Overall Functioning In Patients Research Articles

Assessment of executive functions through a virtual reality task in euthymic patients with bipolar disorder and influence in psychosocial functioning

Introduction Previous research has shown that neurocognitive deficits, especially deficits in executive functions, may persist during euthymia in in patients with bipolar disorder (BD) and that those are associated with an impairment of psychosocial functioning. The assessment of executive functions (EFs) is normally carried out using laboratory tests. Novel methodologies such as virtual reality (VR) allow the creation of immersive environments, to evaluate executive performance with greater potential for ecological validity than evaluations with standard tasks. Objectives The objectives of this project are to evaluate executive performance in euthymic patients with BD with a novel virtual reality task compared to standard computerized tasks, and to find predictors of functioning associated with cognitive performance. Methods This is a cross sectional study in which 46 euthymic patients with BD treated at La Fe University and Polytechnic Hospital were assessed with a battery of standard computerized tasks (ST) (TMT/Stroop,/Go-No-Go/TOL/DOT) and with the Cooking Task virtual reality task. The Cooking Task presents 4 tasks of increasing difficulty in which you must cook food in a specific time. It records total time to complete the task, whether food is cooled or burned, the simultaneous use of two fires, the proper use of seasonings and the time to set the table. Functioning was assessed with the Functioning Assessment Short Test (FAST) that evaluates the overall functioning of patients with a mental illness in 6 subscales. Correlation analyses between cognitive performance variables and clinical variables were done. Multiple linear regression was performed with the FAST score as a dependent variable and cognitive performance variables and relevant clinical variables to executive functioning (months of euthymia, age, and number of total episodes) were included as independent variables. Results A worse psychosocial functioning was significantly associated with a worse performance in standard tasks (TMTA, TMTB, STROOP, and TOL) and cooking task (total time spent on task 2, burning time and total time spent on task 3, and total time spent on task 4). In the regression analysis, the correct simultaneous use of the two fires was the best predictor of a better psychosocial functioning in BD patient. This implies the preserved ability of planning and performing dual tasks. Conclusions Our findings suggest that euthymic patients with BD present deficits in executive functions related with a worse psychosocial functioning. Among the tasks, the cooking task may have a greater sensitivity than standards task to predict real functioning. This in an opportunity to design virtual applications for diagnostic and therapeutic purposes. Disclosure of Interest None Declared

Impact of Somatic and Addictive Comorbidities on the Quality of Life of Patients With Schizoaffective Disorder: A cross-sectional study

IntroductionSchizoaffective disorder is a mental health disorder frequently associated with somatic and addictive comorbidities. This association can be dangerous as it may change the expression of the disease and its prognosis and may even affect the quality of life (QOL) and the overall functioning of patients.ObjectivesThis study aimed to investigate the impact of somatic and addictive comorbidities on QOL and the overall functioning of patients with schizoaffective disorder.MethodsThis paper is a cross-sectional descriptive study conducted at the Department of Psychiatry within outpatient settings over six months. We evaluated the QOL using the SF-36 and Global Assessment of Functioning scale (GAF). We included all patients suffering from a schizoaffective disorder and excluded patients with associated mental impairment, those we could not assess because of another disability, and those with missing records.ResultsFifty-two patients with schizoaffective disorder met our inclusion criteria with an average age of 38. This study found somatic comorbidities in 30.8% of patients, where diabetes ranked first (13.5%), followed by high blood pressure (9.6%). We noted addictive comorbidities in 63.5% of patients, with tobacco, alcohol, and Cannabis being the most consumed substances, with respective rates of 57.7 %,28.8 %, and 13.5%.The QOL assessment revealed an impaired QOL score in 80.8% of patients, whereas 65.4% had a GAF score lower than 70 indicating a deterioration of functioning level. Our results showed that dimension D1 (physical activity) of the SF-36 was strongly influenced by somatic comorbidities, according to an analytical investigation of the association between these two variables (p = 10-4). We also found that the deterioration in the patient’s global functioning was not significantly related to somatic comorbidities (p = 0.28). Furthermore, our studies showed no association between impaired quality of life and substance abuse.ConclusionsSomatic comorbidities and substance abuse have a detrimental effect on patients with pre-existent schizoaffective disorder, and the goals of patient care with a schizoaffective illness go beyond the remission of clinical symptoms to the improvement of quality of life and socio-professional functioning.Disclosure of InterestNone Declared

