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COVID19 pandemic had an important emotional and psychological impact due to the higher rates of boredom, fear, stress, anxiety, depression, etc. (Brooks et al., 2020). Cases of suicide during the COVID-19 pandemic are increasingly reported. According to an Indian study, the main cause of suicide was fear or anticipation of COVID-19 infection.
Objectives
To illustrate a case of suicide attempt after COVID-19 infection.
Methods
We report the case of a Tunisian man who did a suicide attempt after his infection with the coronavirus.
Results
A 35-year-old Tunisian man, married, an official, with no medical or psychiatric history who was admitted in the Oto-rhino-laryngology department, after a suicide attempt by strangulation, five days after the diagnosis of COVID-19 infection. In fact, the patient was very stressed about his infection and feared transmitting the virus to his family. During his quarantine, he became anxious, had insomnia and suicidal thoughts. He was isolated in his room, and prohibit his family to approach his room. He told us that he could not support this anxiety and he decided to suicide to end this situation and save his family.
Conclusions
The COVID-19 pandemic may increase suicide rates. Psychological consequences of this pandemic including suicide may continue to incur later than this actual worldwide crisis. Mental health promotion is the key to prevent and mitigate such mental health consequences.
The relationship between behavioral changes and the menstrual cycle in women at a reproductive age has been investigated in several studies; women during every menstrual cycle experience noticeable changes in levels of sex hormones which are consequently reflected on their mood and behavior. The relationship between the menstrual cycle and the emotion recognition processing has been also studied.
Objectives
The aim of this study was to examine if differences exist between women with Premenstrual Dysphonic Disorder (PMDD) and women without PMDD in Emotion recognition processing across menstrual cycle.
Methods
We examined 26 women with a PMDD and 30 women without PMDD, who have both visited the Mental Health Centre (aged 18-35 y.o., right handed, educational level >9 y., regular cycle duration). Women were clinically interviewed (DSM-V); also the Emotion Recognition Task (ERT) was administered in the luteal and the follicular phase.
Results
Women with PMDD showed significant differences in emotion recognition depending on the the luteal and the follicular phase (according to estradiol and progesterone level) whereas women without PMDD did not present significantly different responses to the emotional stimuli.
Conclusions
Our findings suggest that there is an effect of PMDD on emotional facial recognition across the two phases of the menstrual cycle. Thus, the importance of incorporating ERT in the formal clinical examination of PMDD is highlighted.
PIU has not yet been recognized by diagnostic classification systems, but it has received increasing research and clinical attention. It is defined as a generalized and compulsive use of the Internet associated with a loss of control and negative consequences for the individual
Objectives
The main goal was to analyze the relation between problematic Internet Use and wellbeing in adolescents
Methods
The sample included a total of 1059 adolescents (47% were males). Age range was between 14 and 18 years old (M = 15,12; SD = 1,03). We used the Compulsive Internet Use Scale to assess Problematic Internet Use and the Strengths and Difficulties Questionnaire to screen for psychological difficulties and prosocial behaviour.
Results
The results found in the ANOVA revealed that problematic internet use was statistically significant associated with psychological difficulties and prosocial capabilities (λ = 0.475, F(3,83,000) = 25.569, P ≤ 0.001, η² = 0.215).Adolescents with higher levels of Problematic Internet Use revealed more emotional and behavioural difficulties. In addition. those adolescents with higher levels of prosocial ablities were at a lower risk for Problematic Internet Use.
Conclusions
Previous research have revealed that the use of Internet has almost doubled in the last decade among adolescents across different European countries. Results revealed statistically significant correlations between Problematic Internet Use and indicators of well-being such as emotional difficulties and behavioral problems, as well as prosocial behaviours. Prevention strategies should focus on detecting problematic internet use among adolescents, as it is a variable related with different psychological difficulties that are diminishing adolescents’ well-being.
The use of cannabis is likely to increase as regulations on its consumption are diminishing throughout the world.
Objectives
to identify the prevalence of anxiety and depression symptoms in a group of cannabis users in Tunisia.
Methods
this a transversal descriptive study about 137 participants in the University Hospital Of Mahdia during 2 months.
