ASSESSMENT OF COGNITIVE FUNCTION, SOCIAL DISABILITY AND BASIC LIFE SKILLS IN EUTHYMIC PATIENTS WITH BIPOLAR DISORDER

Background: Data from the literature suggests the presence of cognitive impairments which persist in the euthymic phase of bipolar disorder (BD) and have significant consequences in regards to psychosocial functioning. The aims of our study were: 1) to ascertain the cognitive function (CF), social disability (SD) and basic life skills (BLS) of euthymic patients diagnosed with BD, 2) their relationship and 3) to compare CF, SD and BLS in euthymic patients diagnosed with BD to euthymic patients with recurrent major depressive disorder (rMDD).Subjects and methods: Ninety eight euthymic patients diagnosed either with BD (N=48, mean age 48.79 years, SD = 8.587) or rMDD (N=50, mean age 50.02 years, SD = 9.826) underwent testing using the Brief Assessment of Cognition in Affective Disorders (BAC-A) test, the Sheehan Disability Scale (SDS) and the UCSD performance-based skills assessment (UPSA-brief). Results: Euthymic patients with BD demonstrated significantly lower scores as compared to normal population values in verbal, learning and working memory, verbal fluency, attention and processing speed, affective memory for negative and positive words (p?0.01 each) and motor speed (p<0.05), but not for reasoning/problem solving (p=0.05). Furthermore, their mean total SDS score of 17.60 (SD = 6.450, Sk = -0.833) and its subscale scores were higher, while their UPSA-B total scores were lower (M = 76.01, SD = 17.148, Sk = -0.412). There was a correlation between CF, SD and BLS scores (p<0.01), as well as between BLS and SD scores (p<0.05). The analysis of variance did not however show significant differences between subgroups of patients. Conclusion: Patients with euthymic BD had lower cognitive function, greater social disability and lower basic life skills. There were similar decreases in cognitive and psychosocial function between patients in the euthymic phase of either BD or MDD.

A-063 Viewer Engagement Modulates Activation of Social Brain Systems: Evidence from a Natural Viewing fMRI Paradigm

Objective Engagement is critical for social learning—information that does not engage cognition, even when looked at, will go unprocessed and unlearned. Consequently, atypical engagement can contribute to social disability. Despite its importance, the neural mechanisms underlying engagement remain unknown, largely because no studies have successfully quantified the individualized ways that viewers engage with the world. This study uses patterns of eye-blinking—a novel measure of engagement (Shultz, Klin, Jones, 2011)—to examine how a viewer’s own engagement with social stimuli (e.g. faces) modulates activation of social brain systems. Method Simultaneous functional MRI and eye-tracking data were collected while children (n = 12, ages 8–12) watched naturalistic social videos of children interacting. Eye-fixation and blink patterns were used to identify moments when viewers looked at a face and were ‘highly engaged’ or ‘less engaged’ with those faces. Whole-brain analyses compared brain activation in response to each condition of interest (‘highly engaging faces’, ‘less engaging faces’). Results Whole-brain analyses (z = 2.3, cluster corrected at p < .05) reveal increased activation in bilateral occipital cortex, left middle temporal gyrus, bilateral posterior cingulate, left orbitofrontal cortex and inferior frontal gyrus, right angular gyrus, and right fusiform gyrus, when viewing faces perceived as ‘highly engaging’ versus ‘less engaging’. Conclusion Findings suggest that even when viewing the same stimulus category (e.g. faces), one’s own engagement with the stimulus modulates brain activation, even in canonical face processing areas like the fusiform gyrus. Insights into the neural mechanisms of engagement can inform future understanding of social disability and interventions for social learning.

The challenge of inclusive cities

The purpose of this article is to establish a link between lack of accessibility and social unhappiness. This current scenario will be considered in the work to solve this problem, to present technology as a solution. Despite the fact that we can prove the effectiveness of technologies for inclusion and, therefore, the quality of life, we will consider the complexity of this system. The article concludes on issues of confidentiality, the need for technology, the participation of science in constructive changes in society; change based on a social disability model; by ensuring all these criteria, technology would help shape a city where everyone could live and thrive, regardless of their physical or mental condition.

Systematic Description of 3q29 Duplication Syndrome Reveals New Syndromic Phenotypes: Results from the 3q29 Registry

ABSTRACT3q29 duplication syndrome (3q29Dup) is a rare genomic disorder caused by the reciprocal duplication of the 1.6 Mb 3q29 deletion syndrome region. Case reports indicate the 3q29Dup is likely to be pathogenic, but because no systematic study of the syndrome exists, the full range of manifestations is not well-understood. To develop a better understanding of 3q29 duplication syndrome, we used the 3q29 registry (https://3q29deletion.patientcrossroads.org/) to ascertain 31 individuals with 3q29Dup, the largest cohort ever surveyed in a systematic way. For comparison, we ascertained 117 individuals with the reciprocal 3q29 deletion syndrome (3q29Del) and 64 typically developing controls. We used a custom medical and demographic questionnaire to assess physical and developmental phenotypes, and two standardized instruments, the Social Responsiveness Scale (SRS) and Achenbach Behavior Checklists (CBCL/ABCL), to assess social disability. We find that our 3q29Dup participants report a high rate of problems in the first year of life (80.6%), including feeding problems (58%), failure to gain weight (42%), hypotonia (39%), and respiratory distress (29%). In early childhood, learning problems (87.1%) and seizures (25.8%) are common. Additionally, we find a rate of self-reported ASD diagnoses (39%) similar to that previously identified in 3q29Del (29%), and the granular characteristics of social disability measured using the SRS and CBCL/ABCL are comparable between 3q29Dup and 3q29Del. This is the most comprehensive description of 3q29Dup to date. Our findings can be used to develop evidence-based strategies for early intervention and management of 3q29 duplication syndrome.

Co-production of a pictorial recovery tool for people with psycho-social disability informed by a participatory action research approach—a qualitative study set in India

Mental health problems are recognized as a leading cause of disability and have seen increased allocations of resources and services globally. There is a growing call for solutions supporting global mental health and recovery to be locally relevant and built on the knowledge and skills of people with mental health problems, particularly in low-income countries. Set in Dehradun district, North India, this study aimed to describe first, the process of co-production of a visual tool to support recovery for people affected by psycho-social disability; second, the key outputs developed and third, critical reflection on the process and outputs. The developmental process consisted of participatory action research and qualitative methods conducted by a team of action researchers and an experts by experience (EBE) group of community members. The team generated eight domains for recovery under three meta-domains of normalcy, belonging and contributing and the ensuing recovery tool developed pictures of activities for each domain. Challenges to using a participatory and emancipatory process were addressed by working with a mentor experienced in participatory methods, and by allocating time to concurrent critical reflection on power relationships. Findings underline the important contribution of an EBE group demonstrating their sophisticated and locally valid constructions of recovery and the need for an honest and critically reflective process in all co-productive initiatives. This study generated local conversations around recovery that helped knowledge flow from bottom-to-top and proposes that the grass-root experiences of participants in a disadvantaged environment are needed for meaningful social and health policy responses.