The quality of a woman's relationship with her partner is associated with an increased risk of developing anxiety and depression in the postpartum.

To assess the prevalence of post-partum depression (PPD) and correlation between anxiety and depression in postpartum and the marital relationship in a sample of couples recruited at the Gynaecology Ward, “Maggiore della Carità” Hospital, Novara.

Evaluation of marital relationship functioning with regards to PDD onset.

This longitudinal study involved 44 couples recruited from February 2012 to March 2012. Single women, women suffering from severe chronic illnesses, drug addiction or alcoholism and with a previous diagnosis of psychiatric disorders were excluded. Mothers-to-be were assessed for depression and anxiety, during pregnancy and after delivery with the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory-II (BDI-II). Both parents were assessed with the Relationship Satisfaction Scale (RSS); Relationship Assessment Scale (RAS); Marital Adjustment Test (MAT).

The prevalence of PDD was 18% according to the EPDS and 10.5% according to the BDI-II. No gender differences emerged as far as the partner relationship is concerned. The Chi-square analysis revealed a statistically significant inverse correlation between the development of PDD assessed with EPDS after delivery and RSS score (p = 0.039) and RAS (p = 0.05). A statistically significant inverse correlation emerged between BDI-II and RAS (p = 0.005), and BDD and MAT (p = 0.006).

The prevalence of PDD was consistent with the literature. Satisfaction with the marital relationship and the functioning of parental relationship correlates with PDD onset. Clinical implications are discussed.

Knowledge about the mechanisms underlying the relationship between perfectionism and eating behaviors in overweight/obese women is very scarce.

To investigate the relationship between perfectionism, eating behaviors and affect in overweight women.

The Portuguese validated versions of the Eating Disorders Examination Questionnaire/EDEQ, the Multidimensional Perfectionism Questionnaire and the Profile of Mood States were administered to an outpatient sample of 276 women (Mean age = 43.85 ± 11.89; Mean BMI = 32.82 ± 5.43) attending a weight loss treatment in a public hospital.

Correlations between Social Prescribed Perfectionism/SPP and EDEQ total (T) and its dimensional scores (Weigh and Shape Concern and Dissatisfaction/WSCD, Eating Concern/EC, Restraint) were all moderate (r > .30) and significant (p > .001). Self-Oriented Perfectionism/SOP was also significantly correlated with EDEQ-T, WSCI and Restraint (r = .20). Positive affect/PA was negatively correlated and Negative affect/NA was positively correlated with all EDEQ dimensions (r > .25; p > .001). SPP, but not SOP, was significantly correlated with PA (r = −.27) and NA (r = .34). Participants with high (>M+SD) vs. low (< MSD) SOP and SPP had significantly higher means in EDEQ-T, WSCI, EC and Restraint (all p < .001). Linear regression showed that SPP, PA and NA were predictors of EDEQ-T and WSCI; SPP and NA were predictors of EC; NA was the unique predictor of Restraint (all p < .001). Controlling for NA/PA, SPP still being a significant predictor of all EDEQ, WSCD and EC, accounting for significant increments of variance (4.4%, 2.9% and 4.3%, respectively; p < .001).

As in studies with other type of samples, SPP is related to disordered eating in overweight women.

Antidepressant drugs have been found underused in the older population relative to younger adults, particularly in the USA before Medicare part D. No study assessed the antidepressant use according to age in France.

To compare the patterns of antidepressant use among young and older adults: treatment duration, switches, association of antidepressants, coprescription of psychotropic drugs and adherence to treatment.

A historical cohort study included 27,306 young adults and 7,747 older adults, who were beneficiaries of the French national health care insurance and initiated a new antidepressant treatment over the study period. They were followed for atleast six months.

Most patients received only one type of antidepressant (91.81% of young adults and 91.73% of older). The coprescription of psychotropic drugs was frequent in both groups (62.91% in young adults and 62.36% in older). The associations of antidepressant drugs were rare (1.42% in young adults and 1.50% in older). Elderly patients had a significantly longer duration of treatment than young adults (m = 135.4 days, SD = 198.6 vs m = 104.3 days, SD = 159.6; HR = 0.9; 95%CI=[0.88–0.93]; p < 0,0001). Furthermore, they had a higher probability of good adherence than young adults when treatment was initiated by a general practitioner (23.28% vs 16.02%; OR = 1.3 [1.22–1.41]), a hospital practitioner (OR = 1.76 [1.35–2.30]) or a specialist other than psychiatrist (OR = 1.85 [1.26–2.70]).