Results
In our study population , the consumers were young adults aged between 18 and 35 years old ,of whom 40.8% were professionally active, 23.2% had psychiatric history. Moreover, the use of other substances was regular among users as follows: tobacco among 74.6% of users, alcohol among 72.5% of users, ecstasy among 41.3% of users, cocaine among 25.4% of users. The use of cannabis was considered as a means of exultation for 66.7%, as an anxiolytic for 26.8% and as a sedative for 23.9%. Overall, the effect of cannabis use on anxiety and depression on the HAD scale showed the following results: probable anxiety in 53% of cases, probable state of depression in 72% of time.
Conclusions
The correlation between cannabis use, anxiety and depression remains unclear. Equally concluded, the assumption of self-medication by cannabis stills a topic of discussion.
In 2019 there were 1,760 patients in Denmark’s hospitals who experienced cardiac arrest (IHCA patients = In Hospital Cardiac Arrest patients). Of these patients about 70% survived. There is only limited knowledge about the mental and cognitive state of cardiac arrest survivors. However, it seems, that cardiac arrest survivors, perform mentally and cognitively worse compared to the background population. The mental and cognitive difficulties can lead to reduced quality of life for both those affected and their relatives.
Objectives
Because the above-mentioned area has limited knowledge, further studies are needed to shed more light into the problem.
Methods
To find out if the patients can be included in the study, the patient journals will be studied. After that there will be performed an interview-survey-based study, in which IHCA patients’ possible symptoms of depression, anxiety, PTSD and suicide risk, the patients’ quality of life and any cognitive disorder, shortly after and three months after cardiac arrest, will be examined. The study will also, if possible, focus on the patients’ relatives and on the eventual difficulties they may experience in the aftermath of a relative surviving a cardiac arrest. The above-mentioned will be done using already existing relevant psychiatric and neuropsychological examination tools. In relation to the patients’ relatives, however, a separate survey tool, that has been developed, will be used.
Results
It is an ongoing study. Results are expected in 2023.
Conclusions
In the long run the study hopefully can contribute to establishing relevant help, counseling and rehabilitation for the patients and relatives affected.
Expectations and fears about chemotherapy and radiotherapy in patients with oncological illness may not only affect their subjective well-being (Shaverdian et al., 2018) but also treatment satisfaction and complaints of side effects (Guidolin et al., 2018, Dong et al., 2014, Colagiuri et al., 2013).
Objectives
The aim was to compare beliefs about treatment in patients referred to radiation therapy and chemotherapy, and to reveal their relationship to health anxiety and subjective well-being.
Methods
53 patients referred to radiation therapy and 63 patients referred to chemotherapy completed the Treatment Perception in Oncological Illnesses Scale (Kovyazina et al., 2021), Illness and Treatment Self-Regulation Questionnaire (Kovyazina et al., 2019), Satisfaction with Life Scale (Diener et al., 1985) and Scale of Positive and Negative Experiences (Diener et al., 2009).
Results
Compared to radiation therapy, with chemotherapy, patients tend to be more doubtful about the effectiveness of treatment and more anxious about the need for it (p<.05). Moderated mediation analysis demonstrated that lack of understanding, doubts about the effectiveness and anxiety about radiation and chemotherapy are associated with subjective ill-being indirectly - through a higher level of health anxiety (β=-.79--.35, SE=.17-.26, 95% CI [-1.42 - -.75 – -.37 - -0,08]). Feelings of helplessness regarding treatment mediated the relationship between doubts and confidence about treatment effectiveness and well-being in both groups.
Conclusions
Results demonstrated that some fears and expectations about chemo- and radiotherapy could provoke health anxiety and helplessness regarding treatment that is related to poorer well-being.
Parental reflective function is the ability of a parent to attribute mental states to their child and to themselves. The Parental Reflective Functioning Questionnaire is widely used for the measurement of this construct, the adolescent version of which can be used by parents of children aged 12-18.
Objectives
The aim of our research was to adapt the adolescent version of The Parental Reflective Functioning Questionnaire to the Hungarian language.
Methods
In our study 240 mothers completed the adolescent version of The Parental Reflective Functioning Questionnaire (PRFQ-A), and the Reflective Function Questionnaire (RFQ).
Results
Confirmatory factor analysis did not confirm the original three-factor structure. The principal component analysis resulted in a two-factor structure. Factors corresponded to the original questionnaire’s certainty in mental states (Alpha = .81) and interest and curiosity subscales (Alpha = .70). When analyzing the relationship between parental reflective function and reflective function, the subscales of the parental reflective function questionnaire were examined with two types of median coding in addition to polar coding. During the first median coding, the frequency of scores in the middle of the scales reflected optimal mentalization, while the frequency of extreme values on the scales corresponded to less favorable reflective functioning. With the second median coding, hypermentalization and hypomentalization subscales were also created. The second median transcoding proved to be the most suitable for capturing the relationship between RFQ and PRFQ-A.
