Table of Contents Table of Contents
Previous Page  122 / 916 Next Page
Show Menu
Previous Page 122 / 916 Next Page
Page Background


25th European Congress of Psychiatry / European Psychiatry 41S (2017) S106–S169

(2) The Student-T test was used to compare, between the groups,

themean of scores in YMRS and CGI-S scales and themean of length

of stay.


Baseline characteristicswere similar between the groups.

The majority of patients were also treated with mood stabilizers

(46% with lithium and 45% with valproate).

The mean decrease in CGI-S scores from baseline to the day of dis-

charge was significantly (


< 0.003) higher in the risperidone group


2.81 vs.

2.36). The length of stay was significantly (


< 0.004)

lower in the olanzapine group (mean of 23.03 days vs. mean of



(1) The CGI-S scores in manic patients treated with

risperidone decreased more than in patients treated with olanzap-

ine during admission. (2) The length of stay was significantly lower

in patients treated with olanzapine.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Switching bipolar disorder patients

treated with clozapine to another

antipsychotic medication: A mirror

image study

P. Ifteni

, A. Teodorescu

Universitatea Transilvania din Brasov, Facultatea de Medicina,

Brasov, Romania

Corresponding author.


Bipolar disorder (BD) is associated with periodic

symptoms’ exacerbations, leading to functional impairment, sub-

stance abuse, and increased risk of suicide and accidents. Clozapine

has never been approved for the treatment of BD but it is used in

severe episodes.


The aim of the study is to evaluate the risks and benefits of

switching remitted BD patients treated with clozapine to another

antipsychotic medication.


We assessed the proportion of relapsed patients after

switching clozapine, time until relapse, type of relapse and the

number of admissions.


This was an observational, mirror image study of 62

remitted BD outpatients treatedwith clozapine. Following a change

in drug reimbursement rules by which clozapine was no longer

reimbursable for patients with BD, 25 patients were switched to

another antipsychotic and the rest of 37 continued on clozapine

agreeing to pay treatment.


The mean score of CGI-BP at admission in study was in

on both groups almost similar (2.3 vs. 2.4). After switching, a sig-

nificant proportion of patients relapsed (77%), in 100% cases with a

manic episode requiring hospitalisation. The mean YMRS score at

relapse was significantly higher compared with the evaluation at

the time prior to switching (31.78 (SD = 9.72) vs. 11.99 (SD = 7.29),


< 0.01).


Despite the limitations of this naturalistic study, the

results suggest that switching from clozapine to another antipsy-

chotic may increase the risk of relapses in remitted patients with

BD. The risks, costs and consequences of symptoms exacerba-

tion should be weighed against the quest to control pharmacy


Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Treating cognitive impairments in

bipolar disorders: New leads in the

cognitive remediation field

C. Isaac

1 ,

, M.C. Castillo


, D. Januel



EPS Ville Evrard, Unité de Recherche Clinique, Neuilly-Sur-Marne,



Université Paris 8, Laboratoire de Psychopathologie et de

Neuropsychologie, Saint-Denis, France

Corresponding author.

Cognitive deficits have been overlooked in bipolar spectrum disor-

ders, despite their significant impact on patients’ quality of life.

Indeed, nearly sixty percent of stabilized bipolar patients suffer

from major cognitive impairments that impede their everyday

life functioning. Without proper care, these impairments remain

throughout lifespan and increase with hospitalisations, social iso-

lation or pharmacological treatments. Cognitive remediation is a

cost-effective tool well accepted by patients and caregivers that has

proven its efficacy for treating cognitive impairments in several dis-

orders such as schizophrenia. However, for bipolar disorders, this

psychosocial intervention based on brainplasticity is still in its early

stages. After depicting the state of the art on cognitive impairments

and cognitive remediation inmood disorders, wewill introduce the

ECo program that was specifically designed for bipolar disorders.

We will then present the preliminary results (


= 18) of a double-

blind randomised controlled study that assessed the effect of this

program on cognitive impairments and psychosocial functioning,

at short term and long term (three and nine months). First results

support the hypothesis of a positive impact of the ECo cognitive

remediation programon bipolar patients’ neuropsychological func-

tioning, self-efficacy and quality of life. Cognitive remediation may

be a promising tool for bipolar disorders that meets the needs of

patients, their caregivers and the community.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Bipolar disorder and cannabis

G. Jmii

, M. Zghal , F. Ghali , M. Mezghenni , L. Jouini ,

L. Robbana , F. Ellouze , F. Mrad

Razi Hospital, Department of Psychiatry G-, Tunis, Tunisia

Corresponding author.


People with bipolar disorder frequently struggle

with substance abuse and dependence. Typically, cannabis is the

most commonly abused drug in individuals with bipolar disor-

der. Some investigators have implied that cannabis may actually

be mood stabilizing in patients with bipolar disorder. However,

the relationships between cannabis use and bipolar disorders are

complex and remain incompletely described.


The aim of this study was to identify the characteristics

of addiction to cannabis in bipolar patients type I and determine the

consequences of cannabis on the expression of bipolar illness and



This is a comparative cross-sectional study which

included patients followed in the psychiatry department of the G

Razi hospital for bipolar disorder type I and for substance depend-

ence according to DSM IV diagnostic criteria. Hetero-questionnaire

on sociodemographic variables, clinical and treatment.


The average age was 41 years. The average hospital stay

was 9.18 days. 33.33% of patients were monitored regularly. Most

patients were single and worked as a day labourer. Cannabis was

the most consumed substance. Cannabis use was prior to the

expression of psychiatric illness in 55% of cases. The average num-

ber of hospitalisation in patients with a cannabis addiction was

significantly greater than that observed in the non-addicted group.