The use of antidepressant drugs was similar in both age groups, except for the treatment duration and adherence that were better in the older patients. This result may be attributed to the French healthcare system.

The aim of the study is to evaluate risk factors for attempted suicide in psychiatric patients.

We compared three groups: psychiatric patients who attempted suicide, patients with the same diagnosis and no history of attempted suicide and healthy controls, through the administration of the following tests: TCI, SCL-90, WHOQOL, SASS, SF 36 and IIP.

The subjects were matched for sociodemographic characteristics (sex, age, level of education, field of employment and role, marital status) with a 1:1:1 ratio.

We obtained statistically significant differences between patients who attempted suicide and patient who didn’t in subscales: harm avoidance (TCI, p = 0.021) and environment area (WHOQOL, p = 0.021).

We also underline we were able to discriminate healthy subjects from patients, but we didn’t obtain statistically significant differences between controls and patients who attempted suicide in the subscales egocentricity (IIP, p = 0.051), aggressiveness (IIP, p = 0.057) and self-transcendence (TCI, p = 0.255).

These results underline the importance of caring, with preventing purpose, about personal history data such as socioeconomic status, living environment perceived safety, different tendency to inhibit own behaviors (correlated to previous suicide attempts), closure to external relations and aggressiveness.

The main objective of the study is to explore associations between alcohol consumption and marijuana use in young adults and to discuss the opportunities for brief intervention.

Face to face structured interviews were carried out with 2,221 young adult Czechs (mean age 29.9, sd. 5.8 years). 51.4% were males. Alcohol consumption was calculated using beverage specific quantity frequency method. Alcohol-related problems were assessed using the Czech version of the AUDIT. Frequency of marijuana use in the last twelve months was asked as well.

The overall alcohol consumption was 9.2 litres of pure alcohol per person and year. The last year prevalence of marijuana use was 21.8%. Marijuana use positively correlated with the frequency of beer drinking (r=.27), frequency of heavy episodic drinking [HED] (r = .32) and with the summary score in AUDIT (r = .39). Harmful or problem drinkers (AUDIT score >16) reported marijuana use more frequently than moderate drinkers (60% compared to 18.8%; OR = 6.54; 95% CI = 4.7; 9.1). OR for marihuana use in heavy episodic drinkers was 4.3 (95% CI = 3.3; 5.6).

The results suggest that frequent HED and harmful drinking are closely associated with marijuana use in younger adults. Since marijuana use (including heavy use) is rather common in the Czech Republic, it would be recommendable to also extend screening and brief intervention to reduce the use of cannabis. The existing guidelines for brief intervention should be modified in order to cover marijuana consumption as well.

An analysis of the literature on eating disorders (ED) indicates that Eds are often comorbid with the diagnosis of Personality Disorder (PD). This seems to be a psychopathological feature, characteristic of this patient population. However, the double classification seems to be often insufficient when describing a very complex psychopathological picture. These observations have informed our intention to investigate these two distinct nosographic groups by means of a single construct.

The aim of this study is to identify and describe (through tests that evaluate defense mechanisms) the defensive styles that characterize the two groups of patients, in order to outline a defensive profile that can assimilate or differentiate the psychopathological groups.

The study was carried at the Department of Psichiatry of the San Gerardo Hospital in Monza. The Defence Style Questionnaire-40 (Farma Cortinovis, 2000) was administered and analysed. The sample consisted of 40 participants with eating disorders, recruited among the outpatients for eating disorders, and 40 patients with personality disorders recruited from two Psychiatric Outpatient Services.

The data analysis showed a statistical significance in the use of Immature defense mechanisms and Neurotic defence mechanisms in both clinical samples.The patients with PD used a significantly higher number of psychotic defense mechanisms than patients with ED. These results may suggest that in ED patients, the symptoms can be themselves considered as defense mechanisms, or a defensive style that characterizes and makes specific the psychopathological picture.

Clinical guidelines recommend slow clozapine dose titration, a procedure introduced in the 1980's to decrease the risk of drug-induced seizures and hypotension. The procedure is considered safe, but may delay adequate control of symptoms.

