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Se realizó un ensayo clínico aleatorio con dos grupos de tratamiento: uno que recibió terapia cognitivo-conductual (TCC) y otro con la inclusión de técnicas emocionales (TCCE), ambos de 20 sesiones. La muestra consistió en 237 pacientes, todos ellos con diagnóstico principal de trastornos de ansiedad, y todos remitidos por sus médicos de cabecera. Hubo mejoras significativas en la sintomatología (rasgo de ansiedad, depresión, sintomatología clínica), pero la única diferencia significativa encontrada en la comparación intergrupal fue para la variable "satisfacción vital subjetiva" (p= .017), que fuemayor en el grupo de TCCE. Este grupo también mostró una mayor adherencia al programa de tratamiento (p= .019). Esto refuerza la conveniencia de incluir el tratamiento de terapia de grupo con componentes emocionales en los entornos de atención primaria, destacando la importancia de hacer hincapié en la autoestima.(AU)

A randomized clinical trial was carried out with two treatment groups: one receiving cognitive-behavioral therapy (CBT) and the other with the inclusion of emotional techniques (CEBT), both lasting 20 sessions. The sample consisted of 237 patients, all of them with principal diagnoses of anxiety disorders, and all referred by their general practitioners. There were significant improvements in symptomatology (anxiety trait, depression, clinical symptomatology), but the only significant difference found in the intergroup comparison was for the variable “subjective life satisfaction” (p = .017), which was greater in the CEBT group. This group also displayed better adherence to the treatment program (p = .019). This reinforces the case for including group therapy treatment with emotional components in primary care settings, highlighting the importance of emphasizing self-esteem.(AU)

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OBJECTIVE: Borderline personality disorder (BPD) is a severe mental disorder characterized by emotional crises. To date, crisis interventions for BPD have been conducted via telephone calls and emergency units, which are associated with an extra amount of resources. The aim of this research was to test the usability and satisfaction with a psychotherapeutic mobile app for self-managing crises in BPD. METHOD: The B·RIGHT app was designed based on Artificial Intelligence psychotherapeutic algorithms. Usability and satisfaction with the app were assessed in 25 outpatients diagnosed with BPD (84% female, mean age = 35.80 years) using the System Usability Scale (SUS) and other questionnaires. Clinical features were assessed using the Borderline Symptom List, the Difficulties in Emotion Regulation Scale and Beck's Depression Inventory. RESULTS: Patients with BPD considered the app user-friendly (mean total score = 4.03) and highly satisfactory (mean total score = 4.02), resulting in a positive user experience (mean total score = 4.09). Total usability was negatively associated with age (r = -.44), positively associated with educational level (rho = .47) and with overall emotion dysregulation (r = .51), and negatively associated with depression severity (r = -.47). CONCLUSIONS: The usability and satisfaction testing of the B·RIGHT app showed promising findings, which warrant further research in order to validate its effectiveness.

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Evidence-based psychosocial interventions for borderline personality disorder (BPD) still face multiple challenges regarding treatment accessibility, adherence, duration, and economic costs. Over the last decade, technology has addressed these concerns from different disciplines. The current scoping review aimed to delineate novel and ongoing clinical research on technology-based psychosocial interventions for patients with BPD. Online databases (PubMed, Cochrane Library, EMBASE, Web of Science, PsycInfo, and Google Scholar) were searched up to June 2020. Technology-based psychosocial treatments included innovative communication (eHealth) and computational (e.g., artificial intelligence), computing (e.g., computer-based), or medical (e.g., functional magnetic resonance imaging [fMRI]) software. Clinical research encompassed any testing stage (e.g., feasibility, efficacy). Fifteen studies met the inclusion criteria. The main findings were the following: almost two-thirds of the studies (9/15) tested software explicitly conceived as adjunctive interventions to conventional therapy; nearly half of the studies (7/15) were referred to as dialectical behavior therapy-based software; most studies (13/15) were focused on the initial stage of the clinical research cycle (feasibility/acceptance/usability testing), reporting good results at this point; more than one-third of the studies (6/15) tested mobile apps; there is emerging evidence for Internet-based interventions and real-time fMRI biofeedback but only little evidence for mHealth interventions, virtual and augmented reality, and computer-based interventions; there was no computational technology-based clinical research; and there was no satisfaction/preference, security/safety, or efficiency testing for any software. Taken together, the results suggest that there is a growing but still incipient amount of technology-based psychosocial interventions for BPD supported by some kind of clinical evidence. The limitations and directions for future research are discussed.

