Somatic symptoms with the heterogeneous character that are not fully explained by a medical condition are common in bipolar disorder (BD) which might interfere with the choice of treatment, health care utilization, medical costs as well as functionality.

The purpose of this study was to evaluate somatic symptoms in remitted type 1 BD and to examine the association of somatization, functionality, and childhood trauma which is a known mediator of adult somatization.

After excluding patients with medical comorbidities, 61 patients diagnosed with BD type-1 according to the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) participated in the study. We required at least 8 weeks of remission and confirm it with Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS). Somatization Scale, Functioning Assessment Short Test (FAST) and Childhood Trauma Questionnaire (CTQ) were administered to the participants.

Somatization scores were significantly correlated with CTQ (r=.310, p=.016), FAST- total (r=.307, p=.016), FAST-financial issues (r=.357, p=.005) and FAST-interpersonal relationships (r=.320, p=.012) subscale scores while inversely correlated with years in education (r=-,305, p=.017). When a partial correlation was run to determine the relationship between somatization and functioning whilst controlling for childhood trauma, there was no statistically significant correlation between somatization and functioning (p=.076).

Our study suggests childhood trauma may have a major influence on the relation between somatization and functionality in patients with type- 1 BD. When addressing physical symptoms in patients with type-1 BD, an integrated approach including childhood trauma should be considered.

No significant relationships.

Fatigue is frequently co-existing with other symptoms and is highly prevalent among patients with cancer and geriatric population. There was a lack of knowledge that focus on fatigue clusters in older adults with cancer in hospice care.

To identify fatigue-related symptom clusters in older adult hospice patients and discover to what extent fatigue-related symptom clusters predict functional status while controlling for depression.

This was a cross-sectional study in a sample of 519 older adult hospice patients with cancer, who completed the Memorial Symptom Assessment Scale, the Center for Epidemiological Studies Depression, Boston Short Form Scale, and the Palliative Performance Scale. Data from a multi-center symptom trial were extracted for this secondary analysis using exploratory factor analysis and hierarchical multiple regression analysis.

Data from 519 patients (78 ± 7 years) with terminal cancer who received hospice care under home healthcare services revealed that 39% of the participants experienced fatigue-related symptom clusters (lack of energy, feeling drowsy, and lack of appetite). The fatigue cluster was significantly associated positively with depression (r = 0.253, p < 0.01), and negatively with functional status (r = −0.117, p < 0.01) and was a strong predictor of participants’ low functional status. Furthermore, depression made a significant contribution to this predictive relationship.

Older adult hospice patients with cancer experienced various concurrent symptoms. The fatigue-specific symptom cluster was identified significantly associated with depression and predicted functional status. Fatigue should be routinely monitored in older adults, especially among hospice cancer patients, to help reduce psychological distress and prevent functional decline.

Current definitions for delusional disorder (DD) state that no cognitive or functional impairment is present. However, this assumption lacks empirical validation and has been questioned by numerous authors over the years. Through systematic search we collected articles that compare patients with DD with either healthy controls or patients with schizophrenia on the basis of their cognitive symptoms and their functional outcomes.

Our aim is to draw conclusions from the available evidence on neurocognitive and functional affectation of DD.

Systematic electronic search was performed using Pubmed and Embase databases. Inclusion criteria included that selected articles must be original studies, must be published in peer-reviewed journals, must contain a sample of DD patients that is compared with a sample of healthy controls and/or patients with schizophrenia and that samples must be compared on the basis of cognitive and/or functionality parameters. A qualitative synthesis was performed due to heterogeneity in data.

According to the information collected through our systematic review, DD patients tend to perform worse than healthy control in tests assessing cognitive functions. Results are not as conclusive regarding comparison between DD and schizophrenia, with mixed outcomes. When it comes to functionality, results are not conclusive either, with some degree of evidence pointing towards a better functioning in patients with DD in comparison to patients with schizophrenia.

Results agree with many authors who consider both conditions as part of a psychosis spectrum. Cognitive interventions, such as cognitive remediation, must be studied for their potential role in the treatment of patients with DD.

Functional recovery is the contemporary treatment goal in Major Depressive Disorder (MDD). Although consistency among physician and patient expectations may influence the therapeutic result (Demyttenaere K et al, 2011), patients’ perceptions are not always fully captured. Vortioxetine,a multimodal antidepressant, has shown encouraging data in achieving functional recovery, improving both mood and cognitive symptoms (Mahableshwarkar AR et al, 2015).

