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Attributional style (along with other domains of social cognition) is altered in out-patients with BD and SZ. The presence of residual symptoms and a hostile social cognitive bias may contribute to the functional impairment of both groups.

Objective: To analyze the recognition, identification, and discrimination of facial emotions in a sample of outpatients with bipolar disorder (BD). Methods: Forty-four outpatients with diagnosis of BD and 48 matched control subjects were selected. Both groups were assessed with tests for recognition (Emotion Recognition-40 --ER40), identification (Facial Emotion Identification Test --FEIT), and discrimination (Facial Emotion Discrimination Test --FEDT) of facial emotions, as well as a theory of mind (ToM) verbal test (Hinting Task). Differences between groups were analyzed, controlling the influence of mild depressive and manic symptoms. Results: Patients with BD scored significantly lower than controls on recognition (ER40), identification (FEIT), and discrimination (FEDT) of emotions. Regarding the verbal measure of ToM, a lower score was also observed in patients compared to controls. Patients with mild syndromal depressive symptoms obtained outcomes similar to patients in euthymia. A significant correlation between FEDT scores and global functioning (measured by the Functioning Assessment Short Test, FAST) was found. Conclusions: These results suggest that, even in euthymia, patients with BD experience deficits in recognition, identification, and discrimination of facial emotions, with potential functional implications.

A deficit of social cognition in bipolar disorder has been shown, even when patients are stable. This study compares the attribution of intentions (social-cognitive bias) in a group of 37 outpatients with bipolar disorder with 32 matched control subjects. Bipolar patients scored significantly higher in the Ambiguous Intentions Hostility Questionnaire, showing an angry and intentionality bias (P = .001, P = .02). Differences in blame scale and hostility bias did not reach statistical significance, but a trend was found (P = .06). Bipolar patients with depressive symptoms presented a higher score in the angry bias scale (P = .03) and aggressivity bias scale (P = .004). The global functioning (GAF) correlates significantly with intentionality (P = .005), angry (P = .027), and aggressivity (P = .020) biases. Bipolar patients show a social-cognitive bias that may play a role in their functional outcome.

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BackgroundPatients with first-episode schizophrenia usually respond well to treatment, but relapse is frequent during the first years of the illness and may be associated with clinical deterioration A major concern in treating patients with schizophrenia is non-adherence with medication, with approximately 40% stopping within 1 year and 75% by 2 years. In addition to the impact on the illness, non-adherence creates serious social and psychological consequences. Although it is one of the potentially preventable causes of relapse, hospitalization, and poor outcome non-adherence is one of the most difficult problems to solveAripiprazole is an atypical antipsychotic with partial agonist activity at dopamine D2 receptors and a potentially less burdensome metabolic profile compared with other atypical antipsychotics. A once-monthly, long-acting injectable (LAI) formulation, aripiprazole once-monthly 400 mg (AOM 400), is approved for the treatment of schizophreniaMethodsTo assess the evolution of the functioning and attitude to medication in a sample of patients recently diagnosed of schizophrenia during one year of treatment with aripiprazole once-monthly (AoM)Schizophrenic patients from three Mental Health units in the province of Toledo (Spain) were recruited. The inclusion criteria were an age between 18 and 65 years, a diagnosis of schizophrenia (based on the ICD-10 criteria) in the last 5 years, the start of treatment with AoM in last 6 months, and 12 months of treatment with oral antipsycohtics previosly to the AoM treatment and at least one relapsed in last 4 years. A series of demographic variables were recorded and the GAF (Global Assesment Functioning) scale was used to assess function, while the Drugs Attitude Inventory (DAI) scale was used to evaluate attiudes to medication. The scales were again applied 3, 6 and 12 months after the start of treatment.ResultsN=18 patients (12 males and 6 females), with a mean age of 29 years. There were 1 dropouts during the year of follow-up. The results showed an improvement in GAF score during the 12 months, manifesting from the third month (ANOVA, p<0.05). Likewise, statistically significant differences (ANOVA, p<0.05) were observed with the DAI scale for attitude to treatment; these results persisted over the year of follow-up and were manifest from the third month.DiscussionFirst years of evolution in schizophrenia are determinants for the evolution of the illness. The correct adherence to medication is associated with an adecuated functioningPoor adherence to treatment is a recognised is predictive of poor outcomes (relapse, aggressive behaviour, suicide, substance abuse) and increased risk of hospitalisation Guidelines suggest that long-acting antipsychotic medicines may be offered to people who would prefer such treatment or in cases where avoiding covert non-adherence to antipsychotic medication (either intentional or unintentional) is a clinical priority within the treatment plan.