Does cognitive remediation improve the functional outcomes of bipolar disorder individuals?

Abstract

Introduction: Bipolar disorder (BD) is associated with significant impairments in different areas of everyday functioning. Numerous studies have documented that, even during euthymia, about 70% of those affected present with cognitive impairments. These deficits are of variable magnitude and involve a number of domains, such as episodic memory, attention, and different aspects of executive functioning. In the last fifteen years, neuropsychological aspects of BD have gained increasing interest based on the consistent evidence of a significant negative correlation between cognitive deficits and functional adjustment. These considerations are particularly relevant since a significant percentage of affected individuals exhibit suboptimal general functioning despite receiving adequate pharmacological treatment. In this context, cognitive remediation (CR) hasbeen proposed as an emergent treatment that could help manage some manifestations of BD that pharmacological treatments fail to resolve. Within this context, the current study was conducted with the aim of exploring the efficacy of CR to improve functional outcomes in BD patients.Method: Meta-analysis of randomized controlled trials published up to February, 2022 that explore the effects of CR on the functional outcomes of BD individuals by means of standardized scales.Results: Five studies, with a total of 130 patients under treatment with CR and 125 controls were included. No significant between-group differences were found for longitudinal change in the scores obtained on scales assessing general functioning. Conclusion: The evidence available to date suggests that CR may not be an efficacious treatment for improving the functional outcomesof BD patients. Directions for future research are proposed.