolar disorder (BD) stratified by subgroups of DSM-IV BD (BD-type I and BD-type II) and occupational status(employed/unemployed), and to highlight the significance of occupational status when assessing social and neurocognitive functioning in euthymic BD patients. Methods A total of 81 euthymic BD patients were participated in the study. The severity of the depressive and manic/hypomanic symptoms was measured using the 17-item Hamilton Depression Rating Scale (HDRS-17) and the Young Mania Rating Scale (YMRS), respectively. Social functioning and neurocognitive functioning were evaluated by the Functioning Assessment Short Test (FAST) and neurocognitive measures, respectively. Results Employed BD patients displayed greater social functioning (autonomy, occupational functioning, interpersonal relationship domain) and better verbal learning performance and speed of processing than unemployed BD patients. The correlation between neurocognitive functioning and social functioning was stronger in the employed group than in the unemployed group. There were no significant differences in neurocognitive and social functioning between the BD-I and BD-II groups, and the correlation between neurocognitive functioning and social functioning was similar between the BD-I and BD-II groups. Conclusion Employed BD patients may present greater occupational functioning and interpersonal relationships, as well as better verbal learning performance and speed of processing.

Neurocognitive impairments in euthymic patients with bipolar disorder type II

2016 ◽  
Vol 33 (S1) ◽  
pp. S122-S122
Author(s):  
R.S. Ilhan ◽  
V. Senturk-Cankorur
Keyword(s):  
Bipolar Disorder ◽  
Working Memory ◽  
Executive Functions ◽  
Verbal Memory ◽  
Rating Scale ◽  
Neurocognitive Functioning ◽  
Type I ◽  
Neurocognitive Impairments ◽  
Perseverative Errors ◽  
Disorder Type

IntroductionMost of the studies have indicated that there have been neurocognitive impairments especially in the domains of executive functions, attention, verbal and working memory among euthymic patients with bipolar disorder type I (BD-I). However, there has been limited research investigating neurocognitive functioning in euthymic patients with BD- II.Objectives/aimsAim of this study was to investigate neurocognitive functions in euthymic BD-II patients. Our hypothesis was that euthymic BD-II patients would have neurocognitive impairments in the domains of executive functions, attention, verbal and working memory.MethodsEuthymic BD-II patients (n = 37) and healthy controls (HC) (n = 35) were compared in terms of their neurocognitive functioning in the domains of executive functions assesed by the number of perseverative errors, non-perseverative errors and category completed on the Wisconsin Cart Sorting Test (WCST); working memory assessed by Auditory Consonant Trigrams (ACT); immediate verbal memory assessed by the Logical Memory subscale of the Wechsler Memory Scale I (WMS I) and attention assesed by Stroop Colour-Word Interference Test (SCWIT). Euthymic state was confirmed by the low scores both on Hamilton Depression Rating Scale, Young Mania Rating Scale.ResultsSignificant differences were found between two groups in terms of WCST non-perseverative errors (Z = 3.8, P < 0.01) and category completed subtests (Z = 3.8, P < 0.01), ACT (t = 2.97, P < 0.01) WMSI (Z = 2.4, P = 0.01), SCWIT (t = 3.52, P < 0.01) performances.ConclusionsOur study indicated that euthymic BD-II patients had poorer performance on the domains of executive functions, attention, working memory and verbal memory than the HC group. But future studies with large samples are needed to support our results.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Does the efficacy of asenapine in bipolar disorder increase in the presence of comorbidity with a substance use disorder? A naturalistic study

2016 ◽  
Vol 7 (2) ◽  
pp. 67-77 ◽  
Author(s):  
Sergio De Filippis ◽  
Ilaria Cuomo ◽  
Georgios D. Kotzalidis ◽  
Daniela Pucci ◽  
Pietro Zingaretti ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Substance Use ◽  
Substance Use Disorder ◽  
Repeated Measures ◽  
Rating Scale ◽  
Type I ◽  
Open Label ◽  
Young Mania ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

