Effects of Short-Term Cognitive Remediation on Cognitive Dysfunction in Partially or Fully Remitted Individuals with Bipolar Disorder: Results of a Randomised Controlled Trial

Demant, Kirsa M.; Vinberg, Maj; Kessing, Lars Vedel; Miskowiak, Kamilla Woznica

doi:10.1371/journal.pone.0127955

Cited by 103 publications

(115 citation statements)

References 53 publications

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“…In a recent study, 46 patients with bipolar disorder who were in full or partial remission and had subjective cognitive complaints were randomized to a 12-week cognitive rehabilitation or standard treatment (Demant, Vinberg, Kessing, & Miskowiak, 2015). While there were no group differences for the functional and main cognitive outcomes, those assigned to cognitive rehabilitation had improved subjective sharpness at week 12, and quality of life and verbal fluency at week 26 follow-up (Demant et al, 2015). A small pilot study examined the efficacy of a 10-week cognitive rehabilitation program in 33 patients with major depressive disorder who had not improved after other treatment (Bowie, Gupta, Holshausen, et al, 2013).…”

Section: Treatment Approaches Targeting Cognitive Functionsmentioning

confidence: 99%

Cognitive Function as a Transdiagnostic Treatment Target in Stimulant Use Disorders

Sofuoglu

DeVito

Waters

et al. 2016

Journal of Dual Diagnosis

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Stimulant use disorder is an important public health problem, with an estimated 2.1 million current users in the United States alone. No pharmacological treatments are approved by the U.S. Food and Drug Administration (FDA) for stimulant use disorder and behavioral treatments have variable efficacy and limited availability. Most individuals with stimulant use disorder have other comorbidities, most with overlapping symptoms and cognitive impairments. The goal of this article is to present a rationale for cognition as a treatment target in stimulant use disorder, and to outline potential treatment approaches. Rates of lifetime comorbid psychiatric disorders among people with stimulant use disorders are estimated at 65% - 73%, with the most common being mood disorders (13% - 64%) and anxiety disorders (21% - 50%), as well as non-substance induced psychotic disorders (under 10%). There are several models of addictive behavior, but the dual process model particularly highlights the relevance of cognitive impairments and biases to the development and maintenance of addiction. This model explains addictive behavior as a balance between automatic processes and executive control, which in turn are related to individual (genetics, comorbid disorders, psychosocial factors) and other (craving, triggers, drug use) factors. Certain cognitive impairments, such as attentional bias and approach bias, are most relevant to automatic processes, while sustained attention, response inhibition, and working memory are primarily related to executive control. These cognitive impairments and biases are also common in disorders frequently comorbid with stimulant use disorder, and predict poor treatment retention and clinical outcomes. As such, they may serve as feasible trans-diagnostic treatment targets. There are promising pharmacological, cognitive, and behavioral approaches that aim to enhance cognitive function. Pharmacotherapies target cognitive impairments associated with executive control and include cholinesterase inhibitors (e.g., galantamine, rivastigmine) and monoamine transporter inhibitors (e.g., modafinil, methylphenidate). Cognitive behavioral therapy and cognitive rehabilitation also enhance executive control, while cognitive bias modification targets impairments associated with automatic processes. Cognitive enhancements to improve treatment outcomes is a novel and promising strategy, but its clinical value for the treatment of stimulant use disorder, with or without other psychiatric comorbidities, remains to be determined in future studies.

