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The role of Executive Attention in the association between obsessive-compulsive symptoms and relapses in Major Depressive and Bipolar Disorder

Published online by Cambridge University Press:  01 September 2022

L. Lucassen*
Affiliation:
University of Parma, Department Of Medicine And Surgery, Parma, Italy
I. Tioli
Affiliation:
University of Parma, Department Of Medicine And Surgery, Parma, Italy
M. Ferrari
Affiliation:
AUSL of Parma, Department Of Mental Healthy, Parma, Italy
P. Ossola
Affiliation:
University of Parma, Department Of Medicine And Surgery, Parma, Italy
C. Marchesi
Affiliation:
University of Parma, Department Of Medicine & Surgery, Unit Of Neuroscience, Psychiatric Unit, University Of Parma, Parma, Italy, Parma, Italy
*
*Corresponding author.

Abstract

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Introduction

Major Depressive (MDD) and Bipolar Disorder (BD) are chronic relapsing condition in which mood episodes are interspersed with periods of euthymia. Impairments in Executive Attention (EA) are a trait characteristic of mood disorder that persists also during remission. Similarly prefrontal dysfunctions are crucial in the genesis and maintenance of Obsessive-Compulsive Symptoms (OCS), which are highly comorbid in both MDD and BD.

Objectives

The aim of this study is to test a model in which deficits in EA mediate the relationship between the OCS and the relapse in a cohort of patients with MDD and BD.

Methods

Sixty-four euthymic subjects with BD and MDD performed the Attentional Network Task Revised (ANT-R), that gauges EA in a standard conflict task. Here we adopted a drift diffusion model to measure the task efficiency as the drift rate in incongruent trials. Patients also completed at baseline the YBOCS, a questionnaire that evaluate the severity of OCS. All the participants have been followed-up for up to 5 years and relapses have been recorded.

Results

The association between OCS and time in euthymia was fully mediated by the EA so that greater OCS were associated with poorer executive functions (beta=-0.341; p=0.006) that in turn predicted a sooner relapse (beta=0.349; p=0.005). This held true even when controlling for classic predictors of recurrence such as previous episode distance, the duration of illness and medications.

Conclusions

Treatment targeting executive functions could hence be crucial in preventing relapses in subjects with mood disorders experiencing obsessive compulsive-symptoms.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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