Background: Asenapine is a second-generation antipsychotic approved in Europe for treating moderate-to-severe manic episodes in adults affected by type I bipolar disorder (BD-I). We aimed to compare its efficacy in psychiatric inpatients with BD-I, with or without substance use disorder (SUD). Methods: We administered flexible asenapine doses ranging from 5–20 mg/day to 119 voluntarily hospitalized patients with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) BD-I diagnosis, with or without SUD. Patients were assessed with clinician-rated questionnaires [i.e. Brief Psychiatric Rating Scale (BPRS), Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), and Global Assessment of Functioning (GAF)]. Assessments were carried out at baseline (T0, prior to treatment), and 3 (T1), 7 (T2), 15 (T3), and 30 days (T4) after starting treatment for all clinical scales and at T0 and T4 for the GAF. Results: Patients improved on all scales ( p < 0.001) across all timepoints, as shown both by paired-sample comparisons and by applying a repeated-measures, generalized linear model (GLM). Patients without comorbid SUD showed greater reductions in BPRS scores at T2 and T3, greater reduction in YMRS scores at T3, and lower HARS scores at all timepoints. HDRS scores did not differ between the two groups at any timepoint. However, the reduction in HARS scores in the comorbid group was stronger than in the BD-I only group, albeit not significantly. Side effects were few and mild-to-moderate. Conclusions: The open-label design and the relatively short observation period may expose to both type I and type II statistical errors (false positive and false negatives). Asenapine showed effectiveness and safety in hospitalized BD-I patients. Its effect was stronger in patients without comorbid SUD.

scholarly journals The impact of periventricular white matter lesions in patients with bipolar disorder type I

CNS Spectrums ◽  
2014 ◽  
Vol 21 (1) ◽  
pp. 23-34 ◽  
Author(s):  
Gianluca Serafini ◽  
Maurizio Pompili ◽  
Marco Innamorati ◽  
Nicoletta Girardi ◽  
Leonardo Strusi ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
White Matter ◽  
Rating Scale ◽  
Brain Magnetic Resonance Imaging ◽  
White Matter Lesions ◽  
Periventricular White Matter ◽  
Type I ◽  
Young Mania ◽  
Affective Symptoms ◽  
The Impact

IntroductionWhite matter hyperintensities (WMHs) are one the most common neuroimaging findings in patients with bipolar disorder (BD). It has been suggested that WMHs are associated with impaired insight in schizophrenia and schizoaffective patients; however, the relationship between insight and WMHs in BD type I has not been directly investigated.MethodsPatients with BD-I (148) were recruited and underwent brain magnetic resonance imaging (MRI). Affective symptoms were assessed using Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HDRS17); the presence of impaired insight was based on the corresponding items of YMRS and HDRS17.ResultsMultiple punctate periventricular WMHs (PWMHs) and deep WMHs (DWMHs) were observed in 49.3% and 39.9% of the cases, respectively. Subjects with lower insight for mania had significantly more PWMHs (54.6% vs 22.2%; p < 0.05) when compared to BD-I patients with higher insight for mania. The presence of PWMHs was independently associated with lower insight for mania: patients who denied illness according to the YMRS were 4 times more likely to have PWMHs (95% CI: 1.21/13.42) than other patients.ConclusionsImpaired insight in BD-I is associated with periventricular WMHs. The early identification of BD-I subjects with PWMHs and impaired insight may be crucial for clinicians.

