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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S170–S237


Evaluation of cognitive dysfunction in

a sample of patients affected by

bipolar disorder

E. Stella


, M. La Montagna

1 ,

, L. Borraccino


, F. Ricci



A.I. Triggiani


, F. Panza


, D. Seripa


, G. Miscio


, A. Bellomo



M. Lozupone



University of Foggia, Psychiatric Unit, SPDC, Department of Mental

Health Asl Fg, Foggia, Italy


Laboratory of Physiology, University of Foggia, Department of

Clinical and Experimental Medicine, Foggia, Italy


IRCCS Casa Sollievo della Sofferenza, Department of Medical

Sciences, San Giovanni Rotondo, Italy

Corresponding author.


Cognitive dysfunctions concerning working mem-

ory, attention, psychomotor speed, and verbal memory are a

disabling feature of the bipolar disorder (BD). According to scientific

literature, cognitive disturbances are present not only in depres-

sive and manic phases of BD, but also during the euthymic period,

without regard to whether or not drugs are assumed.


To determine the presence of one or more dysfunctions

in cognitive domains in a sample of subjects suffering from BD, in

euthymic phase, compared with healthy controls.


Evaluation of the following cognitive performances in sub-

jects affected by BD: speed of processing, attention/vigilance,

working memory, verbal learning, visual learning, reasoning and

problem solving, and social cognition.


Forty-six patients affected by BD in the euthymic phase

(mean age: 43.17 years old; 39.13% male), and 58 healthy con-

trols (mean age: 39.21 years old; 51.72% male) were enrolled in the

psychiatric unit of Azienda Sanitaria Locale, Foggia. The neuropsy-

chological battery MATRICS Consensus Cognitive Battery (MCCB)

was administered by trained psychiatrists.


We found the presence of cognitive impairment, affecting

six out of seven of cognitive functions assessed (


< 0.001): speed of

processing, attention/vigilance, working memory, verbal learning,

visual learning, reasoning and problem solving.


These preliminary results from our case-control

study show that cognitive deficits are clearly present also during

the euthymic phases of subjects with bipolar disorder (mainly per-

taining attention/vigilance domain). These cognitive abnormalities

may represent a biomarker of bipolar disorder.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Patterns of impairment in executive

functions within unipolar and bipolar


B. Suciu

1 ,

, R. Paunescu


, I. Miclutia



Children’s Emergency Hospital, Psychiatry Clinic, Cluj-Napoca,



Iuliu Hatieganu University of Medicine and Pharmacy, Department

of Neurosciences, Cluj-Napoca, Romania

Corresponding author.


The majority of studies revealed that cognitive

deficits are an important aspect in many psychiatric illnesses, such

as bipolar disorder and major depressive disorder. In the past, cog-

nitive impairment was considered part of depression and it was

expected to diminish as other mood symptoms improved with



This study is based on the review of recent literature,

performed in order to understand the dimension of executive

impairment in unipolar and bipolar depression.


Both unipolar and bipolar depressed patients display

cognitive deficits in several cognitive domains within executive

functions. Different subcomponents of executive functions are

altered in both types of patients, but impairments in sustained

attention appear specific in bipolar depression while dysfunctional

divided attention is reported in unipolar disorder. Studies describe

deficits in planning strategies and monitoring processes that are

characteristically impaired in unipolar depressed patients. Also

these subjects tend to make more perseverative responses sug-

gesting set shifting deficits and moreover they require longer time

and more cognitive effort in order to accomplish tasks involving

inhibitory control or cognitive flexibility. Other findings suggest

that bipolar I depressed patients perform worse than bipolar II

depressed patients and unipolar depressed patients across all exec-

utive functions especially in the decision making process that is

considered to be a trait marker for bipolar disorder with no differ-

ences between the two types of bipolar subjects.


Executive functions represent a term that includes a

higher order of cognitive abilities with deficits that are present in

bothdisorders but display slightly different patterns of impairment.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Objective quantification of

psychomotor dynamics during

pharmacological treatment of bipolar


P. Terziivanova

, S. Haralanov , E. Haralanova , G. Dzhupanov

Medical University, Psychiatry and Medical Psychology, Sofia,


Corresponding author.


Psychomotor disturbances are among the core

symptoms of endogenous depression. They reflect the underly-

ing pathophysiology of the depressive episode and are sensitive to

the neurobiological effects of its pharmacological treatment. Being

objectively manifested, the psychomotor functions and dysfunc-

tions are technically recordable and measurable by the available

motion analysis systems.


To objectively record and measure the psychomotor

dysfunctions in bipolar depression and their dynamics during phar-

macological treatment.


We introduced an original (internationally patented)

equilibriometricmethod for objective and quantitative recording of

psychomotor dysfunctions during stepping locomotion in 37 hos-

pitalized patients with bipolar depression and 30 well-matched

healthy controls. Two separable psychomotor functions were ana-

lyzed in parallel: conscious (voluntary) activity and subconscious

(automatic) reactivity. Both patients and controls were examined

twice in order to quantify their psychomotor dynamics. Patients

were examined at the first day of their hospitalisation and the day

before their discharge. The two consecutive examinations of the

controls were with equivalent time intervals.


There was no significant psychomotor dynamics



> 0.05) in the healthy controls between their first and second

equilibriometric recording. Psychomotor activity and/or reactivity

of the patients were relatively slower at their first recording and

significantly accelerated (


< 0.05) at their second recording after

effective pharmacological treatment.


Objective recording and quantitative assessment of

psychomotor dynamics in patients with bipolar depression during

the pharmacological treatment of their current episode could be

a sensitive measure of their improvement and might be used as

a surrogate pharmacodynamic biomarker for objective treatment