Physical health profile and associated behaviour during the COVID-19 pandemic in patients with bipolar disorder

Introduction The COVID-19 pandemic has led to an increased psychological strain on public mental health and may impact behavioural, mental, and physical health, presumably with effects on patients with severe mental disorders. Objectives This study examines pandemic-related physical and mental health and (compensatory) behavioural changes, in patients with BD as compared to healthy control individuals. Methods Physical and mental health and self-reported changes in daily structure and behaviour due to pandemic were assessed using a self-constructed questionnaire and the brief symptom inventory (BSI) from outpatient clinics in Germany, Austria, and Denmark in individuals with BD and a healthy control group. Results The present study included 118 individuals with BD and 215 healthy controls. Individuals with BD reported statistically significant higher physical risk burden, increased weight gain, more physical comorbidities, and a decrease in physical activity and they further reported higher rate of COVID-19 testing, had more worries concerning health and experienced more anxiety but less social distancing. Conclusions The COVID-19 pandemic seems to have a greater impact on physical health in individuals with BD than in healthy controls. Individuals with BD appear to be having more difficulties compensating their behaviour due to the pandemic which could amplify the effect of risk factors associated with poorer physical health. This highlights the necessity for optimising and targeting the overall treatment of both mental and physical health in patients with BD during periods with far-reaching changes such as COVID-19 pandemic. Disclosure No significant relationships.


EPV0061
The impact of self-stigma on functioning among remitted patients with bipolar disorder R. Jenhani1 *, S. Ellouze2 , D. Bougacha3 , F. Znaidi 3 and R. Ghachem4 Introduction: Self-stigma is widespread in patients with bipolar disorder, with many consequences for family, social and occupational functioning, as well as treatment adherence.
Objectives: The aim of this study was to evaluate self-stigma in remitted patients with bipolar disorder and to investigate its impact upon functioning.Methods: We conducted a cross-sectional, descriptive, and analytical study of 61 patients with bipolar disorder.Euthymia was verified using the Hamilton scale for depression and the Young scale for mania.We used the Internalized Stigma of Mental Illness (ISMI) to evaluate self-stigma, the Functioning Assessment Short Test (FAST) to assess functioning.Results: The mean age of patients was 43.4 years.The sex ratio was 2.4.The mean score on the ISMI was 2.36.More than half of our patients (59%) were self-stigmatized.Regarding functioning, a global impairment was noted in more than two thirds of the patients (71%).Occupational functioning was the most affected area (82%).Patients with higher self-stigma scores had significantly more impaired functioning (p<10 -3 ).To decompose the relationship between stigma and functioning into more specific spheres, we found that all scores on the different domains of functioning were associated with a significantly higher mean self-stigma score.
Introduction: Lurasidone is an atypical antipsychotic agent with potential antidepressant effects through its antagonist activity at the 5-HT7 receptor.Although treatment-emergent affective switch (TEAS) induced by second-generation antipsychotics are not frequent, several cases have been reported.To our knowledge, there is no evidence of lurasidone-induced TEAS.Objectives: To describe a case of lurasidone-induced mania.Methods: We describe a clinical case of a patient admitted to our psychiatric outpatient unit who developed a manic episode, presumably induced by the introduction of lurasidone.We also conduct a review of the literature on this subject.Results: A 37-year-old man diagnosed with obsessive-compulsive disorder (OCD) and an alcohol use disorder was hospitalized due to OCD decompensation with depressive symptomatology and suicidal thoughts, and for alcohol detoxification process.Since he had a previous history of clomipramine-induced TEAS, he was started on lurasidone up to 111mg to avoid the use of antidepressants, showing a progressive improvement of depressive symptoms.Thus, the patient was discharged when alcohol detoxification process was completed.Eight days after discharge, the patient began to show manic symptoms, so he had to be readmitted.Lurasidone was discontinued and valproic acid up to 1000mg/day as mood stabilizer was added, presenting a positive remission of manic symptoms.
Conclusions: According to our experience, lurasidone may have induced an affective switch in this patient.Based on our findings, patients and psychiatrists should monitor possible lurasidoneinduced mood switching.However, further research is needed in order to back-up this one case report findings.Introduction: Medication adherence by persons with bipolar disorder (BD) is inconsistent.This is disconcerting, as BD is treatment responsive, side-effects are few, and the impact of both hypo/ manic and depressive mood episodes can be considerable (e.g., self-harm).Objectives: For this study, we computed a path model to identify both direct and indirect predictors of medication adherence.This included both clinical and psychosocial independent variables (e.g., BD symptoms, psychological well-being, alcohol misuse).Methods: From the BADAS (Bipolar Affective Disorder and older Adults) Study, we identified a global sample of adults with the BD.Participants were recruited using microtargeted, Facebook advertising.This sample included persons living in Canada, U.S., U.K., Ireland, Australia and New Zealand (M = 55.35 years, SD = 9.65).Results: Direct predictors included perceived cognitive failures and alcohol misuse.Of note, medication adherence is inversely associated with number of prescribed antipsychotic medications.Neither symptoms of depression nor hypo/mania emerged as direct predictors of medication adherence.Similarly, psychological wellbeing appears indirectly associated with adherence (via BD symptoms).Conclusions: Despite the wide age range of participants (22 -73 years), age did not emerge as a predictor of adherence.Nor do cognitive failures appear significantly associated with age suggesting that both young and older adults with BD perceived cognitive loss.

Disclosure:
No significant relationships.Keywords: mania; switch; lurasidone EPV0065 Direct and indirect predictors of medication adherence by adults with bipolar disorder B. Cohen 1 and N. O'Rourke 2 *