The aim of the study was to assess the effectiveness of vortioxetine on mood symptoms, cognitive symptoms and functionality, assessed by patient-rated tools, in MDD outpatients in Greece.

In this non-interventional study, vortioxetine was administered as flexible dosing (5-20 mg/d). Mood symptoms, cognitive symptoms and functioning were assessed by the patient-rated scales PHQ-9, PDQ-D and SDS respectively, at baseline, 1 and 3 months. Repeated measures analysis of variance and t-test were used for the statistical analyses.

336 patients participated in the study. PHQ-9 score ±SD decreased from 16.1±5.3, to 10.0±5.7 and 4.6±4.5, PDQ-D score ±SD decreased from 37.3±16.6 to 23.1±14.8 and 12.0±10.6, SDS Score ±SD decreased from 18.7±5.3 to 12.9±5.9 and to 7.8±6.5, at baseline, 1 and 3 months, respectively. The 3 SDS subscales: work/school life improved from 5.8±2.4 to 4.2±2.2 and 2.6±2.2, social life improved from 6.6±2.0 to 4.5±2.2 and 2.7±2.3 and family life improved from 6.3±2.0 to 4.3±2.1 and 2.6±2.3 -baseline, 1 and 3 months, respectively (p<0.001 for all paired comparisons).

MDD patients in Greece treated with vortioxetine significantly improved on mood symptoms, cognitive symptoms and functioning, enriching the already published efficacy data which is mostly based on clinician-rated scales.

A. Galanopoulos and E. Papalexi are full-time employees in Lundbeck Hellas.

Horticultural therapy is used as alternative treatment option in rehabilitation programs for patients suffering from chronic mental disorders. In Greece, the Psychiatric Hospital of Thessaloniki was the first that organized a organized Rehabilitation Program approved by the Greek Ministry of Health, the “Green Unit - Monada Prasinou”.

The purpose of this study was to investigate the effect of horticultural intervention on the functionality of patients employed in the Green Unit of the Psychiatric Hospital of Thessaloniki.

The Mini-ICF-APP Social Functioning Scale was used to evaluate the functionality of the patients. Horticulture therapy included actual gardening and other agricultural activities. The sample consisted of two groups, 22 inpatient of the Green Unit and 22 patients of outpatient units as a control group. The majority of the patients suffered from Schizophrenia spectrum disorders. Both patients’ groups were evaluated over 12 months (May 2018- May 2019).

At baseline evaluation, the patients of the Green Unit patients presented higher scores only in the mobility and endurance subscale. A year later there was a statistically significant difference in all thirteen subscales. Shortly, the patients were rated as more consistent, organizational, social, flexible, responsible, more confident and enterprising, more adaptable and more able to take care of themselves.

The results suggest that horticulture as a therapeutic method had beneficial effects in all dimensions of patient functionality confirming the hypothesis that such programs should be a priority in the effort of psychosocial reintegration of patients suffering from chronic mental disorders.

The available literature indicates a possible association between metabolic syndrome (MS) which is highly prevalent among patients with bipolar disorder (BD), and functioning.

We sought to compare differences in functional areas of patients with Bipolar Disorder Type 1 (BPD-1)with and without MS in euthymic period.

This study included 69 euthymic BPD-1 patients without MS and 46 age- and sex-matched BPD-1 patients with MS. All participants completed a sociodemographic form; took the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Young Mania Rating Scale score, and Bipolar Disorder Functioning Questionnaire. MS was diagnosed according to the International Diabetes Federation (IDF) criteria.

All of the functioning areas were significantly lower in the BPD-1 with MS group than in the without MS group (p < 0.05). Moreover age at onset of disease was significantly lower in BPD-1 group with MS than without MS (p < 0.05). Number of suicide attempts was significantly higher in BPD-1 group with MS than without MS (p < 0.05). Catatonic and melancholic depression were significantly more prevalent in the BPD-1 with MS than without MS (p < 0.05).

Our findings suggest that MS might have an effect on functioning in BD patients even in euthymic period.

No significant relationships.

Autism spectrum disorders (ASD), is a population that does not usually receive specific treatment.

