S.22.03 Neurocognition and psychosocial function in bipolar disorder

S.22.03 Neurocognition and psychosocial function in bipolar disorder

S.22. Bipolar disorder: from neurobiology to functional outcome S.22.03 Neurocognition and psychosocial function in bipolar disorder O.A. Andreassen1 ...

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S.22. Bipolar disorder: from neurobiology to functional outcome S.22.03 Neurocognition and psychosocial function in bipolar disorder O.A. Andreassen1 ° , C. Simonsen1 , K. Sundet2 . 1 Oslo University Hospital, Psychosis Research Section − TOPBuilding 49 Division of Psychiatry, Oslo, Norway; 2 University of Oslo, Inst. of Psychology, Oslo, Norway Neurocognitive dysfunction is milder in bipolar disorders than in schizophrenia supporting a dimensional approach to these disorders. We examined if neurocognitive dysfunction in bipolar disorder and schizophrenia depends on a history of psychosis or diagnostic category, and how this is related to psychosocial function and clinical symptoms. From the TOP study [1], a sample of schizophrenia spectrum disorders without (n = 60) and with a history of affective episodes (n = 54); individuals with bipolar spectrum disorders with (n = 64) and without a history of psychosis (n = 56) and healthy controls (n = 268) participated. Neurocognition was measured with a comprehensive neuropsychological test battery, symptoms with Inventory of Depressive Symptomatology, Young Mania Rating Scale and Positive and Negative Syndrome Scale and function with Social Functioning Scale and the Global Assessment of Functioning Scale. Compared with controls, the groups with a history of psychosis performed poorer across neurocognitive measures, while the bipolar group without psychosis showed only impaired processing speed. The groups with a history of psychosis were similar, and performed worse than the group without psychosis on several neurocognitive measures. Clinician-rated functioning was poorer in schizophrenia than in bipolar disorder, but self-rated functioning was similar across all groups and poorer than in controls. Neurocognition and current clinical symptoms were associated with psychosocial function, but current symptoms had a greater independent contribution to functioning than neurocognition across clinical groups. This suggests that neurocognitive dysfunction is determined more by history of psychosis than by diagnostic category, and the relationship between neurocognition, symptoms and psychosocial function is similar across diagnostic categories. References [1] Simonsen, C. et al. Neurocognitive Dysfunction in Bipolar and Schizophrenia-Spectrum Disorders Depends on History of Psychosis Rather Than Diagnostic Group. Schizophr Bull. 2009 May 14. [Epub ahead of print].

S.22.04 Predictors of functioning in bipolar disorder S. Dittmann1 ° , F. Seem¨uller1 , K. Hennig-Fast1 , R.R. Engel1 , 1 LudwigM. Riedel1 , H.C. Grunze2 , W.E. Severus1 . Maximilians-University, Department of Psychiatry and Psychotherapy, Munich, Germany; 2 Newcastle University, Institute of Neuroscience, Newcastle upon Tyne, United Kingdom Objectives: Few studies have examined the association between neuropsychological functioning and social adjustment so far [1−3]. Therefore this study was conducted to determine the effects of neuropsychological functioning, clinical and demographic variables on different domains of social adjustment in bipolar disorder. Methodology: 75 patients with bipolar disorder and 42 healthy controls participated in the study. Patients had to be euthymic

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for at least one month. Cognitive functioning was assessed using a neuropsychological battery, social adjustment with the Social Adjustment Scale (SAS). Clinical and demographic variables were collected with standardized rating scales. Multiple linear regression analyses were employed to investigate if neuropsychological, clinical or demographic variables were associated with 4 domains of social adjustment (global adjustment, work, household, social activities). Results: 44.7% of all patients were working in a full-time position meeting their qualifications, 14.9% were working parttime. 13.5% of the patients were unemployed, 4.1% were working in a sheltered working environment, and 2.7% were retired. 20.3% were permanently incapacitated. Compared to healthy controls, patients had significant lower levels of social adjustment in all domains applied. Patients also performed worse on all cognitive domains tested. Stepwise regression analyses revealed a significant and independent association of memory measures with global adjustment, work performance and social activities. Performance in household activities was predicted by age and duration of euthymia. Executive functions did not predict any of the four domains of social adjustment investigated. Conclusion: This study confirms memory as a major predictor of social adjustment. References [1] Rosa, A.R., Reinares, M., Franco, C., Comes, M., Torrent, C., SanchezMoreno, J., Martinez-Aran, A., Salamero, M., Kapczinski, F., Vieta, E. (2009) Clinical predictors of functional outcome of bipolar patients in remission. Bipolar Disord 11, 401–409. [2] Sanchez-Moreno, J., Martinez-Aran, A., Tabares-Seisdedos, R., Torrent, C., Vieta, E., Yuso-Mateos, J.L. (2009) Functioning and disability in bipolar disorder, an extensive review. Psychother Psychosom 78, 285–297. [3] Wingo, A.P., Baldessarini, R.J., Compton, M.T., Harvey, P.D. (2010) Correlates of recovery of social functioning in types I and II bipolar disorder patients. Psychiatry Res, Epub ahead of print.

S.22.05 Neurobiological correlates of treatment response to psychoeducation F. Colom1 ° , I. Pacchiarotti1 , A. Murru1 , A.M.A. Nivoli1 , E. Vieta1 . 1 IDIBAPS-CIBERSAM Hospital Clinic, Institute of Neurosciences, Barcelona, Spain Updated guidelines for treatment of bipolar disorders acknowledge the role of patients’ group psychoeducation on the treatment regime of bipolar disorders (1). Group psychoeducation has proved its prophylactic efficacy (prevention of all kinds of mood episodes) both at short and long-term (2). However, little is known about the mechanism of action of psychoeducation and about possible predictors of response. Determining predictors of response would represent a huge step forward in terms of optimization of routine treatment and cost-efficacy issues. Neuroplasticity is known to play a role in the response or lack of response to several pharmacological treatments but little is known about its role in response to psychological intervention in bipolar disorders. There is some evidence in other psychiatric conditions that markers such as NGF and BDNF may vary along with the psychological treatment success. On the other hand, the increase in p-CREB in T lymphocytes is significantly associated with treatment response in patients treated with either antidepressants or psychotherapy alone (3). Similarly, several recent studies show the role of cytokines (i.e. TNF-a, IL-2, IL-4, IL6, IL-10) in neuronal survival. Cytokine levels have been linked to multiple