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Effects of functional remediation on neurocognitively impaired bipolar patients: enhancement of verbal memory

Published online by Cambridge University Press:  21 September 2015

C. M. Bonnin ,
M. Reinares ,
A. Martínez-Arán ,
V. Balanzá-Martínez ,
B. Sole ,
C. Torrent ,
R. Tabarés-Seisdedos ,
M. P. García-Portilla ,
A. Ibáñez  and
B. L. Amann
...Show all authors
C. M. Bonnin
Affiliation:
Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
M. Reinares
Affiliation:
Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
A. Martínez-Arán*
Affiliation:
Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
V. Balanzá-Martínez
Affiliation:
Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain La Fe University Polytechnic Hospital, Valencia, Spain
B. Sole
Affiliation:
Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
C. Torrent
Affiliation:
Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
R. Tabarés-Seisdedos
Affiliation:
Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
M. P. García-Portilla
Affiliation:
Department of Psychiatry, University of Oviedo, CIBERSAM, Oviedo, Spain
A. Ibáñez
Affiliation:
Department of Psychiatry, Ramon y Cajal University Hospital, University of Alcala, IRYCIS, CIBERSAM, Madrid, Spain
B. L. Amann
Affiliation:
FIDMAG Hermanas Hospitalarias Research Foundation, CIBERSAM, Barcelona, Spain
C. Arango
Affiliation:
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
J. L. Ayuso-Mateos
Affiliation:
Department of Psychiatry, Universidad Autonoma de Madrid, IIS-IP, CIBERSAM, Madrid, Spain
J. M. Crespo
Affiliation:
Department of Psychiatry, University Hospital of Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), CIBERSAM, Barcelona, Spain
A. González-Pinto
Affiliation:
Álava University Hospital, CIBERSAM, University of the Basque Country, Kronikgune, Vitoria, Spain
F. Colom
Affiliation:
Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
E. Vieta
Affiliation:
Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
*
* Address for correspondence: A. Martínez-Arán, Bipolar Disorders Programme, Clinical Institute of Neuroscience, University Clinic Hospital of Barcelona, Villarroel 170 08036-Barcelona, Spain. (Email: amartiar@clinic.ub.es)
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Abstract

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 × time interaction at 6-month follow-up [F2,158 = 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 (F2,158 = 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.

Keywords

Bipolar disorderclinical trialsfunctional remediationneuropsychologyverbal memory

Information

Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 2 , January 2016 , pp. 291 - 301
Copyright
Copyright © Cambridge University Press 2015 

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