European Psychiatry - Volume 41 - April 2017

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S116 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S106–S169
New classifications have recently been proposed, such as the
Predominant Polarity (PP) classification, which is based on the ten-
dency of the patient to relapse in the manic (Manic Predominant
Polarity [MPP]) or the depressive (Depressive Predominant Polarity
[DPP]) poles along the course of the disease.
Objectives To explore the epidemiological and clinical correlates
of PP.
Methods We performed a search of the PubMed and Web of Sci-
ence databases up to June 1st 2016, using the keywords “bipolar
disorder”, “polarity” and “predominant polarity”.
Results The initial search identified 1598 articles. Only 17 arti-
cles met inclusion criteria. Factors associated with MPP are manic
onset, history of drug abuse and a better response to atypical
antipsychotics and mood stabilizers. Meanwhile DPP is associated
with depressive onset, more relapses, longer acute episodes, and
a higher risk of suicide. Moreover, delay until diagnosis, mixed
episodes and comorbid anxiety disorders are more prevalent in
DPP patients, whose treatment often involves quetiapine and
lamotrigine.
Limitations Few prospective studies. Variability of results.
Conclusions PP classification may be useful for the clinical man-
agement of BD. Further research in this field is needed. Future
research should use standardized definitions andmore comparable
methods.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0031
Late onset bipolar disorder: Clinical
characterization
J. Gomes ∗, A. Sousa , H. Afonso , G. Lima
Centro Hospitalar Barreiro-Montijo, Psychiatry, Barreiro, Portugal
∗ Corresponding author.
Introduction Bipolar disease is a chronic mental illness with a
deep personal and social impact. Alongside with the consider-
able progress in understanding and treating bipolar disorder, and
despite the growing interest in geriatric psychiatry, late onset bipo-
lar disorder has been relatively little studied so far.
Objectives To review the literature regarding the epidemiology,
characteristics and clinical implications of late onset bipolar disor-
der.
Methodology A literature review was performed by searching
articles in Pubmed, using the following search terms: “late onset
bipolar disorder” and “elderly bipolar disorder”. All literature in
English published in the last 15 years was examined and 11 articles
were selected.
Results Although the frequency of bipolar disorder type 1 or 2
decrease with age, approximately 6 to 8% of the new cases of
bipolar disorder develop in people over 60 years of age. Clinically,
late-onset bipolar disorder appears to be associated with a bet-
ter level of pre-morbid functioning, a less severe psychopathology
as well as a smaller family burden of psychiatric illness. The term
“secondary mania” postulated by Krauthmamer Klerman has been
used to describe a bipolar disease variant associated with a vari-
ety of organic factors that may be responsible for this late-onset
disease.
Conclusions Late onset bipolar disorder is probably a different
diagnostic than the entity that occurs in younger patients, since
it presents with a different clinical presentation. It is a hetero-
geneous disease with a complex etiology that still needs more
research.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0032
High cognitive reserve in bipolar
disorders as a moderator of
neurocognitive impairment
I. Grande ∗, J. Sanchez-Moreno , B. Solé , E. Jimenez ,
C. Torrent , C.D.M. Bonnin , C. Varo , R. Tabarés-Seisdedos ,
V. Balanza-Martínez , E. Valls , I. Morilla , A.F. Carvalho ,
J.L. Ayuso-Mateos , E. Vieta , A. Martinez-Aran
1 Hospital Clinic de Barcelona, Psychiatry, Barcelona, Spain
2 University of Valencia – Cibersam – Incliva, Medicine, Valencia,
Spain
3 La Fe University and Polytechnic Hospital – University of
Valencia – Cibersam, Department of Medicine, Valencia, Spain
4 Faculty of Medicine, Department of Clinical Medicine and
Translational Psychiatry Research Group, Fortaleza, Brazil
5 Universidad Autónoma de Madrid – Cibersam, Department of
Psychiatry, Madrid, Spain
∗ Corresponding author.
Background Cognitive reserve (CR) reflects the capacity of the
brain to endure neuropathology, minimize clinical manifestations
and successfully complete cognitive tasks. The present study aims
to determine whether high CR may constitute a moderator of cog-
nitive functioning in bipolar disorder (BD).
Methods One hundred and two patients with BD and 32 healthy
controls were enrolled. All patients met DSM-IV criteria for I or II
BD and were euthymic (YMRS ≤ 6 and HDRS≤ 8) during a 6-month
period. All participants were tested with a comprehensive neu-
ropsychological battery, and a Cerebral Reserve Score (CRS) was
estimated. Subjects with a CRS below the group median were clas-
sified as having low CR, whereas participants with a CRS above the
median value were considered to have high CR.
Results Participants with BD with high CR displayed a better
performance in measures of attention (digits forward: F = 4.554,
P = 0.039); phonemic and semantic verbal fluency (FAS: F = 9.328,
P = 0.004; and Animal Naming: F = 8.532, P = 0.006); and verbal
memory (short cued recall of California Verbal Learning Test:
F = 4.236, P = 0.046), after multivariable adjustment for potential
confounders, including number of admissions and prior psychotic
symptoms.
Conclusions High cognitive reserve may therefore be a valuable
construct to explore for predicting neurocognitive performance in
patients with BD regarding premorbid status.
Disclosure of interest Dr. I. Grande has received a Juan Rodés Con-
tract (JR15/00012), Instituto de Salud Carlos III, Spanish Ministry of
Economy and Competiveness, Barcelona, Spain and has served as a
consultant for Ferrer and as a speaker for AstraZeneca, Ferrer and
Janssen-Cilag.
EW0033
Cognitive function in older euthymic
bipolar patients
K. Hajbi , I. Baati , S. Ellouze , S. Mkaouar , I. Abida , J. Masmoudi ∗
CHU Hédi Chaker Sfax, Tunisia, psychiatry “A”, Sfax, Tunisia
∗ Corresponding author.
Objectives To assess cognitive function in older euthymic bipolar
patients. To investigate the relationship between cognitive disor-
ders and clinical features in this population.
Methods We conducted a cross-sectional study during the period
from August to November 2015. It included 34 stable bipolar out-
patients, aged at least 65 years. We used the Montreal Cognitive
Assessment (MoCA) to screen for cognitive disorders. Our patients
were clinically euthymic, as checked by the Hamilton depression
scale and the Young mania scale.
Results The sex ratiowas 1. Themean age of our patientswas 68.2
years. Most of them were married (82.4%), unemployed (55.8%),