Conclusions
The questionnaire proved to be a reliable measure on the Hungarian sample and we recommend using the additional subscales.
Idiopathic Intracranial Hypertension (IIH) is a condition characterized by an increase of intracranial pressure (ICP) with no identifiable cause to date. One-half of patients who suffer from IIH have co-morbid mood disorders, such as Major Depressive Disorder (MDD), that can be refractory to pharmacologic treatment. Electroconvulsive Therapy (ECT) is a safe and effective treatment for treatment-refractory mood disorder, but possesses a relative contra-indication for IIH due to its theoretical increase in ICP. Can ECT become the gold-standard treatment modality for mood disorder from IIH?
Objectives
We aim to synthesize and summarize the state of the literature surrounding the intersection of ECT and IIH. We will present notable findings and propose avenues for future investigation.
Methods
We conducted a literature review using PubMed’s search function. Key terms that were queried are as follows: Idiopathic Intracranial Hypertension, Pseudotumor Cerebri, Benign Intracranial Hypertension, Mood Disorder, Major Depressive Disorder, ECT, Electroconvulsive Therapy.
Results
The prevailing theory of IIH and mood disorder centers around HPA axis dysfunction, which has been heavily theorized to be positively impacted with ECT. ECT itself may not increase the ICP, but the anesthesia might. The only two case reports in the literature presented safe and successful use of ECT’s in patients with IIH and MDD.
Conclusions
More data is needed to draw conclusions, as the literature surrounding ECT’s use in patients with IIH remains sparse. Further studies must explore whether ECT’s use in IIH remains effective. Through this, we may understand more about both IIH and ECT itself.
Asperger Syndrome (AS) exhibits a particular set of difficulties, the foremost of them being the impairment in social interaction. Furthermore, adolescence by itself is a period burdened with many social challenges and distress. The attempt to adjust to them while having AS is much harder, thus it may constitute the premise for the onset of internalizing symptomatology, in particular depression.
Objectives
This study aimed to observe what factors either improved or hindered the long-term outcome. It was analyzed how the different types of interventions influenced the outcome of these individuals in terms of academic performance, social functioning, psychiatric relapses and quality of life.
Methods
Our lot was represented by 16 patients diagnosed with Asperger Syndrome and Major Depressive Disorder (MDD), followed up on a period between 1 to 10 years. The lot was divided into two groups, each with a different therapeutic plan. The main instruments used were clinical observation and parents’ assessments.
Results
In the first group, the adolescents, treated with a complex intervention which included also a psychotherapeutic component, were found to have a positive outcome, 71,42% of them having no other psychiatric comorbidity than Major Depressive Disorder. The adolescents in the second group, who were treated only with pharmacological treatment, were found to have a negative outcome.
Conclusions
The factors that were found to have the most important impact on the long-term outcome were: the integration in a psychotherapy programme, having family support, compliance with the pharmacological treatment and having MDD as the only psychiatric comorbidity.
There is a well-established body of investigations showing that the experience of shame is associated with eating disorders symptoms. Meta-analytical data indicate that body shame is one type of shame that seems to be especially relevant in case of eating disorders. While there are many studies which investigated the association between the predisposition to feel ashamed about one’s body and eating disturbance, there are virtually no inquires on how momentary body shame is related to disturbed eating behaviors.
Objectives
In this study we aimed to investigate the relationship between momentary body shame and disturbed eating behaviors using an intensive longitudinal design.
Methods
Females with high levels of eating disorders symptoms completed five, randomly-initiated surveys per day delivered via a smartphone application for a total of two weeks. The survey evaluated the level of body shame and disturbed eating behaviors (i.e., binge eating, purging, excessive exercises, body checking).
Results
Preliminary results indicate that higher levels of body shame are associated with higher levels of disturbed eating behaviors. The level of body shame was higher in binge eating days compared with non-binge eating days.
Conclusions
Fluctuations in body shame seem to contribute to the maintenance of disturbed eating behaviors. Implications and limitations of these findings are discussed.
Schizophrenia spectrum disorders may severely limit ability to achieve and maintain gainful employment of affected working-age individuals.
