Journal
PSYCHOLOGICAL MEDICINE
Volume 46, Issue 2, Pages 291-301Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291715001713
Keywords
Bipolar disorder; clinical trials; functional remediation; neuropsychology; verbal memory
Categories
Funding
- ETES grant from the Spanish Ministry of Economy and Competitiveness [PI080180, PI08/90825, PI08/90327, PI08/90675, PI08/90224, PI08/90654, PI08/90189, PI08/90916, PI08/90416, PI08/90094, PI11/00637, PI12/00912]
- Fondo Europeo de Desarrollo Regional (FEDER)
- CIBERSAM
- Comissionat per a Universitats i Recerca del DIUE de la Generalitat de Catalunya [2014 SGR 398]
- Beatriu de Pinos, Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement, de la Generalitat de Catalunya i del programa COFUND de les Accions Marie Curie del 7e Programa marc de recerca i desenvolupament tecnologic de la Unio Europea
- Institute of Health Carlos III
- Spanish Ministry of Economy and Competitiveness
- Alicia Koplowitz Research Grant
- Alicia Koplowitz Grant from the Alicia Koplowitz Foundation (Madrid, Spain)
- Spanish Ministry of Health
- Instituto de Salud Carlos III [CP06/00359, CES 12/024]
- Instituto Carlos III [CP08/00140]
- Fondo de Investigacion Sanitaria (FIS) [PI 12/00910]
- NARSAD
- Brain & Behavior Research Foundation
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Background. Functional remediation is a novel intervention with demonstrated efficacy at improving functional outcome in euthymic bipolar patients. However, in a previous trial no significant changes in neurocognitive measures were detected. The objective of the present analysis was to test the efficacy of this therapy in the enhancement of neuropsychological functions in a subgroup of neurocognitively impaired bipolar patients. Method. A total of 188 out of 239 DSM-IV euthymic bipolar patients performing below two standard deviations from the mean of normative data in any neurocognitive test were included in this subanalysis. Repeated-measures analyses of variance were conducted to assess the impact of the treatment arms [functional remediation, psychoeducation, or treatment as usual (TAU)] on participants' neurocognitive and functional outcomes in the subgroup of neurocognitively impaired patients. Results. Patients receiving functional remediation (n = 56) showed an improvement on delayed free recall when compared with the TAU (n = 63) and psychoeducation (n = 69) groups as shown by the group x time interaction at 6-month follow-up [F-2,F-158 = 3.37, degrees of freedom (df) = 2, p = 0.037]. However, Tukey post-hoc analyses revealed that functional remediation was only superior when compared with TAU (p = 0.04), but not with psychoeducation (p = 0.10). Finally, the patients in the functional remediation group also benefited from the treatment in terms of functional outcome (F-2,F-158 = 4.26, df = 2, p = 0.016). Conclusions. Functional remediation is effective at improving verbal memory and psychosocial functioning in a sample of neurocognitively impaired bipolar patients at 6-month follow-up. Neurocognitive enhancement may be one of the active ingredients of this novel intervention, and, specifically, verbal memory appears to be the most sensitive function that improves with functional remediation.
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