Search

Introduction: Theory of mind (ToM) or mentalizing deficits have been found in schizophrenia (SZ) and bipolar disorder (BD), but their relationships to patients' coexistent neurocognitive deficits are still unclear. The present study aimed to explore the possible differential involvement of neurocognitive deficits in ToM impairments in SZ and euthymic BD. Methods: Fifty-three euthymic patients with BD type I, 54 clinically stable patients with SZ, and 53 healthy participants were assessed with an advanced ToM task (Faux Pas Recognition Test) which measures cognitive and affective ToM components, and a comprehensive battery of neuropsychological measures. The three groups were matched for gender, age and education. Results: Patients with BD showed significant impairment, comparable to that in SZ, only in the cognitive facet of ToM, whereas SZ patients had significantly poorer performance than both BD patients and healthy participants in overall and affective ToM. In both SZ and euthymic BD, ToM performance was related to deficits in particular cognitive functions. After controlling for coexistent neurocognitive deficits, overall and affective ToM in SZ were still impaired whereas the cognitive ToM impairment in BD and SZ did not remained statistically significant. Conclusions: Our findings suggest a different profile of ToM deficits between SZ and BD and an independence of ToM dysfunction from concurrent neurocognitive deficits in SZ but not in BD.

The current study aimed to examine the impact of theory of mind (ToM) deficits on body image delusionality in anorexia nervosa (AN) while accounting for the effect of other cognitive functions. ToM and other cognitive functions were assessed in 46 patients with AN and 42 healthy controls. We used the Brown Assessment of Beliefs Scale to assess the degree of delusionality of body image beliefs in AN patients. Delusional body image beliefs were identified in 26.1% and overvalued ideas in 30.4% of the AN patients. Moderate but significant associations were found between impairments in ToM-overall capacity, cognitive and affective components-and body image delusionality. The effect of overall ToM performance on delusionality remained significant after controlling for other cognitive factors. General intelligence was also significantly associated with delusionality. Our findings support the notion that difficulties in taking the perspective of others contribute to insight impairment in AN. Further investigation is required to examine the effect of failures in social cognition and metacognition on insight in AN.

The existing evidence on the specific profile and the determinants of empathic and mentalizing abilities in anorexia nervosa (AN) and bulimia nervosa (BN) is not conclusive. Moreover, it is not clear whether patients with eating disorders also exhibit diminished ability to accurately appraise their own empathic skills. We examine in AN and BN: (a) the impairments in various aspects of empathy and theory of mind (ToM), while accounting for the effect of other cognitive functions and (b) the accuracy of self-appraisal of empathy. Self-reported and performance-based empathy, ToM, and cognitive functions were assessed in 46 patients with AN, 30 patients with BN, and 42 healthy controls (HC). Both AN and BN patients reported diminished overall empathic abilities, whereas only BN patients reported reduced cognitive empathy compared to HC. Deficits in performance-based empathy were found in both patient groups. Cognitive ToM was impaired only in AN. Significant correlations between self-reported and performance-based empathy were found in BN and HC but not in AN. Cognitive deficits negatively affected the self-appraisal of empathy in AN but not empathic skills per se. Our findings highlight a double deficit related to empathic responding in AN: diminished performance and inaccurate self-appraisal of empathic abilities, indicating dysfunctional self-reflection.