Familial load of psychiatric disorders and overall functioning in patients newly diagnosed with bipolar disorder and their unaffected first-degree relatives

Familial load of psychiatric disorders and overall functioning in patients newly diagnosed with bipolar disorder and their unaffected first-degree relatives

Familial load of psychiatric disorders and overall functioning in patients newly diagnosed with bipolar disorder and their unaffected first-degree relatives

BackgroundOverall functioning is already impaired in patients newly diagnosed with bipolar disorder (BD) and, to a lesser degree, also in their unaffected first-degree relatives (UR). Further, aggregation of psychiatric disorders among the patients’ first-degree relatives seems to be associated with higher illness burden and poorer prognosis. However, whether this aggregation of psychiatric disorders among first-degree relatives, the familial load (FL), impacts overall functioning in patients newly diagnosed with BD and their UR remains unresolved.MethodsIn total, 388 patients newly diagnosed with BD, 144 of their UR and 201 healthy control individuals were included. Overall functioning was assessed using three different assessment methods: The interviewer based “Functioning Assessment Short Test” (FAST), the questionnaire “Work and Social Adjustment Scale” (WSAS) and six outcome measures covering the participants’ socio-economic status (SES); educational achievement, employment, work ability, relationship, cohabitation and marital status. Familial load of psychiatric disorder was assessed using the “Family History Research Diagnostic Criteria” interview. Associations between FL and overall functioning in patients and UR were investigated categorically using logistic and continuously in linear regression models.ResultsContrasting with the hypotheses, the FL of psychiatric disorders was not associated with impaired overall functioning, neither in patients newly diagnosed with BD nor in their UR.ConclusionThe findings indicate that impaired functioning in the early phase of BD is not associated with aggregation of psychiatric disorders among first-degree relatives. The observed functional impairment in patients newly diagnosed with BD seems driven by the personal impact of the disorder rather than the impact of having first-degree relatives with psychiatric disorders. Keywords: bipolar disorder, first-degree relatives, familial load of psychiatric disorders, functioning, socio-economic status.

Factors associated with overall functioning in patients with schizophrenia in a general hospital in Peru

ObjectiveTo evaluate the influence of the factors associated with overall functioning in patients with schizophrenia who attended the outpatient clinic of the Hospital Nacional de la Policía [National Police Hospital] “Luis Nicasio Saenz” in 2018–2019. MethodologyNon-experimental quantitative study of a descriptive cross-sectional correlational type. Convenience sampling was carried out, and consisted of 53 patients with schizophrenia. Functioning Assessment Short Test (FAST) was used to assess overall functioning, the Screen for Cognitive Impairment in Psychiatry (SCIP) for cognitive functioning, and a data collection sheet with sociodemographic data and a history of the disease. ResultsIt was found that 34 (62.2%) patients were male; 52 (98.1%), single; 39, (73.6%) without a current job. We found worse overall functioning in patients with a lower educational level (P = .005) and without a current job (P = .004). The total FAST was correlated with the time of the disease (ρ = 0.334, P < .05), the number of previous psychotic episodes (ρ = 0.354, P < .01), the total SCIP score (ρ = 0.542, P < .01) and their working memory dimension (VMT) (ρ = −0.523, P < .05). In the multiple linear regression model, it was found that the variables that most influenced the FAST were the total SCIP score (Beta = −0.528) and the number of previous psychotic episodes (Beta = 0.278). ConclusionThe associated factors that most influence overall functioning in this sample of Peruvian patients with schizophrenia are cognitive functioning and the number of previous psychotic episodes.

