Executive function organizes and directs behaviour but alterations in this cognitive domain can lead to inaccurate perception, interpretation and response to environmental information, which could be a risk factor for suicide.

To explore executive function performance of depressed recent suicide attempters in comparison to depressed past suicide attempters, depressed non-attempters and healthy controls.

96 participants from the Psychiatry Department of the Araba University Hospital-Santiago were recruited as follows: 20 patients with a recent suicide attempt (<30days) diagnosed with a Major Depressive Disorder (MDD), 33 MDD patients with history of attempted suicide, 23 non-attempter MDD patients and 20 healthy controls. All participants underwent a clinical interview and neuropsychological assessment on executive function with the Wisconsin Sorting Card Test. Backward multiple regressions were performed adjusting for significant confounding variables. For group comparisons ANOVA test and Bonferroni post hoc test were performed with p<0.05 significance level.

Patient groups did not differ regarding severity of depression. All patient groups performed significantly worse than healthy controls on executive function. Adjusted comparisons between patient groups indicated that recent suicide attempters had a poorer performance in this cognitive domain in comparison to both depressed lifetime attempters and depressed non-attempters (B=0.296, p=0.019 and B=0.301, p=0.028 respectively).

Executive function performance is altered in recent suicide attempts. As impaired executive function can be a risk factor for suicide, preventive interventions on suicide should focus on its assessment and rehabilitation.

No significant relationships.

Ocular Coherence Tomography (OCT) to measure retinal thickness is the current method to observe neurological impairment in neurodegenerative diseases [1] and in mental disorders [2] due to the composition of the retina itself as an anatomic extension of the brain.There can be found some factors to improve the resilience like the years of study.

Our aim is to evaluate cognitive and clinical impairment in Bipolar Disorder and see the correlation to the retinal thinning.

Twenty-seven patients diagnosed with Bipolar Disorder were assessed in the context of the FINEXT programme (3). Selective attention, executive functions and verbal memory were measured among other variables. Using the OCT technique, we measured the thickness of the ppRNFL, the RFNL, GCL and IPL layers in the macula in both eyes through several radial segments. Partial correlations were performed with Bonferroni correction (p≤0.006) adjusted for age and academic status except for the variable years of study which was adjusted for age.

Significant direct correlations were observed between: - The study-years and the thickness of the retina in the NO and RFNL. -Selective attention and GCL and RFNL layers. -Executive function and the GCL and IPL.

We can observe some preliminar results showing a significant correlation between some layers of the retina, upper segments more frequently, and the outcomes of the neurocognitive assessment. We can see a relationship as well between years of study and the thickness of the Retinal Nerve Fibre Layer in the retina and optic nerve head, the axons of the neurons in the eye.

No significant relationships.

Suicidal behaviour and cognition: A systematic review with special focus on prefrontal deficits Introduction: Suicide is a major health concern worldwide, thus, identifying risk factors would enable a more comprehensive understanding and prevention of this behaviour. Neuropsychological alterations could lead to difficulties in interpreting and managing life events resulting in a higher risk of suicide.

Objective: Bibliographic review about the influence of neuropsychological deficits on suicidal behaviour.

Method: A systematic literature search from 2000 to 2020 was performed in Medline (Pubmed), Web of Science, SciELO Citation Index, PsycInfo, PsycArticles and Cochrane Library databases regarding studies comparing cognition of attempters versus non-attempters that share same psychiatric diagnosis. Results: 1.885 patients diagnosed with an Affective Disorder (n = 1512) and Schizophrenia/ Schizoaffective Disorder (n = 373) were included.

In general comparison, attention was found to be clearly dysfunctional. Regarding diagnosis, patients with Schizophrenia and previous history of suicidal behaviour showed a poorer performance in executive function. Patients with current symptoms of an Affective Disorder and a previous history of suicidal attempt had poorer performance in attention and executive function. Similarly, euthymic affective patients with history of suicidal behaviour had worse decision-making, attention and executive function performance compared to euthymic non-attempters.

Patients who have attempted suicide have a poorer neuropsychological functioning than non-attempters with a similar psychiatric disorder in attention and executive function. These alterations increase vulnerability for suicide.