A comparison of the symptomatic profile between two consecutive depressive episodes in patients with bipolar disorder type I

2010 ◽  
Vol 22 (6) ◽  
pp. 280-283 ◽  
Author(s):  
Marcia B De Macedo-Soares ◽  
Elisa Brietzke ◽  
Rodrigo Da Silva Dias ◽  
Tiago Mendonça ◽  
Camila Moreira ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Rating Scale ◽  
Type I ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Paranoid Symptoms ◽  
Loss Of Appetite ◽  
Depressive Episodes ◽  
Disorder Type

de Macedo-Soares MB, Brietzke E, da Silva Dias R, Mendonca T, Moreira C, Lafer B. A comparison of the symptomatic profile between two consecutive depressive episodes in patients with bipolar disorder type I.Objective:To compare the variability of patterns of depressive symptoms between two consecutive depressive episodes in patients with bipolar disorder type I.Methods:Review of prospectively collected data from 136 subjects of an out-patient bipolar unit from 1997 to 2007. Binomial statistics was used for the analysis of Hamilton Depression Rating Scale (HDRS)-31 items of the first and second episodes, and the correlation of the HDRS-31 item scores of both episodes was determined using the Spearman coefficient.Results:Ten depressive symptoms showed a significant correlation between index and subsequent episodes: psychological anxiety, somatic anxiety, somatic symptoms, diurnal variation, paranoid symptoms, obsessive and compulsive symptoms, hypersomnia, loss of appetite and helplessness. Only four symptoms were stable in both statistical tests: paranoid symptoms, obsessive–compulsive symptoms, loss of appetite and hypersomnia.Conclusions:Paranoid and obsessive–compulsive symptoms, loss of appetite and hypersomnia tended to be found in successive episodes. However, the moderate correlations of the symptoms across two depressive recurrences suggested that clinical presentations in bipolar depression may not be predicted by symptom profiles presented in previous episodes.

Relationship between cognitive functioning and 6-month clinical and functional outcome in patients with first manic episode bipolar I disorder

2010 ◽  
Vol 41 (5) ◽  
pp. 971-982 ◽  
Author(s):  
I. J. Torres ◽  
C. M. DeFreitas ◽  
V. G. DeFreitas ◽  
D. J. Bond ◽  
M. Kunz ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Clinical Outcome ◽  
Cognitive Functioning ◽  
Functional Outcome ◽  
Verbal Learning ◽  
Manic Episode ◽  
Type I ◽  
Co Morbidity ◽  
Dsm Iv ◽  
The Impact

BackgroundAlthough cognitive deficits in bipolar disorder have been associated with diminished functional outcome, this relationship has been studied primarily through cross-sectional designs, and has not been studied in patients early in the course of illness. The purpose of this study was to evaluate the impact of cognitive functioning on longitudinal 6-month functional and clinical outcome in recently diagnosed clinically stable patients with bipolar disorder.MethodA total of 53 recently diagnosed patients with DSM-IV bipolar disorder type I were assessed within 3 months of their first manic episode using a neuropsychological battery measuring verbal/pre-morbid intellectual functioning, learning/memory, spatial/non-verbal reasoning, attention/processing speed and executive function. Functional outcome was assessed at baseline and 6 months using the Multidimensional Scale of Independent Functioning (MSIF) and DSM-IV Global Assessment of Functioning Scale (GAF). Clinical outcome was assessed with symptom ratings and by monitoring onset of new mood episodes.ResultsMemory, particularly verbal learning/memory, was robustly associated with 6-month functional outcome on the MSIF, even after partialling out the influence of mood symptoms and substance abuse co-morbidity. Depression ratings at 6 months, but not cognitive variables, were associated with 6-month GAF scores. Cognitive functioning was not associated with 6-month clinical outcome.ConclusionsMemory was associated with 6-month longitudinal functional but not clinical outcome in recently diagnosed patients with bipolar disorder. These data further support the distinction between clinical and functional outcome, and emphasize the need for identification of, and development of treatments for, cognitive impairments early in the course of bipolar disorder.

