Mindfulness, Attention, and Impulsivity in Bipolar Disorder

Introduction Bipolar disorder (BD) is a chronic mental disorder characterized by mood instability1. BD is further related to neurocognitive and functional disruptions that remain remarkably stable even when patients are euthymic, leading to poor well-being and quality of life. Mindfulness means paying attention on purpose, in the present moment, and involves different facets such as observing, describing, acting with awareness, non-judging and non-reacting of inner experience. It remains unclear whether mindfulness and its specific facets are differentially associated with different aspects of attention and trait impulsivity in individuals with BD. Objectives To examine associations between different mindfulness facets, and different aspects of attention and trait impulsivity in BD. Methods This study was approved by the Hospital Clínic Ethics and Research Board (HCB/2017/0432). After informed consent, 94 outpatients, M age = 45.57, SD = 9.8, range 19-61 years, 41.5% Male, 63.8% BD-I according to DSM-5 criteria, in partial or total remission based on Young Mania Rating Scale (YMRS; M = 1.81, SD = 2.11) and Hamilton Depression Rating Scale (HDRS; M = 5.46, SD = 3.71) were enrolled in this study. Participants were evaluated using the Five Facet Mindfulness Questionnaire (FFMQ) to assess Mindfulness, the Trail Making Test (TMT-A) and the Conner’s Continuous Performance test (CPT-II) to assess Attention, and the Barratt Impulsiveness Scale (BIS-11) to assess Impulsivity. Pearson correlations were performed, and statistical significance was evaluated two-sided at the 5% threshold. Results Mindfulness-Describing was negatively associated with Cognitive and Non-Planning Impulsivity (r = -.43 and -.28, p < .001), Mindfulness-Acting with Awareness was negatively associated with Cognitive, Motor and Non-Planning Impulsivity (r = -.27 to -.45, p < .001), Mindfulness Non-Judging (r = -.33 and -.34, p < .001) and Non-Reacting (r = -.30 and -.46, p < .001) of inner experience were negatively associated with Cognitive and Motor Impulsivity. No associations were found between neither Mindfulness nor Impulsivity with any aspects of Attention. Conclusions Preliminary findings suggest that better performance in specific facets of mindfulness (describing, acting with awareness, non-judging or reacting of inner experience) may be related to a decrease in different aspects of trait impulsivity. Further longitudinal and interventional research is needed on underlying mechanisms. Nonetheless, our study suggests the need for including mindfulness-based approaches to improve behavioral and functional outcomes for those with BD. Funding This work was supported by the European Union Horizon 2020 research and innovation program (EU.3.1.3. Treating and managing disease: Grant 945151), CIBERSAM, FIS PI17/00941 ISCIII, European Regional Development Fund. References 1. Carvalho AF, Firth J, Vieta E. Bipolar Disorder. N Engl J Med. 2020;383(1):58-66. doi:10.1056/NEJMra1906193 Disclosure of Interest None Declared

Introduction: Many studies have investigated whether there exist predictors of good response to antimanic drugs in bipolar disorder (BD).However, these factors predict response or only indicate benign illness course.Objectives: To shed some light on the topic, we tested whether the response to antimanic drugs showed any variability beyond that expected by the effects of illness course and placebo.Methods: We included all double-blind, placebo-controlled RCTs of oral pharmacotherapies targeting adult patients with acute bipolar mania from 1991 to 2020.The primary outcome was the variance of the improvement in manic symptoms in treated individuals compared to placebo.The effect size was the log variability ratio (logVR).We performed a random-effects meta-analysis, including assessments of heterogeneity, sensitivity/cumulative/ subgroup analyses, and meta-regression.Results: 42 RCTs (46 comparisons) from a total of 8,438 BD patients with acute mania (53.7% male, mean age=39.3;5,563 treatment/2,875 control groups) were included in the analysis.Individuals in active treatment groups did not show variability in the response beyond that observed in individuals under placebo (VR=1; 95% C.I. =0.97,1.03; p-value=0.97).No heterogeneity was detected between the studies (I 2 =0%; tau 2 =0%; Q=29.21; df=45; p-value=0.97).Results were similar in the leave-one-out/cumulative/subgroup analyses.Meta-regression did not show influences by age, sample size, sex, severity of manic symptoms at baseline, or clinical features (rapid cycling, mixed or psychotic features).Conclusions: This meta-analysis shows no evidence of differences in the individual response to treatments.These findings suggest that the average treatment effect is a reasonable assumption for the individual BD patient with acute mania.The presented article adds evidence to the equivalent results in schizophrenia-spectrum disorders, clinical high-risk state for psychosis, and major depressive disorder, not supporting classification in responders vs. nonresponders.However, these findings should be balanced with results from other fields supporting such classification.

O0057 Mindfulness, Attention, and Impulsivity in Bipolar Disorder
Introduction: Bipolar disorder (BD) is a chronic mental disorder characterized by mood instability 1 .BD is further related to neurocognitive and functional disruptions that remain remarkably stable even when patients are euthymic, leading to poor well-being and quality of life.Mindfulness means paying attention on purpose, in the present moment, and involves different facets such as observing, describing, acting with awareness, non-judging and nonreacting of inner experience.It remains unclear whether mindfulness and its specific facets are differentially associated with different aspects of attention and trait impulsivity in individuals with BD.

Introduction:
The Functioning Assessment Short Test (FAST) is a relatively specific test for bipolar disorders designed to assess the main functioning problems experienced by patients.Objectives: FAST includes 24 items assessing impairment or disability in 6 domains of functioning: autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal relationships, and leisure time.It has already been translated into standardized versions in several languages.The aim of this study is to measure the validity and reliability of the Korean version of FAST (K-FAST).Methods: A total of 209 bipolar disorder patients were recruited from 14 centers in Korea.K-FAST, Young Mania Rating Scale (YMRS), Bipolar Depression Rating Scale (BDRS), Global Assessment of Functioning (GAF) and the World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF) were administered, and psychometric analysis of the K-FAST was conducted Results: The internal consistency (Cronbach's alpha) of the K-FAST was 0.95.Test-retest reliability analysis showed a strong correlation between the two measures assessed at a 1-week interval (ICC = 0.97; p < 0.001).The K-FAST exhibited significant correlations with GAF (r=-0.771),WHOQOL-BREF (r=-0.326),YMRS (r=0.509) and BDRS (r=0.598).A strong negative correlation with GAF pointed to a reasonable degree of concurrent validity.Although the exploratory factor analysis showed 4 factors, the confirmatory factor analysis of questionnaires had a good fit for a six factors model (CFI=0.925;TLI=0.912;RMSEA=0.078).

Conclusions:
The K-FAST has good psychometric properties, good internal consistency, and can be applicable and acceptable to the Korean context.European Psychiatry S85

Table .
Model fit index of confirmatory factor analysis (n=209) χ2, chi-square; df, degrees of freedom; RMSEA, root mean square error of approximation; CFI, comparative fit index; TLI, Tucker-Lewis index.