The main objective of the present study is to evaluate whether specific interventions within the TAVA program (transition program to adult life for patients with ADS), produce significant improvements in the quality of life of young adults with ASD.

This is a prospective randomized clinical study of patients with ASD (according to DSM-5 criteria) seen in outpatient of the Parc Tauli University Hospital in Sabadell (Barcelona) since September 2017. We compared the quality of life, functionality, caregiver burden, and comorbidity of patients in TAVA program (beneficiaries of group therapy and specific medical and psychosocial interventions), with that of control patients (treatment as usual), after 2 years of intervention.

Our sample is composed of 12 patients with ASD. The average age is 18.4 years. 83% of the sample are men (n = 10). 5 of the patients belonged to TAVA and the other 7 were controls. Overall, TAVA patients presented improvement in the ZARIT and BAI scales compared to control patients. The control patients evolved less favorably in the AAA, SRS and RAAS levels compared to TAVA.

Specific interventions in adults with ASD, improve the caregiver’s feeling of overload and the patients anxiety, compared to the usual interventions. The lack of regulated interventions produces an unfavorable evolution of the core symptoms of autism. More studies are needed to specify efficient interventions to improve the quality of life of adults with ASD.

No significant relationships.

Assesing family functionality in families with a member diagnosed according to DSM IV TR with depressive disorder; depression intensity was assesed with HDRS.

A sample of 3o families (71 members); FFS assesses the most important and consistent five functioning areas: positive affect, comunication, conflicts, worries and rituals.

Values obtained in each of the 40 questions of the scale can give information on variables affecting the increase or decrease in subscales values. Positive affect 35,07, communication 37, conflicts 15,11, worries 40,77, rituals 45,03. The reuslts were compared to those obtained by assessin normal families from a control group of 132 families (323 members).

Differences were noticed. Values obtained in our study represent the standard of functioning of families with a depressed member.

Two-hundred and ninety-five chronic schizophrenia patients from 11 centres were included in the study. Symptom severity was measured with Positive and Negative Syndrome Scale for schizophrenia. QoL and functionality was assessed with Global Assessment of Functioning Scale, Quality of Life Scale, Personal and Social Performance Scale, Psychosocial Remission in Schizophrenia Scale, Functional Recovery Scale in Schizophrenia, Performance-Based Skills Assessment-Brief Version and Subjective Well-being under Neuroleptics Scales.

Two-third of the participants (n = 194) were unemployed. Forty (13.6%) of the participants were involved in full-time work/study, 29 (9.8%) people were involved in part-time work/study, 13 (4.4%) people were engaged in work/study below 50% of the time, but their job was classified as regular and independent. Those who work/study had lower symptoms, better functioning and higher levels of QoL. Also those who work/study full-time displayed better results on these measures than the participants involved in part-time work/study. Age, education, severity of negative symptoms, gender and duration of remission were found to be related to employment status in the logistic regression analysis.

Our findings suggest that work/study status is an important component of functionality.

To investigate the nature of the relationship between cognitive function, mood state, and functionality in predicting awareness in a non-clinically depressed sample of participants with mild to moderate Alzheimer’s disease (AD) in Brazil.

People with AD (PwAD) aged 60 years or older were recruited from an outpatient unit at the Center of AD of the Federal University of Rio de Janeiro, Brazil. Measures of awareness of condition (Assessment Scale of the Psychosocial Impact of the Diagnosis of Dementia), cognitive function (Mini-Mental State Examination), mood state (Cornell Scale for Depression in Dementia), and functionality (Pfeffer Functional Activities Questionnaire) were applied to 264 people with mild to moderate AD and their caregivers. Hypotheses were tested statistically using SEM approach. Three competing models were compared.

The first model, in which the influence of mood state and cognitive function on awareness was mediated by functionality, showed a very good fit to the data and a medium effect size. The competing models, in which the mediating variables were mood state and cognitive function, respectively, only showed poor model fit.

Our model supports the notion that the relationship between different factors and awareness in AD is mediated by functionality and not by depressive mood state or cognitive level. The proposed direct and indirect effects on awareness are discussed, as well as the missing direct influence of mood state on awareness. The understanding of awareness in dementia is crucial and our model gives one possible explanation of its underlying structure in AD.