Bipolar Disorder, Obesity and Cognitive Impairment

2017 ◽  
Vol 41 (S1) ◽  
pp. S207-S207 ◽  
Author(s):  
M. La Montagna ◽  
E. Stella ◽  
F. Ricci ◽  
L. Borraccino ◽  
A.I. Triggiani ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Problem Solving ◽  
Cognitive Deficits ◽  
Cognitive Functions ◽  
Visual Learning ◽  
Verbal Learning ◽  
Speed Of Processing ◽  
Anthropometric Measures ◽  
Cognitive Domains

IntroductionAccording to scientific literature, cognitive impairment is a disabling feature of the bipolar disorder (BD), present in all the phases of the disease. Obesity and metabolic disorders represent another risk factor for cognitive dysfunctions in BD, since the excess of weight could adversely influence several cognitive domains.ObjectiveTo highlight the presence of impairment of cognitive functions in a sample of subjects suffering from BD and obesity.AimsEvaluation of the cognitive performance in a sample of BD patients, considering their anthropometric measures (height and weight) and body mass index (BMI).MethodsThe neuropsychological battery MATRICS Consensus Cognitive Battery (MCCB) was administered by trained physicians for the evaluation of seven different cognitive domains in 46 patients (mean age: 43.17 years old; 39.13% male), affected by BD enrolled in the psychiatric unit of Azienda Sanitaria Locale and University of Foggia. In particular, cognitive functions assessed were speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition. BMI was calculated, and patients were divided into a group of normal weight and another one of overweight or obese, on the base of BMI value (BMI cut-off = 25).ResultsThe obese patients amounted at 56.52%. We have found the presence of cognitive deficits in two of the seven domains assessed, that are speed of processing (P < 0.01) and reasoning and problem solving (P < 0.05) in the sample of overweight patients.ConclusionsCognitive deficits are clearly revealed in BD patients during the euthymic phase of the disorder. The obesity in BD could contribute to increase dysfunctions in cognitive domains.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Clinical Impact of Psychopathy on Bipolar Disorder

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 165
Author(s):  
Giuseppina Calabrò ◽  
Antonio Francesco Musolino ◽  
Andrea Adolfo Filippo ◽  
Renato de Filippis ◽  
Elvira Anna Carbone ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Personality Disorders ◽  
Rating Scale ◽  
Psychopathic Personality ◽  
Type I ◽  
Young Mania ◽  
Manic Symptoms ◽  
Affective Symptoms ◽  
Group 3 ◽  
Group 1

Background and Objectives. Bipolar disorder (BD) is associated with a significant burden due to affective symptoms and behavioral manifestations, but also cognitive and functional impairment. Comorbidity with other psychiatric conditions, including personality disorders, is frequent. The comorbidity with psychopathy deserves special consideration given that both disorders share some clinical characteristics, such as grandiosity, risky behavior or poor insight, among others, that can worsen the outcome of BD. Therefore, this study aimed to evaluate the prevalence of psychopathy in a sample of clinically stabilized patients with BD and its impact on the severity of BD. Materials and Methods. A sample of 111 patients with BD (38 type I and 73 type II) was studied. The Hamilton Depression Rating Scale (HAM-D) and the Young Mania Rating Scale (YMRS) served to assess the severity of BD. Psychopathy was measured by means of the Psychopathic Personality Inventory-Revised (PPI-R). Patients were divided into three groups according to the severity of psychopathy (Group 1: no psychopathy; Group 2: “psychopathic” trait; Group 3: clinical psychopathy). Other measures regarded impulsiveness (Barratt Impulsiveness Scale-11, BIS-11) and empathy (Empathy Quotient, EQ). Comparisons of mania, depression, impulsivity and empathy scores were run with MANOVA considering psychopathy and diagnosis as independent variables. Results. The prevalence of psychopathy was 5.4%. A significant association between the level of psychopathy and YMRS, attentional/cognitive impulsivity and motor impulsivity scores emerged. No interaction between psychopathy and BD diagnosis was found. Post hoc analysis demonstrated significantly higher YMRS scores in Group 3 than in Group 1; that is, patients with psychopathy have more manic symptoms. Conclusion. Psychopathy seems quite frequent among patients with BD. The association of psychopathy with BD results in higher impulsivity and manic symptoms. In light of this, psychopathy should be investigated when assessing patients with BD, regardless of the comorbidity of BD with other personality disorders.