Background: No evidence currently exists characterising global outcomes following major cancer surgery, including esophageal cancer. Therefore, this study aimed to characterise impact of high income countries (HIC) versus low and middle income countries (LMIC) on the outcomes following esophagectomy for esophageal cancer. Method: This international multi-center prospective study across 137 hospitals in 41 countries included patients who underwent an esophagectomy for esophageal cancer, with 90-day follow-up. The main explanatory variable was country income, defined according to the World Bank Data classification. The primary outcome was 90-day postoperative mortality, and secondary outcomes were composite leaks (anastomotic leak or conduit necrosis) and major complications (Clavien-Dindo Grade III-V). Multivariable generalized estimating equation models were used to produce adjusted odds ratios (ORs) and 95% confidence intervals (CI95%). Results: Between April 2018 to December 2018, 2247 patients were included. Patients from HIC were more significantly older, with higher ASA grade, and more advanced tumors. Patients from LMIC had almost three-fold increase in 90-day mortality, compared to HIC (9.4% vs 3.7%, p < 0.001). On adjusted analysis, LMIC were independently associated with higher 90-day mortality (OR: 2.31, CI95%: 1.17-4.55, p = 0.015). However, LMIC were not independently associated with higher rates of anastomotic leaks (OR: 1.06, CI95%: 0.57-1.99, p = 0.9) or major complications (OR: 0.85, CI95%: 0.54-1.32, p = 0.5), compared to HIC. Conclusion: Resections in LMIC were independently associated with higher 90-day postoperative mortality, likely reflecting a failure to rescue of these patients following esophagectomy, despite similar composite anastomotic leaks and major complication rates to HIC. These findings warrant further research, to identify potential issues and solutions to improve global outcomes following esophagectomy for cancer. (C) 2020 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Background The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. Methods Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. Results Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). Conclusion Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on perioperative outcomes in the international multicentre Oesophago-Gastric Anastomosis Audit (OGAA). Analysis of 2232 oesophagectomies has shown that trainee involvement did not negatively impact perioperative outcomes.

Impaired interpersonal, social, and occupational functioning is very often observed in patients with bipolar disorder, not only at the acute stages of the illness but in remission as well. This finding raises the question of multiple factors that might affect psychosocial functioning in bipolar patients, such as residual subsyndromal symptoms and neuropsychological deficits. Social cognition impairment, especially impaired Theory of Mind (ToM), might also play an important role in bipolar patients' every-day functioning, similarly to what was found in patients with schizophrenia. The present study aimed to investigate the potential effect of clinical and cognitive factors on the psychosocial functioning of patients with bipolar disorder during remission, assessing ToM along with a broad range of basic cognitive functions. Forty-nine patients with bipolar disorder type I in remission and 53 healthy participants were assessed in general intelligence, working memory, attention, speed processing, verbal learning and memory, and executive functions using a comprehensive battery of neuropsychological tests. The Faux Pas Recognition Test was used to assess ToM. The two groups were matched for gender, age and education level. The Hamilton Rating Scale for Depression (HDRS), the Young Mania Rating Scale (YMRS), and the Brief Psychiatric Rating Scale (BPRS) were also administered to the patients. Every-day functioning was assessed with the Global Assessment of Functioning (GAF). In order to examine the contribution of many factors in psychosocial functioning, we used hierarchical multiple regression analysis. Bipolar patients presented significant impairment compared to healthy participants in all the basic cognitive functions tested with the exception of verbal memory. Moreover, patients had significant poorer performance than healthy controls in overall psyand cognitive ToM but not in affective ToM as measured by Faux Pas. Psychosocial functioning in patient group was significantly correlated to symptom severity-especially depressive (p

Background: To investigate the phenomenon of internet addiction and concurrent social (off-line) behaviours of an adolescent population a cross-sectional survey of the entire adolescent student population (N = 1270, aged 14–18) of the island of Kos in Greece was conducted. Method: Completion by the survey participants of a demographic questionnaire, the 8-question YDQ (Diagnostic Questionnaire for Internet Addiction) and the 20-question IAT (Internet Addiction Test), followed by comparative analysis between and within usage groups. Results: Results demonstrate that 7.2% of male and 5.1% of female internet users present addictive behaviours while using the internet. Conclusions: Anti-social, aggressive behaviours were significantly correlated with an increase to the pattern of abusive internet use in both sexes. Boys and girls had distinct profiles of off-line and online preferences. Boys tended to favour interest-driven online activities as their levels of addictive behaviour increased while girls favoured communication-driven online activities.