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This study sought to delineate distinctive parenting attitudes in people with obsessive-compulsive disorder (OCD), specific emotional symptoms in their children, and the association between them. Forty OCD parents and their children were compared with 37 parents with adjustment disorders and their children by using standardized clinical questionnaires. Children of OCD parents exhibited significantly greater (subclinical) emotional symptoms when compared with children of non-OCD parents. After controlling for parents' and children's depression and anxiety symptoms, OCD parents reported significantly poorer parenting attitudes overall relative to non-OCD parents. The presence of sexual/somatic obsessions in OCD parents predicted anxiety symptom severity among their children, but both relationships were mediated by parental involvement. These findings indicate the importance of addressing and treating the distinctive parenting attitudes among people with OCD and its influence on their children's emotional symptoms

Este estudio pretende delimitar las actitudes parentales distintivas en personas con trastorno obsesivo-compulsivo (TOC), los síntomas emocionales específicos en sus hijos y la asociación entre ambos. Cuarenta padres con TOC y sus hijos fueron comparados con 37 padres con trastornos adaptativos y sus hijos mediante el uso de cuestionarios clínicos estandarizados. Los hijos de padres con TOC manifestaron significativamente más síntomas emocionales (nivel subclínico) en comparación con los hijos de padres con trastornos adaptativos. Tras controlar el efecto de los síntomas de depresión y ansiedad de los padres y los niños, los padres con TOC indicaban actitudes parentales significativamente peores que las de los padres con trastornos adaptativos. La presencia de obsesiones sexuales/somáticas en los padres con TOC predecía la severidad de los síntomas de ansiedad en sus hijos, si bien dichas relaciones estaban mediadas por el nivel de implicación parental. Estos hallazgos indican la importancia de abordar y tratar las actitudes parentales distintivas de las personas con TOC y su influencia en la sintomatología emocional de sus hijos

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El objetivo del estudio actual es evaluar los cambios en la estructura, la dinámica familiar y la comunicación durante una intervención familiar domiciliaria con pacientes diagnosticados de trastornos del espectro psicótico que muestran resistencia al tratamiento. Se incluyeron en el estudio un total de 12 familias (36 participantes) con descendencia diagnosticada de trastorno psicótico. Para la recopilación de datos se utilizaron diferentes técnicas cualitativas con el fin de triangular la información que proviene de cada una de ellas: un cuestionario de preguntas abiertas y un cuestionario más profundo para los observadores. Los dos ejes que explican la dinámica relacional más estrechamente ligada a la resistencia al tratamiento de estos pacientes fueron el "clima de confianza-desconfianza" y la "ambiguedad claridad-comunicación". Estos indicadores pueden cambiar dinámicamente e interactuar entre sí con el fin de mejorar el clima familiar y la comunicación

The aim of the current study is to assess the changes in the structure, family dynamics, and communication during a domiciliary family intervention with patients diagnosed with psychotic spectrum disorders showing resistance to treatment. A total of 12 families (36 participants) with offspring diagnosed with psychotic disorder were included. For data collection, different qualitative techniques were used in order to triangulate information coming from each of them: a questionnaire of open questions and a deepening questionnaire for the observers. The two axes that explain the relational dynamics most closely linked to the treatment resistance of these patients were "trust-distrust climate" and "clarity-communicational ambiguity". These indicators can dynamically change and interact with each other for the benefit of improving family climate and communication