scholarly journals Latent Profiles of Cognitive Control, Episodic Memory, and Visual Perception Across Psychiatric Disorders Reveal a Dimensional Structure

2019 ◽  
Vol 46 (1) ◽  
pp. 154-162 ◽  
Author(s):  
Jason Smucny ◽  
Ana-Maria Iosif ◽  
Nicholas R Eaton ◽  
Tyler A Lesh ◽  
J Daniel Ragland ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Control ◽  
Episodic Memory ◽  
Latent Profile Analysis ◽  
Rating Scale ◽  
Mental Illnesses ◽  
Diagnostic Ratios ◽  
Type I ◽  
Patient Profile ◽  
Latent Profiles

Abstract Although meta-analyses suggest that schizophrenia (SZ) is associated with a more severe neurocognitive phenotype than mood disorders such as bipolar disorder, considerable between-subject heterogeneity exists in the phenotypic presentation of these deficits across mental illnesses. Indeed, it is unclear whether the processes that underlie cognitive dysfunction in these disorders are unique to each disease or represent a common neurobiological process that varies in severity. Here we used latent profile analysis (LPA) across 3 distinct cognitive domains (cognitive control, episodic memory, and visual integration; using data from the CNTRACS consortium) to identify distinct profiles of patients across psychotic illnesses. LPA was performed on a sample of 223 psychosis patients (59 with Type I bipolar disorder, 88 with SZ, and 76 with schizoaffective disorder). Seventy-three healthy control participants were included for comparison but were not included in sample LPA. Three latent profiles (“Low,” “Moderate,” and “High” ability) were identified as the underlying covariance across the 3 domains. The 3-profile solution provided highly similar fit to a single continuous factor extracted by confirmatory factor analysis, supporting a unidimensional structure. Diagnostic ratios did not significantly differ between profiles, suggesting that these profiles cross diagnostic boundaries (an exception being the Low ability profile, which had only one bipolar patient). Profile membership predicted Brief Psychiatric Rating Scale and Young Mania Rating Scale symptom severity as well as everyday communication skills independent of diagnosis. Biological, clinical and methodological implications of these findings are discussed.

Evaluation of Cognitive Dysfunction in a Sample of Patients Affected by Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S212-S212
Author(s):  
E. Stella ◽  
M. La Montagna ◽  
L. Borraccino ◽  
F. Ricci ◽  
A.I. Triggiani ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Working Memory ◽  
Problem Solving ◽  
Verbal Memory ◽  
Visual Learning ◽  
Verbal Learning ◽  
Healthy Controls ◽  
Speed Of Processing ◽  
Cognitive Disturbances ◽  
Competing Interest

IntroductionCognitive dysfunctions concerning working memory, attention, psychomotor speed, and verbal memory are a disabling feature of the bipolar disorder (BD). According to scientific literature, cognitive disturbances are present not only in depressive and manic phases of BD, but also during the euthymic period, without regard to whether or not drugs are assumed.ObjectiveTo determine the presence of one or more dysfunctions in cognitive domains in a sample of subjects suffering from BD, in euthymic phase, compared with healthy controls.AimsEvaluation of the following cognitive performances in subjects affected by BD: speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition.MethodsForty-six patients affected by BD in the euthymic phase (mean age: 43.17 years old; 39.13% male), and 58 healthy controls (mean age: 39.21 years old; 51.72% male) were enrolled in the psychiatric unit of Azienda Sanitaria Locale, Foggia. The neuropsychological battery MATRICS Consensus Cognitive Battery (MCCB) was administered by trained psychiatrists.ResultsWe found the presence of cognitive impairment, affecting six out of seven of cognitive functions assessed (P < 0.001): speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving.ConclusionsThese preliminary results from our case-control study show that cognitive deficits are clearly present also during the euthymic phases of subjects with bipolar disorder (mainly pertaining attention/vigilance domain). These cognitive abnormalities may represent a biomarker of bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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