Jessica Fernández-Sevillano is beneficiary of the Pre-PhD Training Programme of the Basque Government. Dr. Gonzalez-Pinto has received grants and served as consultant, advisor or CME speaker for the following entities: Almirall, AstraZeneca, Bristol-Myers

Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear.

The aim of the study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years.

The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis.

At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (−10.215 to −0.337) and (−4.731 to −0.605) respectively).

Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.

This work was supported by the Carlos III Institute of Health and European Fund for Regional Development (PI08/1213, PI11/ 01977, PI14/01900, PI08/01026, PI11/02831, PI14/01621, PI08/1161, PI16/ 00359, PI16/01164, PI18/00805), the Basque Foundation for He

To evaluate the influence of cannabis in the long-term follow-up in patients with a first psychotic episode, comparing those who have never used cannabis with (a) those who used cannabis before the first psychotic episode but stopped it during the follow-up, and (b) those who used cannabis both before and after the first psychotic episode.

Patients were followed from the first psychotic admission. They were assessed at 1, 3 and 5 years obtaining information about functional outcome, positive and negative symptoms. At 8th year functional outcome was evaluated. Patients were classified in 3 groups: 40 that never used cannabis (NU), 27 that used cannabis and stopped during follow-up (CUS), and 25 that had continued use during follow-up (CU).

At baseline, there were differences neither in functional outcome nor in negative symptoms. The CUS group improved the functional outcome during the follow-up (p< 0.001), while CU and NU groups did not show any significant results (p= 0.466 and p= 0.370 respectively). CUS group had also a significant decreasing trend in negative symptoms (p= 0.012), whereas for the other two groups no significant results were observed (p= 0.069 and p= 0.226 respectively). All groups improved in positive symptoms during follow-up.

Although cannabis use has deleterious effect, to stop it after the first psychotic episode produces a clearly improvement in the long-term follow-up.

Patients with schizophrenia and bipolar disorder appear to have more difficulties with smoking cessation than the general population. Moreover, gender and unsuccessful smoking cessation are associated with depression and negative emotional experience. Less attention has been given to the association of cigarette smoking in women and the use of other substances.

To determine the influence of gender and substance abuse on smoking cessation in a long-term follow up after a first psychotic episode.

Patients were evaluated at years 1, 3, and 5 obtaining information about functional outcome, positive and negative symptoms and substance use. At 8th year, functional outcome and use of substance were recorded. Patients were classified in two groups: those who stopped smoking during follow-up, and those who did not stop.

At baseline, rates of tobacco smoking were high with no differences between genders. Difficulty with smoking cessation was associated with female (p = 0.017) and typical antipsychotics (p = 0.032). Those who used alcohol continuously were less likely to stop smoking (p = 0.050) controlling for typical antipsychotics. The interaction with gender was not significant. Continuous cannabis use was not associated with smoking cessation, but women who use cannabis continuously were less able to stop smoking than men (adjusted p = 0.036).

Women are less prone to quit smoking than men during long-term follow-up after the development of psychosis. Different treatments should be considered for men and women in relation to tobacco dependence in patients with psychotic disorder. Treatment for women smokers should probably be more supportive and intensive.

Both oxidative stress and the inflammatory chemokine MCP-1 have been linked to the pathophysiology of certain mental illnesses such as psychosis. There are previous studies in rats and dogs suggesting that oxidative stress can cause cognitive impairment.

To correlate oxidative stress and the chemokine MCP-1 levels with cognitive impairment in first episode psychosis.

28 patients with first episode psychosis and 28 healthy controls matched by sex and age were included in the study, who were given a battery of neurocognitive tests and we determined their blood levels of lipid peroxidation (TBARS), nitric oxide, total antioxidant status (TAS), glutathione, activity of enzymes catalase (CAT), glutathione peroxidase (cGPx) and superoxide dismutase (SOD) and the inflammatory chemokine MCP-1.

Healthy controls had better TAS than patients and increased activity of enzymes cGPx and CAT.

We found a statistically significant negative relationship between levels of MCP-1 and working memory, attention and verbal memory. At higher levels of chemokines, worse cognitive functioning in these areas.

Verbal memory was also negatively related, in a meaningful way, with nitric oxide levels in blood.

Likewise, we found that higher levels of glutathione correlated with better scores on the 3 tests performed of verbal fluency.

In patients with a PEP, levels of certain markers of oxidative stress and inflammation are associated with poorer cognitive functioning.