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OBJECTIVE: To ascertain the foundations for a schema-focused therapy model for the treatment of borderline personality disorder. METHODS: The sample consisted of 102 borderline personality disorder outpatients. Dimensional psychopathology was assessed using the Scale for Suicidal Ideation, the Aggression Questionnaire, and the Symptom CheckList Revised. Categorical psychopathology was measured using the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders, Patient Edition. Stepwise linear/logistic multiple regression analyses were used to determine the predictive role of the schema domains tested by the Young Schema Questionnaire on both types of psychopathology. Receiver operating characteristic curves were calculated for those binary outcomes. RESULTS: Regarding dimensional psychopathology, disconnection/rejection predicted greater suicidal ideation (ß = .39, p = .002), physical/overt aggressiveness (ß = .27, p = .05), and psychotic-like symptoms, such as paranoid ideation (ß = .35, p = .003). Other-directedness predicted greater anger/inner aggressiveness (ß = .22, p = .05) and internalizing symptoms, such as phobic anxiety (ß = .39, p = .001). Regarding categorical psychopathology, disconnection/rejection significantly predicted the presence of lifetime comorbidities with eating disorders (adjusted odds ratio [AOR] = 1.12, 95% CI = 0.99-1.24) and posttraumatic stress disorder (AOR = 1.2, 95% CI = 1.04-1.3), resulting in a good balance of sensitivity/specificity, respectively (.97/.96 and .88/.89). Other-directedness significantly predicted the absence of lifetime comorbidity with substance-use disorders (AOR = .74, 95% CI = 0.57-0.95). These relationships remained significant after controlling for confounders (e.g., comorbidity with other personality disorders, clinical global severity). CONCLUSIONS: Two schema domains, disconnection/rejection and other-directedness, were directly associated with dimensional and categorical psychopathology among borderline personality disorder patients. These findings provide further information about the foundations and target interventions when implementing schema-focused therapy on this population.

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BACKGROUND: This theoretical study reviews the main findings and research on home-based treatment for psychosis. The principal purpose was to analyze the various types of home-based service and make recommendations for a service that would meet the needs of both first-episode and resistant patients. We compare the Early Intervention Service, which aims to reduce the range of untreated psychosis (DUP) with other types of home-care and similar interventions that have already been implemented: crisis resolution home teams (CRHTs), Open Dialogue Approach (ODA), social skills training (SST) and foster homes. METHOD: We searched electronic bibliographic databases including PubMed, PsycINFO, and Discovery for relevant publications appearing between 2005 and 2015. Ninetythree publications were deemed eligible for inclusion; 9 of these were systematic reviews and the rest were scientific papers or books. DISCUSSION: We describe in this review the most widely used home-based interventions, including individual and family therapy. Multidisciplinary teams carry out all the interventions discussed. There does not appear to be a form of psychotherapy, which is effective in treating resistant patients. CONCLUSIONS: Home-based interventions improve adherence to treatment, everyday living and social skills and also have a beneficial impact on family conflicts and other social conflicts. As a whole result, the number of incomes is reduced, patients’ quality of life and autonomy are increased and inclusion and community living are improved.

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Sexual masochism disorder is considered the most prevalent paraphilia among women. However, little is known about the etiology and clinical correlates involved in this disorder. We aimed at addressing this issue through a potentially high-risk clinical cohort. This case-control study consisted of 60 women who met DSM-IV criteria for borderline personality disorder (BPD) and 60 women with other personality disorders. For both groups, sexual masochism disorder comorbidity was assessed through the Structured Clinical Interview, Sexual Disorders Module. Several etiological, psychosexual, and personality features were measured. Sexual masochism disorder was 10 times higher in BPD women than in women with other personality disorders (10 vs. 0 %). Among BPD women, those with sexual masochism disorder reported more child sexual abuse, more hostile/dismissing attachments, higher sensation seeking, and more frequently exploratory/impersonal sexual fantasies than BPD without sexual masochism. Correlation analysis confirmed a significant positive relationship between disinhibition and sexual masochism severity for BPD women. Our findings point out that BPD women may represent a high-risk cohort, especially those with higher disinhibition and detached attachment. Childhood sexual abuse may also play a predispositional role on this comorbidity. Further research may help to elucidate the intriguing relationship between both disorders.