Objectives
Assess the employment status in patients with schizophrenia spectrum disorders treated with long acting injectable paliperidone palmitate after the switch from oral antipsychotics.
Methods
A single centre mirror image design study of 115 patients with schizophrenia spectrum disorder was conducted in a tertiary level psychiatric hospital. Data were collected for period of 12 months prior toand 12 months after switching from oral antipsychotic to long acting injectable paliperidone.Employment status for 6 enrolled patients was missing.
Results
Mean age of enrolled patients was 38,4±11,6 years. Of the 109 patients analyzed for employment status, 44,4% remained employed for 12 months after switching to long acting injectable paliperidone while 4,6% patients changed their employment status from unemployed to employed after the switch. No patient changed their employment status from employed to unemployed after the switch. 9,2% patients were already retired at the beginning of study period and 5,5% of patients maintained their student status. 36,7% patients remained unemployed for the whole study period. The correlation between employment status of employed and unemployed patients and duration of illness was borderline significant with p=0,049.
Conclusions
The data from this study suggest that use of long acting injectable paliperidone contributed to preservation of working ability of working-age patients suffering from schizophrenia spectrum disorders.
Subjects with eating disorders (ED) show a high prevalence of childhood trauma.
Objectives
Aim of the study is to evaluate the emotional, biological and behavioral responses to an experimental acute psychosocial stress in subjects with ED with or without childhood maltreatment. Secondary aim is to evaluate the effects of different traumatic experiences (physical and emotional).
Methods
48 women with ED completed the Childhood Trauma Questionnaire (CTQ). 29 participants (14 with Anorexia Nervosa [AN] and 15 with Bulimia Nervosa [BN]) reported an history of childhood maltreatment, while 19 (11 with AN and 8 with BN) did not. Cortisol levels, anxiety and hunger perceptions have been assessed in all participants throughout the Trier Social Stress Test (TSST) as well as body dissatisfaction after stress exposure.
Results
Subjects with childhood trauma showed higher emotional reactivity and body dissatisfaction and lower hunger throughout the TSST than those without childhood trauma. Higher cortisol levels were observed in patients with AN, regardless of the presence of childhood trauma, and in those with BN and history of emotional trauma. Emotional trauma was the childhood trauma explaining most of the observed differences.
Conclusions
Childhood trauma, especially emotional one, can lead to vulnerability to interpersonal stress in individuals with ED. The present study is the first that supports the “maltreated ecophenotype” hypothesis in subjects with ED through an experimental task and the evaluation of multiple levels of response. These data may provide new prospectives on the pathogenetic mechanisms of ED and novel therapeutic implications.
Both public and private sector pharmacists were instrumental in containing this health crisis in Tunisia. The high workload had a considerable impact on their mental health during the outbreak of the Corona Virus.
Objectives
This study aims to assess burnout and the psychological toll of the pandemic among pharmacists in Tunisia during covid-19.
Methods
258 Tunisian pharmacists working in the public and private sector participated in a questionnaire. Burnout was assessed by the Maslach burnout scale. Regression analysis was used to assess the impact of the pandemic on Tunisian pharmacists.
Results
80% of the respondents were women. Participants ranged in age from 22 to 62, 60% were married, 57% had at least one child, and 42% had been working for less than five years. The burnout scale revealed 76% burnout among them. Univariate linear regression showed that female gender (p = 0.014 <0.05) was associated with the development of burnout.
Conclusions
The considerable prevalence of burnout among pharmacists during the COVID-19 pandemic in Tunisia can be attributed to the enormous and overwhelming responsibilities that any health care worker endured.
Family caregiving role of children with epilepsy involves managing the daily lives of these children with disabilities. This can lead to impaired physical and psychological health of the caregiver.
Objectives
To assess the level of burden among caregivers of children with epilepsy and to determine the factors associated with it.
Methods
It was a descriptive and analytical survey. It involved the caregivers of children with epilepsy who were admitted to the pediatric neurology department at the Hedi Chaker University Hospital in Sfax during the period from July to October 2020. We used the 12-item Zarit (ZBI-12), the State-Trait-Anxiety Inventory (STAI), and the “BECK” Depression Inventory (BDI-13) to assess caregiver burden, anxiety and depression respectively.