The acceptability of primary care or community-based behavioural interventions for persistent physical symptoms: Qualitative systematic review.

Persistent physical symptoms (PPS) are often associated with profound physical disability and psychological distress. Interventions for PPS that promote behavioural change aim to reduce levels of symptoms and improve overall functioning in patients. The evidence for these interventions is mixed, with effective relationships between patients and health practitioners (HPs) reported as the key to the success of primary care interventions. The objectives of this systematic review were to synthesize the qualitative evidence and to evaluate the acceptability of behavioural interventions for PPS in primary care, from the perspective of both patients and HPs. A comprehensive literature search was conducted in seven major electronic bibliographic databases, to February 2019. The aim was to identify a broad range of literature including, qualitative research, mixed methods research, and qualitative data embedded in trial reports or process evaluations. Fifty-eight full papers were screened against the inclusion criteria. Nine studies were included and quality-assessed. A qualitative evidence synthesis was conducted using thematic synthesis. Some patients and HPs reported positive gains from taking part in or delivering interventions, with appropriate support and explanation of their symptoms important for patients. Barriers appeared to be underpinned by the relationship between the patients and HPs, and by beliefs and attitudes held by both parties. Patients should be provided with adequate information to make an informed decision about whether an intervention is appropriate for them, and interventions should not end suddenly or without adequate follow-up. HPs should receive training and supervision to address their lack of confidence, and improve their knowledge of PPS.

Subsyndromal symptoms in bipolar disorder

Introduction The inter-critical phase in bipolar disorder may contain symptoms that do not meet the diagnostic criteria for a thymic episode. According to studies, these symptoms are common and usually associated with impaired psychosocial and family functioning.ObjectivesStudy the subsyndromal symptoms in remitted patients with bipolar disorder, and their functioning repercussions.MethodsWe conducted a cross-sectional, descriptive and analytical study, in the outpatient psychiatry department of the University Hospital in Sfax (Tunisia) among 30 remitted patients with bipolar disorder. We used: the Montgomery And Asberg Depression Rating Scale (MADRS), the Angst Hypomania Questionnaire and the FAST test to assess functioning levels.ResultsThe average age of our population was 44.37±15.45 years with a sex ratio (M/F) =0.66. Most of them lived in urban areas (60%) and half of them did not go beyond the primary school level. Most did not have a constant job (76.6%). The average number of previous thymic episodes was 2±1.33 times/year. A quarter of the patients (26.6%) had hypomanic symptoms in the intercritical phase and 20% had depressive symptoms. Hypomanic symptoms were correlated with tobacco use (p=0.035). Depressive symptoms weremore frequent in men (p=0.074). Functioninglevel was lower in subjects living in rural areas (p=0.065).ConclusionsOur study suggests that residual symptoms were frequent with a significant functional impact. As a result, their identification and management are highly essential to improve the overall functioning of patients with bipolar disorder.

Factores asociados al funcionamiento global en pacientes con esquizofrenia de un hospital general del Perú

ObjectiveTo evaluate the influence of the factors associated with overall functioning in patients with schizophrenia who attended the outpatient clinic of the Hospital Nacional de la Policía [National Police Hospital] “Luis Nicasio Saenz” in 2018-2019. MethodologyNon-experimental quantitative study of a descriptive cross-sectional correlational type. Convenience sampling was carried out, and consisted of 53 patients with schizophrenia. Functioning Assessment Short Test (FAST) was used to assess overall functioning, the Screen for Cognitive Impairment in Psychiatry (SCIP) for cognitive functioning, and a data collection sheet with sociodemographic data and a history of the disease. ResultsIt was found that 34 (62.2%) patients were male; 52 (98.1%), single; 39, (73.6%) without a current job. We found worse overall functioning in patients with a lower educational level (p=0.005) and without a current job (p=0.004). The total FAST was correlated with the time of the disease (ρ=0.334, p <0.05), the number of previous psychotic episodes (ρ=0.354, p <0.01), the total SCIP score (ρ=0.542, p <0.01) and their working memory dimension (VMT) (ρ=-0.523, p <0.05). In the multiple linear regression model, it was found that the variables that most influenced the FAST were the total SCIP score (Beta=-0.528) and the number of previous psychotic episodes (Beta=0.278). ConclusionThe associated factors that most influence overall functioning in this sample of Peruvian patients with schizophrenia are cognitive functioning and the number of previous psychotic episodes.

