Individuals with bipolar disorder have a lower quality of life than people without the disorder, even during euthymia (Michalak et al., 2010). Several parameters have been associated with quality of life in bipolar disorder: disturbances in sleep and biological rhythms (Slyepchenko et al., 2019), self-stigmatization and residual depressive signs (Post et al., 2018), comorbid anxiety disorder (Yapici Eser et al., 2018), and hypomanic residual signs (Yoldi-Negrete et al., 2019). To date, few studies have investigated the links between cognition, functioning and quality of life in bipolar disorders and their results are heterogeneous: some studies report no link (Dias et al., 2008; Faurholt-Jepsen et al., 2020) while other studies find that better neurocognition is associated with a better quality of life transversally (Cotrena et al., 2016) and 6 months later (Mackala et al., 2014). In fact, in a recent study, we show that current cognitive performance was only indirectly associated with quality of life (Roux et al., 2024). In this project, we propose to significantly advance the question of the links between neurocognitive, functioning and quality of life by analyzing data from the 12 bipolar expert centers of the FondaMental foundation. Cognition will be measured by a complete neuropsychological battery and quality of life by the EQ-5D. Three measurement times over two years of follow-up will be included in the analyses. Intermediate variables such as residual depression, anxiety-status, will be integrated to better understand the causal pathway linking neurocognition and quality of life. Longitudinal SEM (using cross-lagged panel modeling) will be used with neurocognition as the latent variable. If you are interested in this project, please contact Paul Roux.

Our initial work on the cross-sectional database of people followed at the Versailles Expert Center for Bipolar Disorder suggested a detrimental impact of hyperactivation of maladaptive early schema on functioning independently from the neuropsychological performance. We have the project to analyze longitudinal data of the impact of these schemas on functioning and quality of life one year later (N=200) using multiple linear regressions. Different covariates will be entered into the model such as residual depression, neurocognition, trait anxiety, and metacognition. If you are interested in this project, please contact Paul Roux.

Several previous studies have explored the impact of neurocognition on quality of life in schizophrenia. However, the results are contradictory, as several authors have found a positive association between cognitive performance and quality of life (Herman, 2004; Alptekin et al., 2005; Savilla et al., 2008; Woon et al., 2010; Kim et al., 2021), while others have reported a negative association (Narvaez et al., 2008; Meesters et al., 2013; DeRosse et al., 2018; Kurtz et al., 2019). Finally, other studies report no significant association (Brissos et al., 2008; Chino et al., 2009). In this context, we propose to conduct a systematic review of the literature using the PRISMA method to identify moderators who explain the heterogeneity of the links between neurocognition and quality of life in schizophrenia. In this project, we will then conduct a meta-analysis to measure the size of this association and reduce heterogeneity by grouping studies according to the moderators identified above (type of quality of life measure? type of neuropsychological measures? duration of disorder evolution? control for confounding factors in the association such as depression, insight or self-stigmatization?) and specifying the effect sizes in these subgroups. We will also conduct a multivariate analysis by meta-analytic SEM (metaSEM) to estimate a multiple regression model with the different neuropsychological domains as predictors and quality of life as a dependent variable. The metaSEM will evaluate the unique and combined predictive capacity of quality of life through the different neuropsychological dimensions. The unique predictive capacity of a domain measures the impact of that domain by controlling for the influence of other domains. If you are interested in this project, please contact Paul Roux.

This internship will explore the following question: Do the difficulties of individuals with schizophrenia in representing the emotions, intentions, beliefs and desires of others lead to an increased risk of heteroaggression? In non-clinical samples, theory of mind has been associated with aggression in children (Austin et al 2017) and fear recognition is impaired in violent adult offenders proportionally to their level of psychopathy (Jusyte et al., 2016). If the clinical determinants of heteroagressivity in schizophrenia have been extensively studied, much less is known about their cognitive underpinnings. A metanalysis suggests that neurocognitive is slightly more impaired in violent patients compared to non-violent ones (Reinharth et al., 2014). Such a metanalysis is lacking for social cognition, despite a growing body of evidence for an association between violence in schizophrenia and ToM (Abu-Akel et al., 2004; Altamura et al. 2015; Engelstad et al. 2019; Johansson et al., 2020), emotion recognition (Weiss et al., 2006; Brugman et al., 2016; Bulgari et al. 2019), intentional bias (Waldheter et al, 2005 ) and social reasoning (O’Reilly et al., 2016). If you are interested in this project, please contact Paul Roux.

The comorbidity between ADHD and severe and persistent mental disorders (bipolar and schizophrenia disorder) is frequent and poses a serious therapeutic challenge. In this internship, the student will work on the SNDS (System National des données de Santé) database to measure the prevalence of this comorbidity, the use of psychostimulants in these situations and to check whether psychostimulants increase the risk of psychiatric relapse.

If you are interested in this project, please contact Paul Roux or Eric Brunet-Gouet.