To evaluate the effectiveness and safety of rapid clozapine dose titration in schizophrenia patients at high risk of harming themselves or others.

The rapid clozapine dose titration was used for a consecutive cohort of schizophrenia patients (N = 111, mean age 42.1%, 52% males) admitted to a single psychiatric hospital. Clozapine was started with a dose of 12.5–25 mg and additional doses of 25–50 mg where given as needed every 6 hours. The clozapine treatment was intiated on admission for 73 patients who had been treated with clozapine in the past (Group 1). Thirty-eight patients received clozapine after failing to respond to other antipsychotics (Group 2).

Admission PANSS scores were similar in the 2 groups (104.3 ± 2.9 vs. 103.8 ± 5.1, p = 0.48). Symptom control was obtained after 4.1 ± 3.1 days with a maximum dose of 352.7 ± 176.1 mg clozapine/day in group 1 and after 7.1 ± 4.8 days (p < 0.001) with a maximum dose of 408.6 ± 187.5 mg clozapine/day (p = 0.12) in Group 2. The PANSS scores at discharge indicated similar reduction in symptom severity (60.5 ± 5.4 vs. 59.8 ± 7.4, p = 0.539). None of the patients treated had seizures, syncope, neutropenia or other significant adverse events.

Rapid clozapine dose titration appears safe and effective when used in schizophrenia patients with or without prior exposure to the drug.

Antidepressant withdrawal mania is a rare paradoxical event. It was initially reported in unipolar patients but it can also occur in bipolar patients, despite adequate mood-stabilizing treatment. It has been described with all antidepressant classes and may be self-limited or require medical hospitalization. Tapered withdrawal doesn’t seem to prevent the condition, though most reported cases developed after abrupt antidepressant discontinuation. Chronic antidepressant therapy enhances dopaminergic neurotransmission in the mesolimbic system. Noradrenergic hyperactivity and cholinergic overdrive secondary to antidepressant cessation are the most accepted theoretical mechanisms proposed.

Case report, discussion and literature review.

We report a case of fluoxetine withdrawal mania and discuss its implications on clinical practice.

Case report and non systematic literature review.

We present a case of a divorced 59-year-old woman who developed a manic episode shortly after antidepressant discontinuation. She was under antidepressant therapy since 2001, due to an unipolar chronic depressive disorder. She was put on fluoxetine 20 mg q.d. since 2005. On May 2012, she discontinued the antidepressant therapy upon misunderstanding medical advice. Few weeks later, she was involuntarily admitted to our inpatient unit presenting a manic episode with psychotic features. She started valproic acid 1000 mg q.d. and risperidone 4 mg q.d. and a complete remission was quickly obtained.

This case illustrates the potential for mania related to antidepressant discontinuation. Differential diagnosis includes spontaneous mania, antidepressant withdrawal syndrome and antidepressant induced mania. Finally, the authors discuss the adequacy of categorizing this entity in bipolar spectrum disorders.

The Children's Depression Inventory (CDI) is a 27-item, symptom-oriented scale for youths aged 7-17. In Portugal some psychometric parameters has never been analyzed before.

To analyse the reliability and construct and concurrent validity of the CDI in a Portuguese adolescents sample.

969 adolescents (59.34% girls), aged 15.80 ± 1.51, answered the Portuguese versions of the CDI and of the Rosemberg Self Esteem Scale (SE). To study the temporal stability, 204 (58.74% girls) respondents answered the questionnaires again after approximately 5 weeks.

CDI mean scores were difference between genders [Girls=10.84 ± 6.025 vs. Boys: 8.90 ± 6.477, p < .001]. The Cronbach's alpha (α) was .85 for the total sample, .83 for the Girls, and .87 for the Boys. Pearson correlations between the test and the re-test was r = .81 for the total sample, r = .78 for the Girls sub-sample and r = .83 for the Boys sub-sample. Based on factorial and parallel analysis, a 4-factors structure was selected for the total sample (variance explained, VE = 38.93%), the Girls (VE = 36.92%) and the Boys (VE = 41.98%). The items content were similar in the total sample and by gender, but the order of the factors was different. The four factors were: “Depression and Negative Self Esteem”, “Ineffectiveness and Somatic Symptoms”, “Anhedonia”, “Interpersonal Problems”. The SE and CDI total scores were negative and statistically (p < .001) correlated in the total sample (r = -.67), in Girls (r = -.69) and in Boys (r = -.63).