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BACKGROUND: Childhood trauma has been associated with borderline personality disorder (BPD). However, research has not yet provided conclusive evidence concerning the mediating mechanisms. METHODS: Seventy women diagnosed with BPD were compared with other 60 women who met DSM-IV criteria for other personality disorders on measures of childhood trauma and attachment. RESULTS: Patients with BPD reported higher severity of emotional, physical and sexual abuse than patients with other personality disorders. Moreover, BPD patients also showed greater preoccupied-anxious adult attachment. At model 1, logistic regression analysis revealed that only childhood emotional abuse predicted the occurrence of BPD. At model 2, this association was no longer significant, and the addition of preoccupied-anxious adult attachment was significantly associated with a greater likelihood of BPD diagnosis. CONCLUSIONS: These findings support a specific relationship between childhood emotional abuse and the occurrence of BPD, which may be accounted for by preoccupied-anxious adult attachment. Copyright © 2016 John Wiley & Sons, Ltd.

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OBJECTIVE: Sexuality is somewhat neglected in clinical research on borderline personality disorder (BPD). METHOD: We performed a systematic review from 1980 to November 2014 through PubMed and PsycINFO. RESULTS: Empirical evidence underscores that childhood sexual trauma may be considered a non-specific risk factor for BPD. Furthermore, individuals with BPD also display higher sexual identity disturbances and homosexual relationships than non-BPD individuals. Moreover, patients with BPD also exhibit higher sexual impulsivity than non-BPD. In addition, sexual risk behaviours among individuals with BPD are related to increased rates of sexually transmitted diseases, unwanted pregnancies, rape and commercial sexual relationships, especially among drug abusers. Although psychotherapy is widely recommended for BPD, there has been little systematic research on the effect of these treatments with respect to co-morbid post-traumatic symptoms related to childhood sexual trauma. CONCLUSIONS: Sexuality-related issues represent a major clinical topic within this population. Findings are discussed concerning their methodological limitations and clinical implications. Copyright © 2016 John Wiley & Sons, Ltd.

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Offspring of parents with bipolar disorder (O-BP) is a high-risk cohort for mental illness in general and bipolar disorder (BD) specifically. This review aims to delineate the main clinical features of O-BP, including the psychopathology, interpersonal functioning, temperamental and personality features, neurocognitive deficits and neurobiological dysfunctions. Evidence indicates that several internalizing and externalizing symptoms/disorders are more prevalent in O-BP than in offspring of healthy control parents (O-HC). Furthermore, O-BP exhibits poorer interpersonal functioning than O-HC. Moreover, O-BP also endorses higher activity level, emotionality and behavioral disinhibition compared to O-HC. Besides, O-BP displays greater deficits on memory, cognitive flexibility and social cognition compared to O-HC. Finally, O-BP exhibits dysfunctional modulation in cortico- subcortical areas, more white matter abnormalities and higher cortisol basal levels compared to O-HC. Overall, these findings are discussed regarding the natural course and potential risk factors or endophenotypes for major mood disorders in general and BD specifically.

