Neurocognitive Impairment in Bipolar Disorder and Associated Factors: Using Population-based Norms and a Strict Criterion for Impairment Definition.

BACKGROUND: Cognitive impairment is often identified in individuals with bipolar disorder and is associated with their functional impairment. However, there is controversy surrounding potential classification methods for impairment in cognitive measures. OBJECTIVE: To examine the proportion of cognitive measures indicating impairment of attention, processing speed, memory, visuoconstructional abilities, and executive functions in individuals with bipolar disorder type I (euthymic) and healthy controls, using a strict criterion for defining impairment. METHODS: We gave 43 individuals with bipolar disorder type I and 17 healthy controls a comprehensive clinical and neuropsychological assessment. All scores were standardized using means and standard deviations according to age. Impaired performance in all cognitive measures was determined using a distribution-based threshold of z=±1645. The effects of the sociodemographic and clinical variables on cognitive performance were examined using multiple stepwise backward regression analyses. RESULTS: Clinically significant cognitive impairment was observed more frequently in the bipolar disorder group, compared to controls, on all measures. From participant factors, we found that level of education and number of manic episodes predicted variation in more cognitive measure scores. DISCUSSION: The use of population-based norms to standardize cognitive measures, and a strict criterion to define cognitive impairment, in individuals with bipolar disorder type 1 and healthy controls resulted in a prevalence of impairment in cognitive domains' frequencies of deficits that fell within the ranges previously reported in meta-analyses. CONCLUSIONS: Clinically introducing population norms and a stringent cognitive impairment criterion can facilitate more accurate measures of cognitive impairment in individuals with bipolar disorder.

Sexual function in patients with bipolar disorder type I evaluated in symptomatic remission: a cross-sectional study.

INTRODUCTION: Bipolar disorder (BD) is a chronic pathology that is associated with several impairments throughout a patient's life, including decreased sexual function. Despite the importance in quality of life (QoL), functionality and medication adherence, it is still little investigated in these patients. OBJECTIVE: To compare the sexual function of patients with Bipolar Disorder type I (BD-I), in remission, with healthy controls (HC) and to investigate the clinical and socio-demographic characteristics associated with sexual function in these individuals. Also, to assess the QoL in patients with and without sexual dysfunction (SD). METHODS: Cross-sectional study with 132 patients with BD-I in euthymic phase and 61 HCs from an outpatient clinic. All the participants were evaluated through the Arizona Sexual Scale (ASEX) and the brief version of the World Health Organization Quality of Life Assessment (WHOQoL-BREF). The patients with BD-I were compared with the HCs. The patients were divided into two groups: the ones diagnosed with SD and the ones without it. RESULTS: The patients with BD-I had higher rates of SD (42.4%) compared to the HCs (16.4%) (OR 3.67, 95% CI 1.55 - 8.67; p=0.003). SD in patients was associated with being women (p=0.001), older age (p=0.003) and having a longer duration of untreated illness (p=0.010). Patients with SD had worse QoL scores compared to those without SD. CONCLUSION: Patients with BD-I have a high prevalence of SD and this was associated with worse QoL scores in all domains.

LEGO® therapy as an intervention in autism spectrum disorders: an integrative literature review / A LEGO® Terapia como método de intervenção nas desordens do transtorno do espectro autista: uma revisão integrativa

ABSTRACT Objective: to analyze the effects of LEGO® therapy as an intervention for autism spectrum disorder through an integrative literature review. Methods: the study included a search of electronic databases, and nine empirical studies and three books, detailing the intervention method, were selected. Results: the studies identified quantifiable improvements in social behavior and language/communication after LEGO® therapy. Conclusion: LEGO® therapy is an intervention that favors motivation, interaction, and teamwork using a material that allows a variety of strategies, which have shown proven positive effects on the development of children with ASD.

RESUMO Objetivo: o objetivo desta revisão integrativa é analisar os efeitos da LEGO® Terapia como uma técnica de intervenção nas desordens do Transtorno do Espectro Autista, levantando informações sobre uma técnica de intervenção nos mesmos método terapêutico. Metódos: foi realizada uma pesquisa nas bases de dados eletrônicos e foram utilizados nove artigos que descrevem estudos empíricos de intervenção e três livros sobre o método. Resultados: os estudos identificaram melhoras quantificáveis no comportamento social e na linguagem/comunicação após a intervenção com este método. Conclusão: a LEGO® Terapia tem sido estudada por ser uma intervenção que favorece a motivação, a interação e o trabalho conjunto a partir de um material que permite uma variedade de estratégias, que tem seus efeitos comprovados na evolução do quadro dos indivíduos com TEA