T68. RELATIONSHIP BETWEEN GLOBAL AND COGNITIVE FUNCTIONING IN PATIENTS WITH SCHIZOPHRENIA IN A GENERAL HOSPITAL IN PERU

BackgroundSchizophrenia is a chronic mental disorder, which produces high costs and has a substantial impact on health care budgets globally. This is mainly due to poor global and cognitive functioning in these patients. The objective of this study was to relate global functioning and cognitive functioning in patients with schizophrenia who attend the outpatient clinic of a general hospital in Peru during the years 2018–2019.MethodsNon-experimental quantitative study of descriptive cross-sectional correlational type. The sample was for convenience, and consisted of 53 patients with schizophrenia from the “Hospital Nacional de la PNP”. Functioning Assessment Short Test (FAST) was used to assess global functioning, the Screen for Cognitive Impairment (SCIP), cognitive functioning, and a data collection sheets with the history of the disease.The relationship between FAST and SCIP with the qualitative variables was evaluated by the Mann-Whitney U test or Student’s t test depending on whether they met the normality assumptions. The linear correlation between the FAST, the SCIP and the other quantitative variables was evaluated using Spearman’s Rho.A multiple linear regression model was constructed in which all variables other than the total FAST result are considered using the forward method.ResultsIt was found that 34 (62.2%) were male; 52 (98.1%), single; 39, (73.6%) without a current job. We found worse overall functioning in patients with lower educational level (p = 0.005) and without a current job (p = 0.004). The total FAST was correlated with the time of the disease (ρ = 0.334, p <0.05) and with the number of previous psychotic episodes (ρ = 0.354, p <0.01). We found worse cognitive functioning in patients with lower educational level (p = 0.000) and without a current job (p = 0.017). The SCIP total was correlated to the FAST (ρ = 0.542, p <0.01).The multiple linear regression analysis with the total FAST score as the explained variable evidenced the existence of a relationship between variables that is explained by the equation:Y = 57.032 + (-0.521) X1 + (1.896) X2Where Y is the total FAST score, X1 the total SCIP and X2 the number of previous psychotic episodes. The coefficient of determination was 0.392 and the mean square error of 161.46. The Durbin-Watson statistic was 1,529.DiscussionThis is the first exploratory pilot analysis of the factors associated with global functioning, with special emphasis on cognitive functioning and the history of the disease, in Peruvian patients with schizophrenia.Patients with higher educational level and those who have a current job showed a better global and cognitive functioning. It was found an indirect and significant relationship of moderate intensity between cognitive functioning and its subtest with global functioning, that is, a lower level of cognitive functioning is related to greater difficulties in the daily functioning of patients with schizophrenia. Both the bivariate analysis and the linear regression model found a relationship between global and cognitive functioning. In the multiple linear regression model, it was found that the total SCIP was the one that had the most influence on global functioning (Beta = -0.528), that is, lower levels of cognitive functioning are related to high levels of poor global functioning.Taking these results into account, we recommend implementing functional and cognitive evaluation programs in patients with schizophrenia at the “Hospital Nacional de la PNP”. Future longitudinal studies should be performed on samples from larger patients, especially with a first psychotic episode, with the purpose of seeking a cause-effect relationship between global and cognitive functioning in patients with schizophrenia.