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Los descendientes de padres con trastorno bipolar (O-BP offspring of parents with bipolar disorder) son una cohorte de alto riesgo para la enfermedad mental en general y el trastorno bipolar en particular. Esta revisión tiene como objetivo delimitar las principales características clínicas de los O-BP, incluyendo su psicopatología, funcionamiento interpersonal, características temperamentales y de personalidad, los déficits neurocognitivos y las disfunciones neurobiológicas. La evidencia indica que varios síntomas/trastornos internalizantes y externalizantes son más frecuentes en O-BP que en hijos de padres sanos (O-HC offspring of healthy control parents). Por otra parte, los O-BP exhiben peor funcionamiento interpersonal que los O-HC. Por otra parte, los O-BP también presentan mayor nivel de actividad, emotividad y desinhibición conductual en comparación con los O-HC. Además, los O-BP muestra mayores déficits de memoria, flexibilidad cognitiva y cognición social en comparación con los O-HC. Por último, los O-BP exhiben una modulación disfuncional de áreas córtico-subcorticales, anomalías de la sustancia blanca y niveles de cortisol basal más elevados en comparación con los O-HC. En general, estos resultados son discutidos en relación a los factores de riesgo, curso natural y potenciales endofenotipos para los trastornos del estado de ánimo en general y el trastorno bipolar específicamente

Offspring of parents with bipolar disorder (O-BP) is a high-risk cohort for mental illness in general and bipolar disorder (BD) specifically. This review aims to delineate the main clinical features of O-BP, including the psychopathology, interpersonal functioning, temperamental and personality features, neurocognitive deficits and neurobiological dysfunctions. Evidence indicates that several internalizing and externalizing symptoms/disorders are more prevalent in O-BP than in offspring of healthy control parents (O-HC). Furthermore, O-BP exhibits poorer interpersonal functioning than O-HC. Moreover, O-BP also endorses higher activity level, emotionality and behavioral disinhibition compared to O-HC. Besides, O-BP displays greater deficits on memory, cognitive flexibility and social cognition compared to O-HC. Finally, O-BP exhibits dysfunctional modulation in cortico-subcortical areas, more white matter abnormalities and higher cortisol basal levels compared to O-HC. Overall, these findings are discussed regarding the natural course and potential risk factors or endophenotypes for major mood disorders in general and BD specifically

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BACKGROUND: With the advent of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders, body dysmorphic disorder (BDD) has been subsumed into the obsessive-compulsive disorders and related disorders (OCDRD) category. OBJECTIVE: We aimed to determine the empirical evidence regarding the potential relationship between BDD and obsessive-compulsive disorder (OCD) based on the prevalence data, etiopathogenic pathways, and clinical characterization of patients with both disorders. METHOD: A comprehensive search of databases (PubMed and PsycINFO) was performed. Published manuscripts between 1985 and May 2015 were identified. Overall, 53 studies fulfilled inclusion criteria. RESULTS: Lifetime comorbidity rates of BDD-OCD are almost three times higher in samples with a primary diagnosis of BDD than those with primary OCD (27.5% vs 10.4%). However, other mental disorders, such as social phobia or major mood depression, are more likely among both types of psychiatric samples. Empirical evidence regarding the etiopathogenic pathways for BDD-OCD comorbidity is still inconclusive, whether concerning common shared features or one disorder as a risk factor for the other. Specifically, current findings concerning third variables show more divergences than similarities when comparing both disorders. Preliminary data on the clinical characterization of the patients with BDD and OCD indicate that the deleterious clinical impact of BDD in OCD patients is greater than vice versa. CONCLUSION: Despite the recent inclusion of BDD within the OCDRD, data from comparative studies between BDD and OCD need further evidence for supporting this nosological approach. To better define this issue, comparative studies between BDD, OCD, and social phobia should be carried out.