The Portuguese CDI has good reliability and validity, showing to be an adequate instrument for measuring depressive symptoms in Portuguese adolescents.

Sexual identity is often neglected in the analyzes of a potential patient and this represents a very bias and a potential blurring factor especially when we research about attempted suicide or substance abuse.

We analyzed EBM Literature published in the last five year, and text otherwise and previously published but esteemed as important for our purpose.

Lesbian population (L) have a greater and huger use of illicit drug.

It's necessary to add that a great part of L population uses drug by injection, thus including all the considerations about related infections (2).

Epidemiologically,we can attest that 10% of bisex (B) and 8,8% of L population have an ev drug intake.

It results of the greatest interest the fact that we can measure an increase in rapist's victims in the population analyzed compared to GP (64%vs44%), and in ⅓ of the cases violence occurred during childhood.

Adding that homosexual population is at major risk of suicide and attempted suicide, we are obliged to wonder if there's a common pathway or a sum of risk factors leading to these conducts.

The evidence of a possible correlation between sexual abuse and via PTSD the conservation of victim role, as well as the development of dissociation or personality disorder might explain a deeper use of illicit drug or alcohol in this population. International researchers in the field of SUD strongly demand to analyze sexual orientation as a risk factor for SUD since the given evidence quoted above.

ECT remains as one of the most effective and secure psychiatric treatments for a wide variety of disorders, like depression, bipolar disorder or schizophrenia. Although not fully known, several theories hypothesize about its mechanism of action. To be effective, it has to induce a generalized convulsion of at least 15 seconds.

To analyze and compare convulsion times regarding diagnosis and treatment phase (acute, continuation or maintenance) to discern whether these factors influence convulsion time.

1675 ECT sessions were performed on 117 patients during a year at a universitary hospital. Convulsion times were analyzed comparing them according to main diagnosis (bipolar disorder, major depressive disorder, schizophrenia, schizoaffective disorder), as well as according to treatment phase (acute, continuation, maintenance).

Schizophrenia mean convulsion time was 40,77 seconds (CI95% 39,25-42.28), for schizoaffective disorder it was 34,59 seconds (CI95% 32,74-36,44), for bipolar disorder 35,13 seconds (CI95% 33,83-36,43) and for major depressive disorder 34,90 seconds (CI95% 32,72- 37,07), with a statistical significance between groups of p < 0.001.

According to treatment phase, mean convulsion time in the acute phase was 34,94 seconds (CI95% 33,81-36,19), in the continuation phase it was 39,61 seconds (ICI95% 37,28-42,29), and in the maintenance phase it was 39,00 seconds (CI95% 37,92-40,18), with a statistical significance between groups of p < 0.001.

Although there exist statistically significant differences between groups according to diagnosis and treatment phase, they are not clinically relevant, thus concluding that neither diagnosis nor treatment phase seem to influence convulsion time to a relevant degree.

Women take sick-leave more often than men, in general and especially because of psychiatric disorders.

The aim of the present study was to describe and analyse sick-leave due to psychiatric morbidity and its relation to age and occupation, with a special focus on sex differences.

We conducted a retrospective and descriptive study in external consultation of the psychiatric hospital Razi. We collected the records of patients seen between 01/07/2011 and 30/09/2012 and who received sick leave for psychiatric illness.

92 patients were included (78 female, 14 male) with mean age of 43,6 years. Sick-leave duration was longer for women. The greatest gender differences were found in the youngest and oldest age-groups. Women had higher incidence also in the longest spells (86% vs 14%).

Depressive disorders were found among 73% of cases. Highest incidence of sick-leave was found among those with a combination of psychiatric and physical morbidity.

Psychiatric disorder is an important factor in sick-leave among women, especially regarding length of absence. Further studies on the influence of sex integration on sickness absence need to be done.

The utility of Mobile Crisis Unit (MCU) and its target population has been a controversial issue and many scientific articles have been writen about it (1,2).

The aim of this study is to identify the demographic and clinical features of patients diagnosed with psychotic disorder who have been hospitalized and have not required hospitalization in psychiatric unit through a Mobile Crisis Unit (MCU).