Previous studies in bipolar disorder suggest patients' deficient performance in Theory of Mind tasks, both during manic or depressive episodes and in remission. However, most of the extant studies were cross-sectional and did not control for potential confounders such as residual symptoms or co-existent deficits in other cognitive functions. The present study is the first prospective study that assessed the effect of remission on Theory of Mind (ToM) in patients with Bipolar Disorder (BD) controlling for other cognitive deficits. ToM was assessed in 29 patients with BD type I during an episode of the illness and in remission as well as in 29 healthy controls. The two groups were pair-matched for gender, age and education level. Three tests with different levels of complexity were used to assess ToM: First Order False Belief Task, Hinting Task and Faux Pas Recognition Test. Concomitantly, a comprehensive battery of neuropsychological tests was administered to all participants assessing general intelligence, working memory, attention, speed processing, verbal learning, and memory and executive functions. The Hamilton Rating Scale for Depression, Young Mania Rating Scale, Brief Psychiatric Rating Scale, and GAF were also administered to the patients. Differences between patients--in acute phase and in remission--and the control group on neuropsychological tests were tested using one-way ANOVA with post hoc Bonferroni corrections. The effect of other cognitive deficits on patients' ToM dysfunction was controlled for using general linear models. The patients showed significantly lower performance in all ToM tests during the acute phases as compared to the control group (p values from 0.001 to 0.014). However, these impairments did not persist beyond acute mood episode, except patients' poor performance on Faux Pas (p=0.001). Additionally, patients had poorer performance compared to control group in verbal learning and memory (p0.001) as well as visuospatial working memory (p0.001) during both the acute and the euthymic phases of the illness. Patients also had poorer performance than healthy controls in immediate memory (p=0.026) and executive functions (p=0.001), however only during episodes of illness. Differences in Faux Pas did not remain statistically significant when the effect of verbal memory and visuospatial working memory was controlled for. Differences in other ToM tests during episodes did not remain statistically significant, when other cognitive functions that were found impaired in patients during episodes, were controlled for. The findings of this study support the hypothesis that ToM dysfunction in BD is associated with mood symptoms and it might reflect underlying cognitive deficits rather than representing a specific trait marker of the disorder.

There is a substantial body of evidence suggesting that cognitive deficits in schizophrenia (SΖ) and bipolar disorder (BD) persist after the subsidence of active symptoms. However, it is unclear whether the cognitive deficits observed in patients with BD are quantitatively or qualitatively similar to those in SΖ patients. The aim of the study was to assess and compare the cognitive functioning of patients with clinically stable SZ and BD. To the best of our knowledge, this is the first study including a comparison of the Theory of Mind between patients with SZ and BD. General intelligence, attention, speed of processing, working memory, verbal memory and learning, visuospatial ability, executive functions and ToM were assessed in 21 patients with SZ in remission, 23 euthymic BD type I patients, and 27 healthy controls (HC), using WAIS-Vocabulary, Block design, and Digit span, Babcock Story Recall Test, Rey Auditory Verbal Learning Test, Stroop Word-Colour Test, Wisconsin Card Sorting Test, Trail Making Test, and Faux Pas Recognition Test. The three groups were matched for gender, age and education. The SZ and BD groups were also matched in terms of illness duration and the age of the onset of the illness. To be enrolled in the study patients should have been clinically stable for 3 months, operationalized as no change in total Brief Psychiatric Rating Scale, Hamilton Depression Rating Scale (8), and Young Mania Rating Scale (6). One-way ANOVA with post hoc Bonferroni corrections was used for the between groups comparisons. Both BD and SC patients were significantly impaired in general intellectual ability, verbal memory and learning, and executive functions compared to HC. Patients with SZ performed significantly worse than patients with BD on verbal memory tasks, whereas BD group did not have significant lower score than SZ in any task. SZ patients performed worse than HC group on attention, processing speed and immediate memory tests, while BD patients on visuospatial ability and working memory. Both SZ and BD groups did not differ from HC regarding Theory of Mind. Our results indicate that stable SZ and euthymic BD exhibit similar profiles of cognitive impairment, consistently with previous studies suggesting that the differences are related to the extent and degree of impairments, rather than being qualitative. Finally, our findings offer support to the hypothesis that the Theory of Mind does not represent a trait marker of schizophrenia or bipolar disorder.