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El trastorno bipolar pediátrico (TBP) se ha convertido en un campo de investigación en el que los tratamientos psicosociales han proporcionado una gran cantidad de hallazgos empíricos en la última década. Abordamos esta cuestión a través de una revisión sistemática destinada a establecer su eficacia y viabilidad como terapias adyuvantes para los jóvenes con TBP o en alto riesgo de TBP. Se realizó una búsqueda exhaustiva en bases de datos entre 1990 y septiembre del 2014. En total, 33 estudios se relacionaron específicamente con el tema y 20 de ellos eran artículos originales. La evidencia muestra que tanto la «psicoeducación familiar» como la «terapia familiar para adolescentes» son tratamientos probablemente eficaces en el TBP. Del mismo modo, la «terapia cognitivo-conductual centrada en el niño y la familia» se puede caracterizar como un tratamiento en fase experimental. Las terapias restantes no obtienen suficiente apoyo empírico, ya sea por la presencia de hallazgos inconsistentes entre los distintos ensayos clínicos, ya por contar con datos únicamente provenientes de estudios de casos. Además, los resultados de los estudios sobre tratamientos psicosociales proporcionan resultados concluyentes en cuanto a la viabilidad y aceptabilidad de dichas terapias. Son necesarios ensayos clínicos controlados con muestras de mayor tamaño con el fin de disminuir las deficiencias metodológicas encontradas en una gran parte de los tratamientos descritos (AU)

Pediatric bipolar disorder (PBD) has emerged as a research field in which psychosocial treatments have provided a plethora of empirical findings over the last decade. We addressed this issue through a systematic review aimed of establishing their effectiveness and feasibility as adjunctive therapies for youth with PBD or at high-risk for PBD. A comprehensive search of databases was performed between 1990 and September 2014. Overall, 33 studies were specifically related to the issue and 20 of them were original articles. Evidence suggests that both «multi-family psychoeducational psychotherapy» and «family-focused therapy» are possible effective treatments for PBD. Likewise, «child and family-focused cognitive-behavioral therapy» may be characterized as a treatment in its experimental phase. The remaining therapies fail to obtain enough empirical support due to inconsistent findings among clinical trials or data solely based on case reports. Studies of psychosocial treatments provide concluding results concerning their feasibility and acceptability. Larger sample sizes and more randomized controlled trials are mandatory for diminishing methodological shortcomings encountered in the treatments displayed (AU)

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Pediatric bipolar disorder (PBD) has emerged as a research field in which psychosocial treatments have provided a plethora of empirical findings over the last decade. We addressed this issue through a systematic review aimed of establishing their effectiveness and feasibility as adjunctive therapies for youth with PBD or at high-risk for PBD. A comprehensive search of databases was performed between 1990 and September 2014. Overall, 33 studies were specifically related to the issue and 20 of them were original articles. Evidence suggests that both "multi-family psychoeducational psychotherapy' and "family-focused therapy" are possible effective treatments for PBD. Likewise, "child and family-focused cognitive-behavioral therapy" may be characterized as a treatment in its experimental phase. The remaining therapies fail to obtain enough empirical support due to inconsistent findings among clinical trials or data solely based on case reports. Studies of psychosocial treatments provide concluding results concerning their feasibility and acceptability. Larger sample sizes and more randomized controlled trials are mandatory for diminishing methodological shortcomings encountered in the treatments displayed.

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BACKGROUND: Research on pediatric bipolar disorder (PBD) is providing a plethora of empirical findings regarding its comorbidity. We addressed this question through a systematic review concerning the prevalence, clinical impact, etiology and treatment of main comorbid disorders involved. METHOD: A comprehensive database search was performed from 1990 to August 2014. Overall, 167 studies fulfilled the inclusion criteria. RESULTS: Bipolar youth tend to suffer from comorbid disorders, with highest weighted mean prevalence rate arising from anxiety disorders (54%), followed by attention deficit hyperactivity disorder (ADHD) (48%), disruptive behavior disorders (31%), and substance use disorders (SUD) (31%). Furthermore, evidence indicates that ADHD and anxiety disorders negatively affect the symptomatology, neurocognitive profile, clinical course and the global functioning of PBD. Likewise, several theories have been posited to explain comorbidity rates in PBD, specifically common risk factors, one disorder being a risk factor for the other and nosological artefacts. Lastly, randomized controlled trials highlight a stronger therapeutic response to stimulants and atomoxetine (vs. placebo) as adjunctive interventions for comorbid ADHD symptoms. In addition, research focused on the treatment of other comorbid disorders postulates some benefits from mood stabilizers and/or SGA. LIMITATIONS: Epidemiologic follow-up studies are needed to avoid the risk of nosological artefacts. Likewise, more research is needed on pervasive developmental disorders and anxiety disorders, especially regarding their etiology and treatment. CONCLUSIONS: Psychiatric comorbidity is highly prevalent and is associated with a deleterious clinical effect on pediatric bipolarity. Different etiological pathways may explain the presence of these comorbid disorders among bipolar youth. Standardized treatments are providing ongoing data regarding their effectiveness for these comorbidities among bipolar youth.