We collected retrospectively demographic and clinical variables. These include psychiatric rating scales of severity: Clinical Global Impression Scale (CGI) and Psychiatric Disease Severity (GEP); of functionality as Global Assessment of Functioning Scale (GAF); the aggressive behaviour and violence scale (AVAT) and psychopathology with the Positive and Negative Syndrome Scale (PANSS) of a total of 136 patients between June 2007 and July 2010.

There have been found stadisticaly significative differences between patients who have been hospitalized versus patients who have not in the items of treatment adherence and security staff intervention (Table 1). There is a positive correlation between patients who required hospitalization and the clinical scales CGI, GEP, GAF, AVAT, SUMD, PANSS-P and PANSS-G (Table 2).

We can conclude that patients cared for by the Mobile Crisis Unit (MCU) that require of psychiatric hospitalization have poor adherence to previous treatment. A high frequency of cases require intervention of security staff for having a higher risk of aggressiveness at the moment of hospitalization. The presence of greater psychopathology and functionality severity in patients hospitalized through the Mobile Crisis Unit (MCU) is also considered.

People with schizophrenia and bipolar disorder are more likely to smoke, smoke more cigarettes per day and have greater mortality from smoking-related disease than those in the general population.

To describe the sample and to identify the relationship between the pattern of tobacco use and psychopathology.

Multicenter, observational, prospective, 12-month follow up study to assess the clinical efficacy of a multicomponent smoking cessation program specifically designed for patients with severe mental illness.

65 patients from 3 Mental Health Centers sited in Spain [64.6% males; mean age (SD) = 44.63 (8.93)].

1. (1) Pattern of tobacco use: Fargerstrom Test for Nicotine physical Dependence; Glover-Nilsson Test for Nicotine psychological Dependence; expired carbon monoxide (CO); n° cigarettes/day; n° smoking years.

2. (2) Psychopathology: PANSS; Hamilton; Young; CGI-G.

Schizophrenia 64.6% and bipolar 26.2%; suicide attempts 36.9% (2.83 mean of suicide attemps); economically active 7.7%. There is no differences: in psychopatology severity between “heavy smokers” (ppm ≥ 26 or n° cigarettes/day ≥ 30) and “non heavy smokers” (ppm < 26 or n° cigarettes/day < 30) and in the pattern of tobacco use between schizophrenia and bipolar patients. There is no relationship between psychopatology severity and the pattern of tobacco use in schizophrenia patients. Finally, there is relationship between depressive symptoms (Hamilton) and nicotine psychological dependence (Glover-Nilsson Test) in bipolar disorder patients (r = 0.72, p = 0.004).

In bipolar disorder patients, there is relationship between the severity of depressive symptoms and the dependence of nicotine.

Wernicke-Korsakoff (W-K) syndrome is a neuropsychiatric disorder resulting from thiamine deficiency, which is associated with significant morbidity and mortality. According to autopsy-based studies, it is still greatly underdiagnosed. In this case study and review, we focus on late diagnosed W-K related with alcohol misuse, and we give a short review about the topic focusing on its prompt diagnosis and adequate treatment.

We intend to underline that W-K syndrome, a preventable neurological condition and even treatable in its early phase if suspected, is underdiagnosed, with critical consequences for the patient's prognosis.

Using a case-report format, we describe three cases of W-K syndrome which were initially misdiagnosed in different general hospitals. We summarize complementary explorations, therapeutic management and evolution, and after that we shortly review the topic.

The three patients were diagnosed of W-K syndrome in the psychiatry unit, weeks after being visited in the emergency facilities, where it was not suspected nor detected or prevented. All of them ended up with cognitive disabilities of a different degree, always with a remarkable impact in their functioning. One of them achieved some amelioration with thiamine in high doses, despite its late detection.

W-K can be prevented and treated if early detected, but it is underdiagnosed, with severe consequences for the patients. We suggest some measures that could enhance its detection and prevention, like modifying emergency room protocols, both diagnostic and therapeutic.

This study presents the first results of a project on alexythymia and emotional connections in a sample of 8 patients with EDs. The project aims to evaluate changes in emotional expressions through the language used, by means of the Italian measure of the referential process. Changes in the alexithymic condition will be examined through the outcome and qualitative analysis of the psychotherapeutic process.

25 verbatim transcribed psychotherapeutic sessions were analyzed and correlated with TAS20, EDI-2, PBI, BUT, SWAP200, and between these and the narrative indices of the IDAAP.

