Bipolar disorder is a chronic mood disorder with episodic progress and high relapse rate. Growing evidence suggests that individuals with bipolar disorder display cognitive impairment which persists even throughout periods of symptom's remission. 137 bipolar patients met the inclusion criteria (depressive episode: DSM-IV-TR criteria for major depressive episode, HAMD score ≥17; manic/hypomanic episode: DSM-IV-TR criteria for manic/hypomanic episode, YMRS score ≥12, euthymic: 6 months of remission, HAMD score ≤8, YMRS score ≤6; and mixed: DSM-IV-TR criteria for mixed episode, HAMD score >8 and YMRS score >6) and were therefore enrolled in the study. Patients were free of psychotic symptoms (hallucinations/delusions) at the moment of testing. Control group consisted of 62 healthy subjects without history of neurological and/or psychiatric disorder. Cognitive battery has been applied in order to assess verbal memory, working memory, psychomotor speed, verbal fluency, attention and speed of information processing, and executive function. Following data were collected: demographics, psychiatric history, age of illness onset; current and previous treatment (including hospitalizations). Cognitive deficits were assessed in bipolar patients experiencing manic, depressive, mixed episodes or who were euthymic in mood. Results were compared between the subgroups and with healthy individuals. The association of impaired cognition with illness course was analyzed. Bipolar patients showed cognitive deficits in all evaluated domains when compared to controls. The lowest scores were obtained for the verbal fluency test. After adjusting for current episode, manic subgroup showed greater cognitive impairment in verbal and working memory, executive function/reasoning and problem solving, compared to depressive, mixed, and euthymic subgroup. Low-neurocognitive performance was directly associated with a predominance of manic episodes and severe course of bipolar illness. An increased number of past manic episodes was the strongest correlated event with the poorest outcomes in verbal memory testing. Other factors correlated with poor verbal memory scores in manic subgroup were age at illness onset (positive correlation), illness length, and hospitalizations (negative correlations). Bipolar patients showed cognitive deficits regardless of the phase of illness. Subjects experiencing a manic episode displayed higher deficits in verbal and working memory, executive function/reasoning, and problem solving. Severe course of illness also showed significant contribution in terms of cognitive impairment.

Endogenous depression represents a severe mental health condition projected to become one of the worldwide leading causes of years lived with disability. The currently available clinical and non-clinical interventions designed to alleviate endogenous depression-associated symptoms encounter a series of inconveniences, from the lack of intervention effectiveness and medication adherence to unpleasant side effects. In addition, depressive individuals tend to be more frequent users of primary care units, which markedly affects the overall treatment costs. In parallel with the growing incidence of endogenous depression, researchers in sleep science have discovered multiple links between rapid eye movement (REM) sleep patterns and endogenous depression. Recent findings suggest that prolonged periods of REM sleep are associated with different psychiatric disorders, including endogenous depression. In addition, a growing body of experimental work confidently describes REM sleep deprivation (REM-D) as the underlying mechanism of most pharmaceutical antidepressants, proving its utility as either an independent or adjuvant approach to alleviating the symptoms of endogenous depression. In this regard, REM-D is currently being explored for its potential value as a sleep intervention-based method for improving the clinical management of endogenous depression. Therefore, this narrative review represents a comprehensive inventory of the currently available evidence supporting the potential use of REM-D as a reliable, non-pharmaceutical approach for treating endogenous depression, or as an adjuvant practice that could improve the effectiveness of currently used medication.

Schizophrenic patients reveal sexual dysfunctions at the onset of the disorder but more profound in chronicity, after long-term anti-psychotic treatment. Various aspects of the sexuality of chronic female schizophrenic patients and sexual side-effects of conventional and atypical anti-psychotics were evaluated. Fifty female chronic schizophrenic patients treated with conventional and atypical anti-psychotics, compared to 50 matched controls, were assessed with: PANSS, UKU sexual side-effects component, GAF, SDBQ-female version and the WHOQOL-BREF. Results showed that schizophrenic female patients were hyposexual, were dissatisfied with their sexual life, had experiences of sexual abuse, emphasizing a high sexual conservatism. The evolution of schizophrenia affected their professional and marital status, their general level of functioning and their quality of life; even novel anti-psychotics are responsible for sexual side-effects comparable to those produced by conventional anti-psychotics. Direct enquiry about sexuality in this group, along with information, symptom and side-effect management, could lead to long-term acceptance of, and adherence to, anti-psychotic medication of sexually active persons suffering from schizophrenia and a better functioning and enjoyment of life.

Cognitive functions have been investigated across depressed, manic, hypomanic, mixed and euthymic episodes of bipolar disorder, but the stability or the progression of cognitive impairment is still under research. The purpose of the present study was to assess the outcome of cognitive functions in bipolar patients following a depressive episode, after a 6-month period in the absence of mood symptoms. 63 bipolar patients were tested with a battery of neurocognitive tests both at baseline (during an acute depressive episode) and after 6 months of euthymia. The cognitive domains assessed included memory, attention, verbal fluency, processing speed and executive functions. Cognitive performances were compared with those of a control group (40 healthy control subjects), both in depression and in euthymia. Patients scored worse than control subjects in several cognitive domains, both in depression and euthymia. The most impaired cognitive functions were executive functions and verbal memory. Between the two moments of assessment bipolar patients obtained a significant improvement in memory, verbal fluency, attention and information processing speed. Psychomotor speed showed no difference between depression and euthymia. Bipolar patients showed impairment in several cognitive domains during depression. A certain degree of impairment remained even after the remission of the affective episode in relationship with the executive functions. Between depression and euthymia, bipolar patients showed important cognitive improvements.

Denis Pavăl, Nicoleta Gherghel-Pavăl, Octavia Oana Căpățînă, Adina Stan, Lajos Raduly, Liviuța Budișan, Ioana Valentina Micluția. Clin Psychopharmacol Neurosci 2024;22:520-30. https://doi.org/10.9758/cpn.24.1164