Impairments of empathy have been observed in patients with various psychiatric Disorders. Yet, little research on empathy concerning mood disorders exists.

To compare empathy levels in euthymic bipolar patients (BP) and healthy controls (HC).

A cross-sectional and comparative study of 78 patients followed for bipolar disorder, during euthymia, at the psychiatric outpatient clinic at CHU Hédi Chaker in Sfax, and 78 age-gender matched HC. We used a socio-demographic and clinical data sheet and the Questionnaire of Cognitive And Affective Empathy (QCAE) to assess empathy with its two dimensions : “Affective empathy” and “Cognitive empathy”.

The average age was 36.27 years, the sex ratio was 5.5. Bipolar I disorder was diagnosed in 88.5% of patients. The mean age of onset was 27.73 years, and the mean duration of illness was 8.4 years. Total scores of empathy as well as scores of cognitive and affective empathy were higher in HC than in BP. *Total QCAE BP vs HC : 72.49 vs 80.53 *Cognitive empathy BP vs HC : 43.21 vs 94.24 *Affective empathy BP vs HC : 29.36 vs 30.44 A significant difference in QCAE score and cognitive empathy score between BP and HC was found (p<10-3).

In our study, euthymic BP have been less empathetic than HC. Research on the subject are small and few. Thus, more studies are needed to confirm our results on the effect of mood disorders on empathy.

No significant relationships.

Numerous studies have documented high rates of functional impairment among bipolar disorder patients, even during phases of euthymia.

To study different domains of functioning impairment in bipolar patients during euthymic phase.

A cross-sectional and descriptive study of 78 patients followed for bipolar disorder, during euthymia, at the psychiatric outpatient clinic at CHU Hédi Chaker in Sfax. We used a socio-demographic and clinical data sheet and the Functioning Assessment Short Test (FAST) to assess functionning : A functional impairment was retained for a total FAST score > 11.

The average age was 36.27 years, the sex ratio was 5.5. Bipolar I disorder was diagnosed in 88.5% of patients. The mean age of onset was 27.73 years, and the mean duration of illness was 8.4 years. *The mean total score at the FAST was 22.23. *Functioning was altered on 69.2% of patients. *The occupational and the cognitive functioning were the two most altered domains in our population (respective mean scores : 8.69 and 5.74). *Autonomy was altered on 17.9% of patients. *Occupationnal functioning was altered on 76.9% of patients. *Cognitive functioning was altered on 70.5% of patients. *Financial issues were observed on 34.6% of patients. *Interpersonal relationships were altered on 41% of patients. *Leisure time difficulties were present with 24.4% of patients.

This work has focused on the very high frequency of functional handicap in euthymic bipolar patients. Thus, several measures must be put in place to prevent or mitigate the negative effects of the impaired functioning on these patients.

No significant relationships.

The capacity to focus and concentrate or to direct attention supports many aspects of cognitive functioning including short-term memory and higher-level cognitive functions. The purpose was to assess attentional networks in euthymic patients with unipolar depression using the Attentional Network Test (ANT).

We investigated performance of attention by virtue of ANT during remission from unipolar depressive disorder and tested a hypothesis that there are no differences between outpatient group (euthymic patients, N = 32) and matched controls in attentional variables, the relationship of attentional networks and everyday cognitive failures.

No differences between the groups in attentional networks were found and no relationship between attentional networks and cognitive failures was found.

One assessment during remission could be insufficient to recognize long-term pattern of cognitive functions.

These data show non-impaired attentional networks possibly explained by sufficient level of remission and ameliorated influence of high education on cognition.

Persistent impairment in cognitive function has been described in euthymic individuals with bipolar disorder. Collective work indicates that obesity is associated with reduced cognitive function in otherwise healthy individuals. This sub-group post-hoc analysis preliminarily explores and examines the association between overweight/obesity and cognitive function in euthymic individuals with bipolar disorder.