Schizophrenia and drug addiction comorbidity: recent advances in our understanding of behavioural susceptibility and neural mechanisms

Schizophrenia is a severe psychiatric disorder which is worsened substantially by substance abuse/addiction. Substance abuse affects nearly 50% of individuals with schizophrenia, extends across several drug classes (e.g. nicotine, cannabinoids, ethanol, psychostimulants) and worsens overall functioning of patients. Prominent theories explaining schizophrenia and addiction comorbidity include the primary addiction hypothesis (i.e. schizophrenia susceptibility primes drug reward circuits, increasing drug addiction risk following drug exposure), the two-hit hypothesis (i.e. drug abuse and other genetic and/or environmental risk factors contribute to schizophrenia development) and the self-medication hypothesis (i.e. drug use alleviates schizophrenia symptoms). Animal models can be used to evaluate the utility and validity of these theories. Since this literature was last reviewed by Ng and colleagues in 2013 [Neurosci Biobehav Rev, 37(5)], significant advances have been made to our understanding of schizophrenia and substance abuse comorbidity. Here we review advances in the field since 2013, focussing on two key questions: 1) Does schizophrenia susceptibility increase susceptibility to drug addiction (assessing the primary addiction hypothesis), and 2) Do abused drugs exacerbate or ameliorate schizophrenia symptoms (assessing the two-hit hypothesis and the self-medication hypothesis). We addressed these questions using data from several schizophrenia preclinical models (e.g. genetic, lesion, neurodevelopmental, pharmacological) across drug classes (e.g. nicotine, cannabinoids, ethanol, psychostimulants). We conclude that addiction-like behaviour is present in several preclinical schizophrenia models, and drugs of abuse can exacerbate but also ameliorate schizophrenia-relevant behaviours. These behavioural changes are associated with altered receptor system function (e.g. dopaminergic, glutamatergic, GABAergic) critically implicated in schizophrenia and addiction pathology.

A Meta-Analysis of the Effect of Interpersonal and Social Rhythm Therapy on Symptom and Functioning Improvement in Patients with Bipolar Disorders

We conducted a meta-analysis by analyzing randomized controlled trials (RCTs), to investigate whether interpersonal and social rhythm therapy (IPSRT) exerts improvement effects on patients with bipolar disorders. We searched for relevant articles in 8 databases, included PubMed, Medline, CINAHL, Embase, PsycArticles, PsycInfo, Cochrane, and CEPS, without limitations on publication year and language. Randomized controlled trials (RCTs) used IPSRT as an intervention, and patients with bipolar disorders were included. Two reviewers independently searched, screened the articles, and extracted the data. Treatment effects, heterogeneity, publication bias, and risk of bias were examined. Analyses were performed using the random-effects model. We included and analyzed 5 independent RCTs with 631 patients. IPSRT significantly improved overall functioning (i.e. occupational, social, and impaired functioning; Hedges’s g (g) = −0.344); however, IPSRT did not significantly improve the symptoms. IPSRT had small effects on improving overall functioning in patients with bipolar disorders, which suggested that IPSRT was an adjunctive treatment. This meta-analysis showed that IPRST was effective in improving overall functioning for patients with bipolar disorders.

Elaborate Ways for Rehabilitation Stroke Patients Using Drug Treatment with Cerebrolysin vs. Advanced Physical Therapy Techniques

Stroke patients are a major problem for their families because of the weight and limitations of recovery procedures. In this study, it is desired to show the benefits of virtual reality utilization both singularly and in tandem with the drug, namely the dual use of virtual realities and cerebrolysin. The aim of the study was to evaluate the overall functioning of patients diagnosed with stroke and their recovery.We compare patients who received drug treatment and physiotherapy and those who benefited from advanced physiotherapy (assisted by virtual reality) and drug treatment. The study group has a total of 42 participants (15 women and 27 men), of whom 22 received medical treatment and 20 underwent medical treatment and a virtual reality based physical therapy. The study also shows the starting point for rehabilitation respectively that how started rehabilitation prior to the 1-year mark and after the 1 year mark.The analysis was carried out over a period of 1.5 years in the hospital with a specially militarized status for the former patients and followers for a period of 1 years and seeing their evolution in several tests of: balance, posture, speed and assessment of the degree of functionality. The Health Improvement Analysis was done on these parameters and on the answers given in a clinical self-evaluation questionnaire. The physical therapy and exercise added to medical treatment play a considerable part in the recovery of overall functioning of patients with stroke.