The relation between TAS20 and PBI supports a link between alexythymia and parenting styles: neglect and overprotection seem to contribute to difficulties in forming emotional connections. The positive correlation found between the TAS20 and some EDI2 subscales indicates a tendency to express misunderstood stimuli by means of the body. A positive correlation between MHIWRAD2 and TAS20 may suggest strong phases of emotional activation due to emotional dysregulation. The analysis of the significant correlations between the PBI and the RA measures indicate that parenting styles are related to language. A positive correlation between the IWRAD indices and maternal overprotectiveness was found: maternal overprotectiveness may be associated to strong emotional activation which is in turn characterized by emotional dysregulation. The associations between the narrative indices and the high functioning measure of the SWAP200 suggest that the reflexive components is related to high functioning; emotional dysregulation, as expressed by the variability in RA peaks, seems to be connected to low functioning.

During the 6 months of recruitment, the patients admitted for depressive symptom complaints were screened with a medical history and socio-demographic inventory, the SCID II, the Hamilton Depression Rating Scale (HAM-D), the Beck Anxiety Interview (BAI), and the Beck Depression Interview (BDI). The patients will be retested through a follow-up after 3 and 6 months with HAM-D, BDI and BAI. Only the feminine part of the sample was considered (n = 60) and divided by SCID II results in Borderline Personality Disorder [B] (n = 33), Other PD [O] (n = 14) and negative [N](n = 9); 4 patients refused to complete the tests [R].

Statistically, there were no significant differences among the groups, if the same test is compared at the same moment; however, during follow-up B improves in a statistically significant way compared to others. Moreover, those of B who underwent psychotherapy statistically had significantly lower scores than those of B who did not.

Research clearly demonstrates the importance of PD, and in particular borderline, in determining admissions due to depressive symptomathology. Moreover, Borderline PD patients improve more than other patients after an admission, particularly if they underwent psychotherapy.

The benefit-risk ratio of a long duration of antidepressant drug treatment (ADT) may not be favourable. A pragmatic way to study the consequences of ADT duration in accordance with practice guidelines is to assess its impact on health care use.

To assess the economic impact of ADT duration in a real-life setting through the changes in direct health care costs.

A historical fixed cohort study included 27,134 patients aged 18 and over with a new ADT registered in the national insurance database. The economic impact concerned health care expenditure in the first three months after treatment discontinuation. Generalized linear models compared two groups of treatment duration: less than six months and six months and over.

After adjustment for care costs before and during ADT, gender, age, chronic diseases, welfare entitlement and prescriber specialty, total health care costs (in log) [-0.06 (-0.14;0.01) p = 0.11] and psychiatric care costs (in square root) [-0.08 (-0.41;0.25) p = 0.6] were similar in both groups after ADT discontinuation. Non-psychiatric care costs were significantly lower in the “long treatment duration” group compared with the “short treatment duration” group [-11.4 (-15.8;-7.0) p < 0.0001]. The decreases in total and non-psychiatric care costs after the ADT episode were larger in the “long treatment duration” group compared with the “short treatment duration” group.

With regard to health care costs and global health, ADT of short duration appear less effective than treatment of recommended duration.

Bipolar disorder (BD) is strongly associated with suicidal behaviors. Suicidal behavior is based on a stress/vulnerability model. Several factors have been identified, including clinical features (such as impulsivity) and cognitive deficits (such as impaired decision making or problem solving). Identifying specific factors in BD patients is needed to better prevent suicidal behaviors.

1. 1) To identify clinical and cognitive characteristics associated with suicidal behaviors in euthymic BD patients.

2. 2) To determine a correlation between neuropsychological variables and the number and characteristics of suicidal attempts.

214 euthymic BD patients from the national network of “Centres Experts Bipolaires” were included and divided into two groups based on the personal history of suicide attempts. Socio-demographic and clinical variables were collected and neuropsychological functions were assessed (attention, memory and executive functions).

We found an association between suicidal behavior and gender, employment status. Suicidal attempters had significantly more mixed episodes and hospitalizations. There was no difference between the two groups concerning neuropsychological measures. The number of suicide attempts and verbal fluency scores were negatively correlated.

The lack of significant differences in neuropsychological scores may be due to a common vulnerability between suicidal behaviors and BD. Further studies, especially prospective ones, are needed in order to characterize high risk BD patients in order to develop effective specific preventive strategies.