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Section: Treatment Approaches Targeting Cognitive Functionsmentioning

confidence: 99%

Cognitive Function as a Transdiagnostic Treatment Target in Stimulant Use Disorders

Sofuoglu

DeVito

Waters

et al. 2016

Journal of Dual Diagnosis

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“…Previously reported studies have implemented cognitive training alone or in conjunction with other symptom management and therapeutic interventions (e.g., mood management and psychoeducation) (Deckersbach et al, 2010; Preiss et al, 2013; Torrent et al, 2013; Demant et al, 2015). The cognitive training portion of these studies targeted specific processing deficits in BD, such as memory, executive function, and attention.…”

Section: Introductionmentioning

confidence: 99%

“…Studies by Deckersbach et al (2010) and Preiss et al (2013) resulted in significant cognitive and mood improvement after training, specifically with gains on measures of executive function and reductions in reported depressive symptoms. On the other hand, similarly well-constructed studies to address cognitive and psychosocial deficits in BD failed to find significant improvement in cognitive function (Torrent et al, 2013; Demant et al, 2015). While cognitive gains were not reported, the Torrent et al (2013) participants did exhibit significantly improved scores on a functional outcome measure.…”

Section: Introductionmentioning

confidence: 99%

Enhancing Executive Function and Neural Health in Bipolar Disorder through Reasoning Training

et al. 2016

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Cognitive deficits in executive function and memory among individuals with bipolar disorder (BD) are well-documented; however, only recently have efforts begun to address whether such cognitive deficits can be ameliorated through cognitive training. This pilot study examined the effects of a top–down, cognitive reasoning training program in adults with BD on both brain and cognitive measures. Twenty-seven participants (11 males, 16 females), aged 21–70 years old, completed the study. Participants completed neurocognitive testing and functional magnetic resonance imaging (fMRI) before and after training, consisting of 8 h (2 h/week) of training in small groups. The training delivered information processing strategies that were implemented and applicable to a variety of daily living contexts. Results indicated that participants showed significant gains in the primary outcome measure of complex abstraction, also referred to as gist reasoning, as well as in untrained domains of executive function and memory. We found a significant increase in resting cerebral blood flow (CBF) in left inferior frontal gyrus after cognitive training. We also found that resting CBF in the right frontal middle gyrus correlated positively with performance on the measure of complex abstraction. This feasibility study provides promising evidence that short-term reasoning training can enhance cognitive performance and brain health in adults with BD. These data motivate further efforts to explore adjuvant therapeutics to improve cognitive performance and underlying brain systems in bipolar, as well as other psychiatric disorders. Clinicaltrials.gov Identifier: NCT02843282, http://www.clinicaltrials.gov/ct2/show/NCT02843282

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“…Two recent randomized trials suggest limited impact of broadly targeted cognitive remediation on objective cognitive performance in euthymic patients with BD, despite earlier open trials indicating some enhancement of cognitive ability 82,83 . Nonetheless, in the larger trial reported by Torrent involving an intervention that provided psychoeducation and behavioral practice of cognitive compensatory techniques, psychosocial functioning was enhanced to a significant degree when compared to a symptom focused psychoeducation group 82 .…”

Section: Interventions To Remediate Cognitive Impairment In Bipolar Dmentioning

confidence: 99%

Bipolar Depression and Cognitive Impairment

Depp

Dev

Eyler

2016

Psychiatric Clinics of North America

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Synopsis Bipolar depression and cognitive impairment are pervasive and highly disabling aspects of the illness. Although cognitive impairment is partially independent from mood episodes, depressive symptoms may increase the risk of cognitive impairment in bipolar disorder through inflammatory processes as well as health risks such as obesity and sedentary behavior. Novel treatment avenues at the intersection of bipolar depression and cognitive impairment target inflammation and/or health behaviors such as diet, physical activity and sleep hygiene.

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Effects of Short-Term Cognitive Remediation on Cognitive Dysfunction in Partially or Fully Remitted Individuals with Bipolar Disorder: Results of a Randomised Controlled Trial

Cited by 103 publications

References 53 publications

Cognitive Function as a Transdiagnostic Treatment Target in Stimulant Use Disorders

Cognitive Function as a Transdiagnostic Treatment Target in Stimulant Use Disorders

Enhancing Executive Function and Neural Health in Bipolar Disorder through Reasoning Training

Bipolar Depression and Cognitive Impairment

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