Oriented mentalization-based treatment for borderline personality disorder patients: preliminary results at Camposampiero Mental Health Center.

This contribution presents two brief reports about preliminary results of 18 months of oriented Mentalization-Based Treatment (MBT), with Borderline Personality Disorder patients, recruited at the Camposampiero Mental Health Center. Following in large part Bateman and Fonagy guidelines for MBT in institutional settings, this paper presents preliminary results in two brief reports related to two cohorts of patient underwent to the oriented MBT in Camposampiero Mental Health Center (MHC). In the first study, we analyzed a group of 9 patients: an anamnestic schedule was administered; then, symptoms (SCL-90-R), psychodiagnostic scale and global health functioning (Health of the Nation Outcome Scale, Structured Clinical Interview for DSM-IV Axis II Disorder [SCID-II], Global Assessment of Functioning, [GAF]), data on service impact and service costs (Cassel Community Adjustment Questionnaire, Patient Evaluation Schedule and folder data) were provided at the beginning (T0), at the end of the treatment (T2) and 1 year after the end of the MBT project. The second study showed a micro-analytical change on a second patient cohort (n=6) at T0, 3, 6 and 9 months (T1) were presented considering specifically mentalization (Comparative Psychotherapy Process Scale, Modes of Mentalization Scale, Mentalization Imbalances Scale) and patienttherapist session evaluation trends (Session Evaluation Questionnaire) and patient reflective functioning at T0 and T2 (Reflective Functioning Questionnaire). Aims and hypotheses of the two studies pointed out how the oriented MBT bring to an improvement of the overall functioning of the patients, a reduction of the symptoms, a decrease of the diagnostic criteria for the Borderline Personality Disorder (BPD) and the other Axis II disorders, a reduction of the workload hours for the MHC staff and of the costs of the assistance. The analyses of both the studies were carried out using non-parametric statistics (Friedman test, Spearman correlation, Chi-square). Preliminary results confirmed the improvement in the overall functioning of patients (GAF), the reduction in BPD-related symptoms and in diagnostic criteria for BPD (SCID-II), the improvement of patients’ mentalization skills, and a significant reduction in workload for health staff. Standing the limits and the preliminary results, the two brief reports demonstrate the feasibility of an oriented MBT within an Italian Public Service and the effectiveness of this treatment pathway for patients with BPD, leaving some open questions to stimulate a fruitful clinical discussion.

Predictive factors of overall functioning improvement in patients with chronic schizophrenia and schizoaffective disorder treated with paliperidone palmitate and aripiprazole monohydrate.

Long-acting injectable (LAI) antipsychotics can improve medication adherence and reduce hospitalisation rates compared with oral treatments. Paliperidone palmitate (PAL) and aripiprazole monohydrate (ARI) LAI treatments were associated with improvements in global functioning in patients with schizophrenia. The objective of this study was to assess the predictive factors of better overall functioning in patients with chronic schizophrenia and schizoaffective disorder treated with PAL and ARI. Enrolled were 143 (97 males, 46 females, mean age 38.24years, SD=12.65) patients with a diagnosis of schizophrenia or schizoaffective disorder, whom we allocated in two groups (PAL and ARI treatments). We assessed global functioning, amount of oral medications, adherence to oral treatment, and number of hospitalisations before LAI introduction and at assessment time point. Longer treatment time with LAIs (p<.001), lower number of oral drugs (p<.001), and hospitalisations (p=.002) before LAI introduction, and shorter duration of illness (p=.038) predicted better Global Assessment of Functioning scores in the whole sample (R2 =0.337). Early administration and longer duration of ARI or PAL treatments could play a significant role in improving global functioning of patients with schizophrenia and schizoaffective disorder. Better improvement in functioning could be achieved with ARI in young individuals with recent illness onset and PAL in patients at risk for recurrent hospitalisations.