Preoccupation with body shape and weight is characteristic of both anorexia nervosa and bulimia nervosa. Despite their diagnostic and clinical significance, evidence on the nature of the underlying beliefs is relatively scarce. We used the Brown Assessment of Beliefs Scale (BABS) to assess the degree of delusionality of body image beliefs in seventy-two participants: 39 with anorexia and 33 with bulimia nervosa. We also investigated the relationship between body image delusionality and other clinical characteristics in eating disorders. Only patients with anorexia nervosa (28.8%) had delusional body image beliefs, whereas overvalued ideas appeared to be frequent in both anorexia and bulimia nervosa. Body image delusionality in anorexia nervosa was associated with restrictive eating pathology, early onset of the disorder and body dissatisfaction, whereas in the bulimia group it was linked to shorter duration of the illness, more intense dieting behaviors and specific psychological factors: ineffectiveness and maturity fears. Results suggest that a delusional variant of anorexia nervosa represents the one end of a continuum of insight among patients with eating disorders. Categorization of patients with eating disorders based on the level of delusionality of body image beliefs could facilitate further research on the role of insight deficits in these disorders.

IntroductionOutcome assessment has been highlighted as a crucial factor in the evaluation and transformation of mental health services, providing evidences for the improvement of clinical practice.ObjectiveThis is the first clinical study in Greece to investigate the relationship between the crucial outcome measures of needs, quality of life, disability and psychopathology for patients suffering from schizophrenia. Furthermore, service evaluation based on the assessment of the above outcome measures has never taken place in the country.AimsTo examine the associations between the patients’ needs and other treatment outcome indicators:– quality of life;– disability;– dimensions of schizophrenia symptomatology.MethodThe CAN-R, WHOQOL-BREF, WHODAS 2.0 and PANSS scales were administered to a sample of fifty-three schizophrenia patients and the correlations between the above outcome measures were computed.Results(1) Significant negative correlations emerged between the total number of needs and unmet needs and subjectively assessed quality of life. (2) Significant positive correlations emerged between the total number of needs and unmet needs and subjectively assessed disability. (3) Significant positive correlations were found between the dimensions of schizophrenia symptomatology (positive/negative/general) and the total number of needs in our sample.ConclusionAccording to our findings:– as the number of unmet needs increases patients’ quality of life is lowered;– a possible relationship exists between unmet needs and subjectively assessed disability;– a possible relationship exists between needs and all the dimensions of schizophrenia symptomatology.Disclosure of interestThe authors have not supplied their declaration of competing interest.

ObjectivesThere is a substantial body of evidence that cognitive deficits in schizophrenia and bipolar disorder persist after the subsidence of active symptoms. The aim of the study was to assess and compare the cognitive functioning of patients with clinically stable schizophrenia and bipolar disorder.MethodsAttention, memory, verbal learning ability, visuospatial ability, executive functions and social cognition were assessed in 21 patients with schizophrenia in remission, 23 euthymic bipolar-I patients, and 27 normal controls, using WAIS - Vocabulary, Block design, and Digit span, Stroop Test, Babcock Story Recall Test, Rey Auditory Verbal Learning Test (RAVLT), Trail Making Test (Trails A and B), Wisconsin Card Sorting Test (WCST), and Faux Pas Recognition Test. The three groups were matched for gender, age and education. One-way ANOVA with post hoc Bonferroni corrections was used for the between groups comparisons.ResultsBoth bipolar disorder and schizophrenia patients were significantly impaired on tests of working memory, learning abilities, and executive functions compared to control subjects. Patients with schizophrenia performed significantly worse than patients with bipolar disorder on attention and verbal memory tasks, whereas the latter performed worse than normal controls on visuospatial ability tasks.Table 1Comparison of neuropsychological function Bipolar Disorder Mean (SD)Schizophrenia Mean (SD)Normal controls Mean (SD)FpPost-hoc test (p)WAIS - Vocabulary10.1 (1.8)10.2 (1.8)12.0 (1.6)6.06.004S < N (.015) B < N (.008)WAIS - Block design7.9 (2.5)9.9 (3.6)10.3 (2.7)3.76.032B < N (.039)Stroop - Word84.3 (18.7)82.3 (26.8)97.7 (16.5)4.03.022S < N (.038)Stroop - Colour59.5 (12.3)56.8 (16.8)72.0 (12.1)8.74.000S < N (.001) B < N (.006)Babcock - Delay recall12.1 (3.9)7.7 (3.3)13.2 (3.3)15.71.000S < N (.000) S < B (.000)WCST - categories2.4 (1.4)2.5 (1.3)3.1 (1.1)2.49.090nsWCST - perseverative errors14.6 (13.1)18.5 (16.4)11.1 (8.2)1.30.280nsTrails B164.1 (83.2)170.2 (76.8)86.7 (43.3)11.68.000S > N (.000) B > N (.001)Faux Pas - detection38.6 (11.6)40.1 (14.6)46.2 (9.6)2.64.080nsConclusionsOur results indicate that stable schizophrenia and euthymic bipolar disorder exhibit different but overlapping profiles of cognitive impairment.

