Cognitive remediation therapy for patients with bipolar disorder: A randomised proof-of-concept trial.
CRT
bipolar
cognitive enhancement
cognitive remediation
randomised trial
Journal
Bipolar disorders
ISSN: 1399-5618
Titre abrégé: Bipolar Disord
Pays: Denmark
ID NLM: 100883596
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
pubmed:
26
6
2020
medline:
27
4
2021
entrez:
26
6
2020
Statut:
ppublish
Résumé
Cognitive remediation therapy (CRT) may benefit people with bipolar disorder type I and II for whom cognitive impairment is a major contributor to disability. Extensive research has demonstrated CRT to improve cognition and psychosocial functioning in people with different diagnoses, but randomised trials of evidenced therapy programmes are lacking for bipolar disorders. The Cognitive Remediation in Bipolar (CRiB) study aimed to determine whether an established CRT programme is feasible and acceptable for people with bipolar disorders. This proof-of-concept, single-blind randomised trial recruited participants aged 18-65 with bipolar disorder, not currently experiencing an episode. They were 1:1 block randomised to treatment-as-usual (TAU) with or without individual CRT for 12 weeks. The partly computerised CRT programme ("CIRCuiTS") was therapist-led and is evidence-based from trials in those with psychotic illnesses. Data were collected and analysed by investigators blinded to group allocation. The main outcomes (week 13 and 25) examined participant retention, intervention feasibility and putative effects of CRT on cognitive and psychosocial functioning via intention-to-treat analyses. ISRCTN ID32290525. Sixty participants were recruited (02/2016-06/2018) and randomised to CRT (n = 29) or TAU (n = 31). Trial withdrawals were equivalent (CRT n = 2/29; TAU n = 5/31). CRT satisfaction indicated high acceptability. Intention-to-treat analyses (N = 60) demonstrated greater improvements for CRT- than TAU-randomised participants: at both week 13 and 25, CIRCuiTS participants showed larger improvements in the following domains (week 25 effect sizes reported here): IQ (SES = 0.71, 95% CI [0.29,1.13]), working memory (SES = 0.70, 95% CI [0.31,1.10]), executive function (SES = 0.93, 95% CI [0.33,1.54]), psychosocial functioning (SES = 0.49, 95% CI [0.18,0.80]) and goal attainment (SES = 2.02, 95% CI [0.89,3.14]). No serious adverse events were reported. CRT is feasible for individuals with bipolar disorders and may enhance cognition and functioning. The reported effect sizes from this proof-of-concept trial encourage further investigation in a definitive trial.
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
196-208Subventions
Organisme : Department of Health
ID : PB-PG-0614-34075
Pays : United Kingdom
Informations de copyright
© 2020 The Authors. Bipolar Disorders published by John Wiley & Sons Ltd.
Références
Miskowiak KW, Carvalho AF, Vieta E, Kessing LV, Kessing LV. Cognitive enhancement treatments for bipolar disorder: A systematic review and methodological recommendations. Eur Neuropsychopharmacol. 2016;26(10):1541-1561.
Burdick KE, Russo M, Frangou S, et al. Empirical evidence for discrete neurocognitive subgroups in bipolar disorder: clinical implications. Psychol Med. 2014;44(14):3083-3096.
Bellani M, Biagianti B, Zovetti N, et al. The effects of cognitive remediation on cognitive abilities and real-world functioning among people with bipolar disorder: A systematic review. J Affect Disord. 2019; 257:691-697.
Tsapekos D, Seccomandi B, Mantingh T, et al. Cognitive enhancement interventions for people with bipolar disorder: a systematic review of methodological quality, treatment approaches, and outcomes. Bipolar Disord. 2020;22(3):216-230.
Wykes T, Huddy V, Cellard C, et al. A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes. Am J Psychiatry. 2011;168(5):472-485.
Anaya C, Martinez Aran A, Ayuso-Mateos JL, et al. A systematic review of cognitive remediation for schizo-affective and affective disorders. J Affect Disord. 2012;142(1-3):13-21.
Reeder C, Huddy V, Cella M, et al. A new generation computerised metacognitive cognitive remediation programme for schizophrenia (CIRCuiTS): a randomised controlled trial. Psychol Med. 2017;47(15):2720-2730.
Trotta A, Murray RM, MacCabe JH. Do premorbid and post-onset cognitive functioning differ between schizophrenia and bipolar disorder? A systematic review and meta-analysis. Psychol Med. 2015;45(2):381-394.
Lewandowski KE, Sperry SH, Cohen BM, et al. Treatment to enhance cognition in bipolar disorder (TREC-BD): Efficacy of a randomized controlled trial of cognitive remediation versus active control. J Clin Psychiatry. 2017;78(9):e1242-e1249.
Demant KM, Vinberg M, Kessing LV, Miskowiak KW. Effects of short-term cognitive remediation on cognitive dysfunction in partially or fully remitted individuals with bipolar disorder: Results of a randomised controlled trial. PLoS One. 2015;10(6):e0127955.
Strawbridge R, Fish J, Halari R, et al. The Cognitive Remediation in Bipolar (CRiB) pilot study: study protocol for a randomised controlled trial. Trials. 2016;29(17):371.
Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56-62.
Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133:429-435.
Chisholm D, Knapp MRJ, Knudsen HC, et al. Socio-Demographic and Service Receipt Inventory - European Version: development of an instrument for international research: EPSILON Study 5. Br J Psychiatry. 2000;177(S39):s28-33.
Drake RJ, Day CJ, Picucci R, et al. A naturalistic, randomized, controlled trial combining cognitive remediation with cognitive-behavioural therapy after first-episode non-affective psychosis. Psychol Med. 2014;44(9):1889-1899.
Reeder C, Pile V, Crawford P, et al. The feasibility and acceptability to service users of CIRCuiTS, a computerized cognitive remediation therapy programme for schizophrenia. Behav Cogn Psychother. 2016;44(3):288-305.
Rose D, Wykes T, Farrier D, et al. What do clients think of cognitive remediation therapy? A consumer-led investigation of satisfaction and side effects. Am J Psychiatr Rehabil. 2008;11(2):181-204.
Dolan P. The measurement of health-related quality of life for use in resource allocation decisions in health care. In: Handbook of Health Economics. Amsterdam, Netherlands: Elsevier, 2000:1723-1760.
Wechsler WD. Adult Intelligence Scale-Fourth Edition. London, UK: Pearson; 2010.
Wechsler D. Wechsler Memory Scale-Fourth Edition (WMS-IV) Technical and Interpretive Manual. London, UK: Pearson; 2009.
Wechsler D. Wechsler Abbreviated Scale of Intelligence, 2nd edn., London, UK: Pearson; 2011.
Delis D, Kaplan E, Kramer J. Delis-Kaplan executive function system (DKEFS). San Antonio, TX: Psychological Corporation; 2001.
Manly T, Hawkins K, Evans J, et al. Rehabilitation of executive function: facilitation of effective goal management on complex tasks using periodic auditory alerts. Neuropsychologia. 2002;40(3):271-281.
Sullivan MJ, Edgley K, Dehoux E. A survey of multiple sclerosis: I. Perceived cognitive problems and compensatory strategy use. Canadian. J Rehabil. 1990;4(2):99-105.
Patterson TL, Goldman S, McKibbin CL, et al. UCSD Performance-Based Skills Assessment: development of a new measure of everyday functioning for severely mentally ill adults. Schizophr Bull. 2001;27(2):235-245.
Rosa AR, Sánchez-Moreno J, Martínez-Aran A, et al. Validity and reliability of the Functioning Assessment Short Test (FAST) in bipolar disorder. Clin Pract Epidemiol Ment Health. 2007;3(1):5.
Turner-Stokes L. Goal attainment scaling (GAS) in rehabilitation: a practical guide. Clin Rehabil. 2009;23(4):362-370.
Browne RH. On the use of a pilot sample for sample size determination. Stat Med. 1995;14(17):1933-1940.
Core R, Team R. A language and environment for statistical computing. R package 3.6.1. Vienna, Austria, 2019http://www.R-project.org/
Curtis LA, Burns A. Unit Costs of Health and Social Care. 2015. http://www.pssru.ac.uk/project-pages/unit-costs/2015/index.php
Miskowiak KW, Burdick KE, Martinez-Aran A, et al. Methodological recommendations for cognition trials in bipolar disorder by the International Society for Bipolar Disorders Targeting Cognition Task Force. Bipolar Disord. 2017;19(8):614-626.
Bonnín CM, Martínez-Arán A, Reinares M, et al. Thresholds for severity, remission and recovery using the functioning assessment short test (FAST) in bipolar disorder. J Affect Disord. 2018;240:57-62.
Bugge C, Williams B, Hagen S, et al. A process for Decision-making after Pilot and feasibility Trials (ADePT): development following a feasibility study of a complex intervention for pelvic organ prolapse. Trials. 2013;14:353.
Torrent C, del Bonnin CM, Martínez-Arán A, et al. Efficacy of functional remediation in bipolar disorder: A multicenter randomized controlled study. Am J Psychiatry. 2013;170(8):852-859.
Wykes T, Joyce E, Velikonja T, et al. The CIRCuiTS study (Implementation of cognitive remediation in early intervention services): protocol for a randomised controlled trial. Trials. 2018;19:183.
Deckersbach T, Nierenberg AA, Kessler R, et al. Cognitive rehabilitation for bipolar disorder: An open trial for employed patients with residual depressive symptoms. CNS Neurosci Ther. 2010;16(5):298-307.
Veeh J, Kopf J, Kittel-Schneider S, et al. Cognitive remediation for bipolar patients with objective cognitive impairment: A naturalistic study. Int. J Bipolar Disord. 2017;5(1):8. https://doi.org/10.1186/s40345-017-0079-3
Wykes T, Reeder C, Huddy V, et al. Developing models of how cognitive improvements change functioning: Mediation, moderation and moderated mediation. Schizophr Res. 2012;138(1):88-93.
Nestsiarovich A, Hurwitz NG, Nelson SJ, et al. Systemic challenges in bipolar disorder management: A patient-centered approach. Bipolar Disord. 2017;19(8):676-688.