Results
Forty-four caregivers participated in the survey. Their average age was 36 years and their relationship with patient was mother in 93.2% of cases. Among 44 children with epilepsy, 56.8% were boys and 34.1% were schooled. They had psychiatric comorbidity in 15.9% of cases. According to the ZBI scale, the level of burden was high in 45.5% of cases. The total ZBI score was significantly higher among caregivers with primary school level (p=0.05) and those with somatic disease (p=0.004). It was not correlated with the presence of child’s dependence on the others (p=0.20). High levels of depression, anxiety-state, and anxiety-trait among caregivers were correlated with the level of burden (p 0.000; 0.000 and 0.001, respectively).
Conclusions
Being a caregiver of a child with epilepsy is a burdensome circumstance. Hence the importance of offering psychological assistance for these caregivers.
Healthcare services are primarily focusing on medical and physical treatment of COVID-19 while psychosocial and mental health needs are not considered a priority.
Objectives
The purpose of this study was to explore how recovered individuals with COVID-19 adapted to their psychological and social stressors during infection period.
Methods
A descriptive phenomenological approach conducted using a purposeful sample of 13 individuals recovered from COVID-19 in Jordan. Data collected using unstructured interviews.
Results
Perception of being diagnosed with COVID-19 revealed to three major themes; positive learning (acceptance, avoiding social pressure, and normalizing), tolerating ambiguity (denial and seeking information and guidance), and resilience (caring family, professionals’ support, self-grieving, optimism, positive thinking, and spirituality).
Conclusions
The study indicates that there is a need to integrate psychosocial and mental health care services into healthcare plans provided to individuals with COVID-19.
Increasing educational attainment (EA) could decrease the occurrence of depression. We investigated the relationship between EA and depressive symptoms in older individuals across four European regions.
Objectives
1) examine association between EA and depressive symptoms 2) determine, if there is an upper limit to this association 3) explore regional and demographic differences within this relationship across Europe
Methods
We studied 108 315 Europeans (54 % women, median age 63 years old) in Europe assessing EA and depressive symptoms. Logistic regression estimated the association between EA and depressive symptoms, adjusting for sociodemographic and health-related factors; testing for sex/age/region and education interactions.
Results
Higher EA was associated with lower odds of depressive symptoms, independent of sociodemographic and health-related factors. A threshold of the lowest odds of depressive symptoms was detected at the first stage of tertiary education (OR 0.60; 95% CI 0.55-0.65; p<0.001; relative to no education). Central and Eastern Europe showed the strongest association (OR for high vs. low education 0.37; 95% CI 0.33-0.40; p<0.001) and Scandinavia the weakest (OR for high vs. low education 0.69; 95% CI 0.60-0.80; p<0.001). The association was strongest amongst younger individuals. There was a sex and education interaction only within Central and Eastern Europe.
Conclusions
Level of EA is reflected in later-life depressive symptoms, suggesting that supporting individuals in achieving EA, and considering those with lower EA at increased risk for depression, could lead to decreased burden of depression across the life-course. Further educational support in Central and Eastern Europe may decrease the higher burden of depressive symptoms in women.
Serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants thanks to the overall safety and tolerability spectrum. However, they can cause different side effects that not all of them are well identified.
Objectives
We intend to clarify the clinical presentation of mydriasis caused by Escitalopram.
Methods
Reporting the case of a patient suffering a major depressive disorder, that presented a mydriasis after adjusting her antidepressant medication. Then, we conducted a literature review using “PubMed” database and keywords “Mydriasis”, “escitalopram”, “SSRI”,” side effects”.
Results
A 29-year-old female with no past clinical history, presented in May 2021 a severe depression requiring an antidepressant treatment. Under 10 mg per day of escitalopram there was a partial remission of the symptoms, leading to increase the dose by another 10 mg. One month after taking 20 mg/day, she consults before the appointment suffering from a blurry vision and photophobia. Ophthalmologic examination showed a bilateral reactive half-mydriasis, eye pressure was 14 mmHg and fundus examination was normal. Iatrogenic origin of mydriasis was suspected. A gradual interruption of the medication lead to disappearance of the latter. A pharmacological investigation concluded to the suspension of escitalopram and to be vigilant if antidepressant medication would be needed.
Conclusions
Mydriasis is an uncommon side effect caused by SSRI that needs to be kept in mind by clinicians. Therapeutic patient education can help to detect abnormal side effects and treat them if needed.