Introduction There is substantial evidence that patients with schizophrenia present with impaired Theory of Mind (ToM). ToM impairment has been also reported in euthymic bipolar disorder (BD). However, data from direct comparisons of patients with schizophrenia and BD on ToM abilities are limited. Objectives It has been suggested that different aspects of mentalizing processing, such as epistemic and emotional mental representations, i.e. cognitive and affective ToM, must be separately examined. Aims The aim of the study was to compare ToM ability and both its cognitive and affective components between schizophrenic and euthymic BD patients. Methods Fifty three BD type I euthymic patients, 54 patients with schizophrenia and 53 healthy controls (HC) completed a multi-facet battery of ToM tasks, including False belief task, Hinting task and Faux Pas Recognition Test (FP). Besides the overall ability to recognize Faux Pas, two specific components of ToM – cognitive and affective – were assessed with FP. The three groups were matched for gender, age and education. Results BD and schizophrenia patients showed no impairment in the False belief task. Schizophrenia patients performed significantly lower than HC and BD patients in Hinting task, FP recognition and affective ToM. Both patient groups were impaired in cognitive ToM. However, only BD patients with a history of psychosis performed significantly lower than HC in affective ToM. Conclusions In contrast to schizophrenia patients, euthymic BD patients show a specific deficit only in cognitive but not in affective ToM. Further research on the impact of these deficits on social and occupational functioning is warranted.

Introduction Deficits in social cognition, especially in Theory of Mind (ToM) and empathy, may contribute in poor social functioning of patients with bipolar disorder (BD). Objectives Previous studies have found impaired empathy in euthymic patients with bipolar disorder using self-report measures of empathy. However, evidence on the neuropsychological processes that underlie empathic abilities in BD is scarce. Aims The aim of the study was to assess empathy and ToM abilities in euthymic BD using both self-report and neuropsychological measures. Methods Fifty-seven euthymic BD patients and 53 healthy control subjects completed the Empathy Quotient, a self-report measure of empathy. A multi-level battery of ToM tasks was applied in all study participants, including First order false beliefs stories, Hinting task and Faux Pas Recognition Test (FP). Besides the ability to recognize Faux Pas, three specific components of ToM were assessed with FP: the affective ToM, the cognitive ToM, and the emotional perspective taking. The two groups were matched for gender, age and education. Results Patients with BD reported significantly lower levels of empathy than healthy controls. There was no significant difference between the two groups in the First order false beliefs and Hinting task scores. Patients had significantly lower score than healthy controls in FP recognition and cognitive ToM. However, there was no significant difference between the two groups in affective ToM and emotional perspective taking. Conclusions Deficits in higher order ToM were found in the euthymic BD. These deficits might have important contribution to empathy impairments found, using self-report scales.

Introduction Lack of insight is a major obstacle in treating patients with anorexia nervosa (AN). In everyday practice, clinicians often describe as delusional AN patients who strongly deny their emaciation. Objectives Despite their diagnostic and clinical significance the level of delusionality of body image beliefs in eating disorders (EDs) has not yet been systematically investigated. Aims In the present study we assessed for the first time the delusionality of body image beliefs in AN subtypes and BN. We hypothesized that body image beliefs would be delusional only in a subgroup of AN patients and that the patients with restrictive AN would demonstrate the higher levels of delusionality. Methods We used the Brown Assessment of Beliefs Scale (BABS) to assess the degree of delusionality of body image beliefs in seventy-two participants: 39 with AN and 33 with BN. We also investigated the relationship between body image delusionality and other clinical characteristics in AN. Results Only patients with anorexia nervosa (28.8%) had delusional body image beliefs, whereas overvalued ideas appeared to be frequent in both AN and BN. Body image delusionality in AN was associated with restrictive eating pathology, early onset of the disorder and body dissatisfaction. Conclusions Results suggest that a delusional variant of anorexia nervosa represents the one end of a continuum of insight among patients with eating disorders. Delusionality constitutes a clinical feature independent of weight loss or eating pathology and thus a distinct component of AN psychopathology, contributing to treatment resistance and illness chronicity.

