Cognitive remediation may improve executive function in bipolar disorder

Cognitive remediation may aid neurocognitive performance, including attention, working memory, and problem solving.
Cognitive remediation may aid neurocognitive performance, including attention, working memory, and problem solving.

Cognitive remediation may be beneficial for executive function in patients with bipolar disorder and objective cognitive impairment, according to a study in the International Journal of Bipolar Disorders.

The findings are based on a cognitive remediation program developed by Julia Veeh, from the Department of Psychiatry, Goethe University in Frankfurt, and colleagues that was used to evaluate its effect on objective and subjective neuropsychologic performance, psychosocial functioning, and quality of life among patients with bipolar disorder.

The program involved the combination of cognitive training software along with group sessions to improve patients' cognitive skills. A total of 102 patients with bipolar disorder underwent neuropsychological screening. Thirty-nine patients had distinct cognitive impairments, and 26 from this group participated in the cognitive remediation program for 12 weeks and were then retested. Ten matched controls were measured at baseline and follow-up after 3 months with treatment as usual.

The researchers observed a significant improvement in cognitive performance after cognitive remediation within the training group in working memory, problem solving, and divided attention. The control group did not improve on any test measure. The investigators also observed a significant reduction of sub-depressive symptoms after the cognitive remediation program. However, no changes in psychosocial functioning and quality of life were detected. Subjective cognitive complaints were not associated with objective test performance, according to the study authors.

Dr Veeh's group wrote that the study “indicates that cognitive remediation could positively affect neurocognitive performance like attention, working memory and problem solving in bipolar disorder.

“Furthermore, our results give preliminary evidence for the potential of cognitive remediation to reduce sub-depressive symptoms in patients who are partially remitted," they continued. "Therefore, we suggest that cognitive remediation should be provided exclusively to patients with objective cognitive deficits as the subjective evaluation of cognitive impairments is not associated with objective test performance.”

The authors noted that larger, randomized controlled trials are needed to fully identify the possible implications of cognitive remediation in bipolar disorder.

Reference

  1. Veeh J, Kopf J, Kittel‑Schneider S, Deckert J, Reif A. Cognitive remediation for bipolar patients with objective cognitive impairment: a naturalistic study. Int J Bipolar Disord. 2017;5(1):8. Epub 2017 Apr 13. doi: 10.1186/s40345-017-0079-3
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