Early-onset psychosis: What is the diagnostic outcome?

Background and objectivesSchizophrenia and bipolar disorder may show overlapping symptom profiles especially in early-onset cases. The aim of this study was to establish a final diagnosis, examine possible similarities and differences in symptom presentations, and overall functioning of patients with early-onset psychotic episode. MethodsAdolescents, presenting with at least one psychotic symptom, who were clinically followed up for at least 6 months, constituted our sample. Psychiatric diagnoses were established by using Schedule for Affective Disorders and Schizophrenia for School Aged Children Present-Lifetime Version (K-SADS-PL), psychotic symptoms were assessed by Positive and Negative Syndrome Scale (PANSS), and level of functioning was determined by Children's Global Assessment Scale (CGAS). ResultsOf 51 patients, 55% received a diagnosis of Psychotic Disorder (PD) and 45% a Mood Disorder (MD). Besides a major overlap in symptom presentation, there were significant differences in distribution. Hallucinations, disorganized speech, and withdrawal/isolation were encountered significantly more in the PD group, whereas hyperactivity, increased speech, and aggression were significantly more frequent in the MD group. PANSS positive, negative, and general psychopathology scores were significantly higher in the PD group. The difference was more pronounced in terms of PANSS negative scores. Overall functioning was similar in two groups. ConclusionsAdolescents with early-onset psychotic episodes present with a combination of psychotic and mood related symptoms. Initial assessments may have the risk of misdiagnosis. During follow-up, clinicians should not underestimate the possibility of a mood disorder with psychotic features, whereas negative psychotic symptoms may have a discriminative value in favor of psychotic disorders.

Clozapine blockade of MK-801-induced learning/memory impairment in the mEPM: Role of 5-HT1A receptors and hippocampal BDNF levels

Cognitive impairment associated with schizophrenia (CIAS) is highly prevalent and affects the overall functioning of patients. Clozapine (Clz), an atypical antipsychotic drug, significantly improves CIAS although the underlying mechanisms remain under study. The role of the 5-HT1A receptor (5-HT1A-R) in the ability of Clz to prevent the learning/memory impairment induced by MK-801 was investigated using the modified elevated plus-maze (mEPM) considering the Transfer latency (TL) as an index of spatial memory. We also investigated if changes in hippocampal brain-derived neurotrophic factor (BDNF) levels underlie the behavioral prevention induced by Clz.Clz (0.5 and 1mg/kg)- or vehicle-pretreated Wistar rats were injected with MK-801 (0.05mg/kg) or saline. TL was evaluated 35min later (TL1, acquisition session) while learning/memory performance was measured 24h (TL2, retention session) and 48h later (TL3, long-lasting effect). WAY-100635, a 5-HT1A-R antagonist, was pre-injected (0.3mg/kg) to examine the presumed 5-HT1A-R involvement in Clz action. At TL2, another experimental group treated with Clz and MK-801 and its respective control groups were added to measure BDNF protein levels by ELISA.TL1 and TL3 were not significantly modified by the different treatments. MK-801 increased TL2 compared to control group leading a disruption of spatial memory processing which was markedly attenuated by Clz. WAY-100635 suppressed this action supporting a relevant role of 5-HT1A-R in the Clz mechanism of action to improve spatial memory dysfunction. Although a significant decrease of hippocampal BDNF levels underlies the learning/memory impairment induced by MK-801, this effect was not significantly prevented by Clz.

Cognitive Remediation and Bias Modification Strategies in Mood and Anxiety Disorders.