Obsessive-Compulsive Symptoms (OCS) are common in patients with schizophrenia, with a prevalence of 3.5% to 25%.
Objectives
The aim of our study was to assess the frequency of OCS in patients with schizophrenia, and to study the clinical and evolutionary characteristics of schizophrenia and OCS comorbidity.
Methods
We conducted a cross-sectional, descriptive, and analytical study. Thirty schizophrenic patients were recruited in the department of psychiatry B of Hedi Chaker university hospital of Sfax. We used the Yale-Brown Obsession-Compulsion Scale (Y-BOCS) to assess obsessive and compulsive symptoms, at the end of hospitalization, after clinical remission of schizophrenic symptoms.
Results
The mean age of patients was 41.2, that of disease onset was 27.3. Most of patients were male (86.7%) and unemployed (81.3%). A personal history of suicide attempts was found in 16.6% of patients. The average number of hospitalizations was 8.83. OCS were noted in 36% of patients with a Y-BOCS mean score of 5.5. Patients with OCS had significantly more frequent alcohol use (p = 0,008), a higher number (p = 0.03) and longer duration of hospitalizations (P = 0,034) and are more frequently treated with atypical antipsychotics (p = 0.001).
Conclusions
Our results show that patients with schizophrenia frequently present OCS. This comorbidity has a negative impact on the evolution and the prognosis of the disease, as well as the functioning of patients. Therefore, it should be investigated in order to ensure better care and promote the socio-professional reintegration of these patients.
Endorsing conspiracy theories seems to constitute a major feature of contemporary collective anti-vaccine movements (Vignaud & Salvadori, 2019). As revealed by the COVID-19 pandemic, this contributes to increased worldwide vaccine hesitancy (de Figueiredo et al., 2020).
Objectives
The present work aims at providing novel insight into the collective psychological underpinnings of conspiracy-based vaccine discourses.
Methods
Our approach is inspired by Jung’s view that human groups produce narratives to project their collective conflicts (e.g., social, religious, political) onto reality. We analyze these projections in relation to the “halo effect” phenomenon, namely taking metaphorical extensions of (scientific) concepts at face value (e.g. Keller, 1995). Accordingly, we discuss one version of “the Great Reset” theory, claiming that COVID-19 vaccines are used by “the elite” to control behavior and abolish fundamental freedoms.
Results
Our analysis suggests that Western societies are manifesting some of their existential concerns through anti-vaccine discourse. In “the Great Reset” narrative, characters (people, vaccines, elites, immune systems, etc.) and plot can be read as symbols of, respectively, structural elements of the collective psyche (socio-cultural values, aggressive drives, death anxiety, psychic defenses, etc.), and dynamic interrelations among these elements.
Conclusions
Conspiracy theories can be understood as shared narratives serving the purpose of giving shape to collective fears. Within such a framework, references to “vaccines” and “immunity” are the manifestations of a state of crisis of collective psychic defenses.
In bipolar disorder, cognitive deficits persist across mood episodes and euthymia. Despite recent advances, cognitive impairment in bipolar disorder remains poorly understood. The presentation will focus on recent work where different approaches are used to clarify the role of cognitive deficits in bipolar disorder.
Objectives
First, we have examined the clinical relevance of cognitive impairments and examined if cognitive abilities differ between bipolar disorder subtypes and healthy controls. Second, we examined if cognitive abilities differ between individuals with bipolar disorder with and without attention-deficit hyperactivity disorder. Third, we examined the relationship between cognitive functioning and occupational functioning. Lastly, we examined if long-term changes in cognitive functioning in bipolar disorder patients differ from normal aging.
Methods
The St. Göran Bipolar Project is an interdisciplinary, prospective, naturalistic study of bipolar disorder. Patients were recruited and followed-up at two specialized out-patient clinics in Stockholm and Gothenburg, Sweden.
Results
We showed that there is evidence for significant cognitive heterogeneity in bipolar disorder. Comorbid ADHD could not explain this heterogeneity. Moreover, we showed that excutive functioning is a powerful predictor of occupational functioning. The cognitive trajectory over a 6-year period did not differ between bipolar disorder patients and healthy controls.
Conclusions
There is no conclusive cognitive profile characterizing bipolar disorder. However, cognitive functioning is of great importance in understanding occupational functioning in bipolar disorder. Contrary to the assumption that cognitive impairments may be progressive we show that changes in cognitive functioning over time do not differ between patients and healthy controls.