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Epidemiological studies have found that obsessive­compulsive disorder (OCD) is estimated to occur in 12% of patients with schizophrenia. Whether this "schizo-obsessive" subgroup may be posited as a clinical entity with a distinct neuropsychological profile and treatment-related features remains unclear. A sample of 30 patients who met DSM-IV criteria for both schizophrenia/schizoaffective disorder and OCD was compared with 30 OCD subjects and with 37 patients with schizophrenia/schizoaffective disorder. Neuropsychological domains were measured by the Wechsler Adult Intelligence Scale - Third Edition (WAIS-III), the Trail Making Test (TMT), and the verbal fluency test (FAS). Treatment-related variables were assessed with the Clinical Global Improvement scale (CGI), the Drug Attitude Inventory (DAI), and dosage/type of antipsychotic medications. One-way analysis of variance revealed statistically significant differences among the three groups in "working memory," "block design," "semantic fluency," TMT-A, and TMT-B. However, the Bonferroni correction showed no statistical differences between both psychotic groups. In addition, there were no significant differences among the three groups in the CGI and DAI, although "schizo-obsessive" patients tended to display slightly higher scores on these variables than the other groups. Overall, these findings do not support the hypothesis that comorbidity between schizophrenia spectrum disorders and OCD may reflect a distinct clinical entity. However, further research with larger sample sizes and a more comprehensive clinical assessment are needed. Our findings also underscore the fact that divergences among assessment instruments, as well as confounding variables, may influence results on neuropsychological domains.

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BACKGROUND: Pediatric bipolar disorder (PBD) has emerged as a field of research in which neuropsychological studies are continuously providing new empirical findings. Despite this, a comprehensive framework for neurocognitive impairments is still lacking, and most of the evidence remains unconnected. We addressed this question through a systematic review of neuropsychological research, with the aim of elucidating the main issues concerning this topic. METHOD: A comprehensive search of databases (PubMed, PsycINFO) was performed. Published manuscripts between 1990 and January 2014 were identified. Overall, 124 studies fulfilled inclusion criteria. Methodological differences between studies required a descriptive review of findings. RESULTS: Evidence indicates that verbal/visual-spatial memory, processing speed, working memory, and social cognition are neurocognitive domains impaired in PBD youth. Furthermore, these deficits are greater among those who suffer acute affective symptoms, PBD type I, and/or attention deficit hyperactivity disorder (ADHD) comorbidity. In addition, several neurocognitive deficits imply certain changes in prefrontal cortex activity and are somewhat associated with psychosocial and academic disabilities. Strikingly, these deficits are consistently similar to those encountered in ADHD as well as severe mood dysregulation (SMD). Besides, some neurocognitive impairments appear before the onset of the illness and tend to maintain stable across adolescence. Finally, any therapy has not yet demonstrated to be effective on diminishing these neurocognitive impairments. LIMITATIONS: More prolonged follow-up studies aimed at delineating the course of treatment and the response to it are warranted. CONCLUSIONS: Despite noteworthy research on the neurocognitive profile of PBD, our knowledge is still lagging behind evidence from adult counterparts.

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