ObjectivesPrevious studies have provided evidence for Theory of Mind (ToM) impairment in bipolar disorder (BD). The aim of the study was to determine whether ToM impairment can be considered as a trait- marker or a state characteristic of BD.MethodsToM was assessed in 29 patients with bipolar-I during an episode and in remission as well as in 29 pair-matched for age, gender and education level healthy controls. Three different ToM tests were used (multilevel assessment): First Order False Belief Stories, Hinting Test, Faux Pas Recognition Test. Attention, memory, verbal learning ability, visuospatial ability, executive functions were also assessed using WAIS – Vocabulary, Block design, and Digit span, Stroop Test, Rey Auditory Verbal Learning Test, Trail Making Test, Wisconsin Card Sorting Test. Paired t-test was used to compare patients’ neuropsychological performance in episode and euthimic states and one-way ANOVA with post hoc Bonferroni corrections for the between groups comparisons.ResultsPatients showed significant impairments on ToM tasks in the acute phase compared to the control group. ToM deficits did not persist beyond mood episode, except patients’ poor performance on Faux Pas. Dysfunction in verbal learning, working memory, visospatial ability was found during both the acute and the euthymic phases in relation to the comparison group. Poorer performance in attention, immediate verbal memory and executive function tasks was observed only in the acute phase of the illness.ConclusionsImpairments in social cognition might reflect underlying general cognitive deficits and residual symptoms rather than representing a specific trait-marker in BD.

ObjectivesCognitive function seems to be impaired during both the acute and euthymic phases of bipolar disorder. The aim of the study was to determine the effect of remission on cognitive functioning in bipolar disorder.MethodsAttention, memory, verbal learning ability, visuospatial ability, executive functions and social cognition were assessed in 19 patients with bipolar-I patients during an episode of the illness and in remission as well as in 16 normal controls, using WAIS - Vocabulary, Block design, and Digit span, Stroop Test, Babcock Story Recall Test, Rey Auditory Verbal Learning Test (RAVLT), Trail Making Test (Trails A and B), Wisconsin Card Sorting Test (WCST), and Faux Pas Recognition Test. The two groups were matched for gender, age and education. Paired t-test was used to compare patients’ neuropsycholigical performance in episode and euthimic states and one-way ANOVA with post hoc Bonferroni corrections for the between groups comparisons.ResultsPatients showed cognitive dysfunction in verbal learning, visospatial ability, executive functions and social cognition during both the acute and the euthymic phases in relation to the comparison group. Poorer performance in attention and working memory tasks was observed only in the acute phase of the illness. Performance in verbal learning and executive function tasks was significantly improved but still impaired in remission. BD-Ep (n = 19) Mean (SD)BD-Rem(n = 19) Mean (SD)tp WAIS - Vocabulary9.6 (1.7)9.9 (1.6)- 1.55.137BD-Ep < NC BD-Rem < NCWAIS - Block design7.9 (2.2)8.3 (1.9)- 0.64.532BD-Ep < NC BD-Rem < NCStroop - Word77.9 (19.2)82.8 (19.8)- 1.21.243BD-Ep < NCStroop - Colour56.7 (14.8)60.3 (12.9)- 1.28.218BD-Ep < NCRAVLT - Best learning9.9 (2.6)11.0 (2.8)- 2.52.021BD-Ep < NC BD-Rem < NCRAVLT - Delay recall7.3 (3.3)9.2 (3.5)- 3.41.003BD-Ep < NC BD-Rem < NCWCST - perseverative errors19.5 (10.6)13.5 (7.9)3.21.005BD-Ep > NCTrails B181.0 (92.2)167.1 (91.4)1.28.218BD-Ep > NC BD-Rem > NCFaux Pas - detection35.0 (8.9)37.8 (10.5)- 1.15.266BD-Ep < NC BD-Rem < NC[The effect of remission on cognitive functioning]ConclusionsPatients with bipolar disorder exhibit similar profiles of cognitive impairment during the acute and the euthymic phases of the illness.