Euthymic adults with DSM-IV-TR-defined bipolar I or II disorder were enrolled. Subjects included in this post-hoc analysis (n = 67) were divided into two groups (normal weight, body mass index [BMI] of 18.5–24.9kg/m2; overweight/obese, BMI≥25.0kg/m2). Demographic and clinical information were obtained at screening. At baseline, study participants completed a comprehensive cognitive battery to assess premorbid IQ, verbal learning and memory, attention and psychomotor processing speed, executive function, general intellectual abilities, recollection and habit memory, as well as self-perceptions of cognitive failures.

BMI was negatively correlated with attention and psychomotor processing speed as measured by the Digit Symbol Substitution Test (P<0.01). Overweight and obese bipolar individuals had a significantly lower score on the Verbal Fluency Test when compared to normal weight subjects (P<0.05). For all other measures of cognitive function, non-significant trends suggesting a negative association with BMI were observed, with the exception of measures of executive function (i.e. Trail Making Test B) and recollection memory (i.e. process-dissociation task).

Notwithstanding the post-hoc methodology and relatively small sample size, the results of this study suggest a possible negative effect of overweight/obesity on cognitive function in euthymic individuals with bipolar disorder. Taken together, these data provide the impetus for more rigorous evaluation of the mediational role of overweight/obesity (and other medical co-morbidity) on cognitive function in psychiatric populations.

Bipolar disorder I (BD-I) is defined by episodes of mania, depression and euthymic states. These episodes are among other symptoms characterized by altered reward processing and negative symptoms (NS), in particular apathy. However, the neural correlates of these deficits are not well understood.

We first assessed the severity of NS in 25 euthymic BD-I patients compared with 25 healthy controls (HC) and 27 patients with schizophrenia (SZ). Then, we investigated ventral (VS) and dorsal striatal (DS) activation during reward anticipation in a Monetary Incentive Delayed Task and its association with NS.

In BD-I patients NS were clearly present and the severity of apathy was comparable to SZ patients. Apathy scores in the BD-I group but not in the SZ group correlated with sub-syndromal depression scores. At the neural level, we found significant VS and DS activation in BD-I patients and no group differences with HC or SZ patients. In contrast to patients with SZ, apathy did not correlate with striatal activation during reward anticipation. Explorative whole-brain analyses revealed reduced extra-striatal activation in BD-I patients compared with HC and an association between reduced activation of the inferior frontal gyrus and apathy.

This study found that in BD-I patients apathy is present to an extent comparable to SZ, but is more strongly related to sub-syndromal depressive symptoms. The findings support the view of different pathophysiological mechanisms underlying apathy in the two disorders and suggest that extra-striatal dysfunction may contribute to impaired reward processing and apathy in BD-I.

Cognitive deficits are a well-established feature of bipolar disorders (BD), even during periods of euthymia, but risk factors associated with cognitive deficits in euthymic BD are still poorly understood. We aimed to validate classification criteria for the identification of clinically significant cognitive impairment, based on psychometric properties, to estimate the prevalence of neuropsychological deficits in euthymic BD, and identify risk factors for cognitive deficits using a multivariate approach.

We investigated neuropsychological performance in 476 euthymic patients with BD recruited via the French network of BD expert centres. We used a battery of tests, assessing five domains of cognition. Five criteria for the identification of neuropsychological impairment were tested based on their convergent and concurrent validity. Uni- and multivariate logistic regressions between cognitive impairment and several clinical and demographic variables were performed to identify risk factors for neuropsychological impairment in BD.

One cut-off had satisfactory psychometric properties and yielded a prevalence of 12.4% for cognitive deficits in euthymic BD. Antipsychotics use were associated with the presence of a cognitive deficit.

This is the first study to validate a criterion for clinically significant cognitive impairment in BD. We report a lower prevalence of cognitive impairment than previous studies, which may have overestimated its prevalence. Patients with euthymic BD and cognitive impairment may benefit from cognitive remediation.