Cognitive impairments and biases, which are prevalent in patients with mood and anxiety disorders, can affect quality of life and functioning. Traditional treatments are only insufficiently addressing these impairments and biases. We review the cognitive impairments and biases present in these disorders as well as treatments targeting these domains. Interventions aimed at improving cognitive impairments and biases may help improve cognitive deficits and overall functioning in patients with mood and anxiety disorders. Direct comparisons of treatments for cognitive impairments or biases versus more traditional psychosocial interventions have produced diverse results. Overall, treatments for cognitive impairments and cognitive biases warrant additional study in clinical trials. Future research should explore cognitive remediation and cognitive bias modification adjunctive to psychosocial treatments to optimize patient outcomes in mood and anxiety disorders.

Social support and bipolar disorder

Background Bipolar disorder is a chronic condition that affects the functioning of its carriers in many different ways, even when treated properly. Therefore, it’s also important to identify the psychosocial aspects that could contribute to an improvement of this population’s quality of life.Objective Carry out a literature review on the role of social support in cases of bipolar disorder.Method A research on the following online databases PubMed, Lilacs and SciELO was conducted by using the keywords “social support” or “social networks” and “mood disorders” or “bipolar disorder” or “affective disorder,” with no defined timeline.Results Only 13 studies concerning the topic of social support and BD were found in the search for related articles. Generally speaking, the results show low rates of social support for BD patients.Discussion Despite the growing interest in the overall functioning of patients with bipolar disorder, studies on social support are still rare. Besides, the existing studies on the subject use different methodologies, making it difficult to establish data comparisons.

Bipolar disorder and self-stigma: A comparison with schizophrenia

AimEven though numerous studies have focused on the effects of self-stigma on patients with schizophrenia, little is known about self-stigma of patients with bipolar disorder (BD). In this study, a self-administered scale of self-stigmatising attitudes of patients with BD and schizophrenia was used to explore these attitudes, examine the potential differences between the two groups and study the factors that influence stigma within groups. MethodsSelf-stigma of 120 patients with schizophrenia and BD was assessed with the Self-stigma Questionnaire (SSQ) and the Stigma Inventory for Mental Illness (SIMI). Presence of clinical symptoms, overall functioning and level of self-esteem were also evaluated. ResultsSelf-stigma is present in both groups but differs in its intensity. Patients with BD experience self-stigma in a lesser degree without affecting their social life or overall functioning. Patients with schizophrenia adopt more intense self-stigmatising attitudes leading to social exclusion and lower level of overall functioning. LimitationsThe results are limited by the small sample size, whereas the inclusion of other questionnaires would broaden our insight to self-stigma. ConclusionsSelf-stigma has a direct effect on overall functioning of patients with BD and schizophrenia tampering the clinical outcome of therapeutic interventions. Therefore, it should be incorporated in every treatment plan and be addressed as a clinical symptom of the mental illness.

P.8.b.008 Self-stigmatisation and adherence to treatment

Even though numerous studies have focused on the effects of self-stigma on patients with schizophrenia, little is known about self-stigma of patients with bipolar disorder (BD). In this study, a self-administered scale of self-stigmatising attitudes of patients with BD and schizophrenia was used to explore these attitudes, examine the potential differences between the two groups and study the factors that influence stigma within groups.Self-stigma of 120 patients with schizophrenia and BD was assessed with the Self-stigma Questionnaire (SSQ) and the Stigma Inventory for Mental Illness (SIMI). Presence of clinical symptoms, overall functioning and level of self-esteem were also evaluated.Self-stigma is present in both groups but differs in its intensity. Patients with BD experience self-stigma in a lesser degree without affecting their social life or overall functioning. Patients with schizophrenia adopt more intense self-stigmatising attitudes leading to social exclusion and lower level of overall functioning.The results are limited by the small sample size, whereas the inclusion of other questionnaires would broaden our insight to self-stigma.Self-stigma has a direct effect on overall functioning of patients with BD and schizophrenia tampering the clinical outcome of therapeutic interventions. Therefore, it should be incorporated in every treatment plan and be addressed as a clinical symptom of the mental illness.