To examine the predictive diagnostic value of affective symptomatology in a first-episode psychosis (FEP) sample with 5 years’ follow-up.

Affective dimensions (depressive, manic, activation, dysphoric) were measured at baseline and 5 years in 112 FEP patients based on a factor structure analysis using the Young Mania Rating Scale and Hamilton Depression Rating Scale. Patients were classified as having a diagnosis of bipolar disorder at baseline (BDi), bipolar disorder at 5 years (BDf), or “other psychosis”. The ability of affective dimensions to discriminate between these diagnostic groups and to predict a bipolar disorder diagnosis was analysed.

Manic dimension score was higher in BDi vs. BDf, and both groups had higher manic and activation scores vs. “other psychosis”. Activation dimension predicted a bipolar diagnosis at 5 years (odds ratio = 1.383; 95% confidence interval, 1.205–1.587; P = 0.000), and showed high levels of sensitivity (86.2%), specificity (71.7%), positive (57.8%) and negative predictive value (90.5%). Absence of the manic dimension and presence of the depressive dimension were both significant predictors of an early misdiagnosis.

The activation dimension is a diagnostic predictor for bipolar disorder in FEP. The manic dimension contributes to a bipolar diagnosis and its absence can lead to early misdiagnosis.

Pro/antiinflammatory imbalance has been found in first-episode psychotic (FEP) patients, even 12 months later. Current research is every time more focused in the need to find biomarkers to understand the underlying pathophysiological mechanisms of this severe illness.

To assess peripherical levels of neurotrophins and their receptors and their correlation with inflammation, clinical symptomatology and response to antipsychotic treatment, over the time.

Ninety-four FEP patients and 80 matched healthy controls were included. Blood samples were taken at baseline to measure BDNF and NGF and their receptor levels (TrkB-full, TrkB-truncated and TrkA) and pro/antiinflammatory parameters (NFkB, COX-2, iNOS, PPARgamma, 15d-PG12). Patients were followed-up during 12 months.

BDNF TrkB-full receptor and NFG TrkA receptor levels increased during the follow-up whereas BDNF TrkB-truncated form receptor decreased. After adjusting for confounding variables, baseline levels of proinflamatory variables were significantly related to TrkB-full/TrkB-truncated ratio (FL/T), suggesting that a higher proinflammatory status is related to a higher FL/T ratio expression. Furthermore, baseline FL/T ratio could have a predictor role of patient's functionality 1 year after the illness onset, depending on whether patient is treated or not with antipsychotic drugs.

Inflammatory processes, neurotrophic pathways and functional status of FEP patients seem to be related which is of great traslational relevance. Specific, the expression of the 2 isoforms of BDNF receptor should be taken into account before starting an antipsychotic drug treatment.

The authors have not supplied their declaration of competing interest.

The bipolar disorder (BD) has an important effect over the lives of patients and families. The attitude of the family is a modifiable factor through specific interventions and it has been related with BD prognosis.

Study a sample of families and patients with BD.

Compare between two groups its course of burden of caring for family members with BD. Also, we will see the course of the functionality in patients.

Sample of 148 individuals who caring a familiar with BD. Seventy-six of these followed psychoeducation session are going to be experimental group (EG), and the others 72 did not followed any session are going to be control group (CG). There is a follow-up at 6 months and one year. To see the course of the burden and the functionality it will be used mixed models.

At baseline, there were not significant differences between CG and EG in objective and subjective burden and functionality. But over time there were significant results in the three cases. For objective burden (b = −0.016; P = 0.0001) EG presented a drop (b = −0.014; P = 0.0062), while CG did not show changes (b = 0.002; P = 0.4691). For subjective burden (b = −0.014; P = 0.0058) without significant results for CG (b = −0.352; P = 0.3203) and a significant decrease in EG (b = −0.017; P = 0.003). For the functionality (b = 1.474; P = 0.000) there was a significant increase in EG (b = 1.349; P = 0.000) but not for CG (b = −0.125; P = 0.3828).

Two groups did not differ at baseline however after the psychoeducation sessions appear clear differences, decreasing the burden for EG group and the functionality also improved for EG.

The authors have not supplied their declaration of competing interest.

Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years.

The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis.

At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (−10.215 to −0.337) and (−4.731 to −0.605) respectively).

Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.