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Background Patients with bipolar disorder experience impairments in their occupational functioning, despite remission of symptoms. Previous research has shown that neurocognitive deficits, especially deficits in executive functions, may persist during euthymia and are associated with diminished occupational functioning. Objectives The aim of this scoping review was to identify published studies that report on the relationships between executive functions and occupational functioning in BD to review current knowledge and identify knowledge gaps. In addition to traditional neuropsychological approaches, we aimed to describe executive functioning from a self-regulation perspective, including emotion regulation. Methods We applied the methodological framework as described by Arksey and O’Malley (Int J Soc Res Methodol Theory Pract 8:19–32, 2005) and Levac et al. (Implement Sci 5:1–9, 2010). We searched PubMed and psycINFO for literature up to November 2021, after which we screened papers based on inclusion criteria. Two reviewers independently performed the screening process, data charting process, and synthesis of results. Results The search yielded 1202 references after deduplication, of which 222 remained after initial screening. The screening and inclusion process yielded 82 eligible papers in which relationships between executive functions and occupational functioning are examined. Conclusion Neurocognitive deficits, including in executive functions and self-regulation, are associated with and predictive of diminished occupational functioning. Definitions and measurements for neurocognitive functions and occupational functioning differ greatly between studies, which complicates comparisons. Studies on functional remediation show promising results for improving occupational functioning in patients with BD. In research and clinical practice more attention is needed towards the quality of work functioning and the various contexts in which patients with BD experience deficits.

Patients with older age bipolar disorder (OABD), defined as bipolar disorder (BD) in people aged over 50 years, often exhibit greater cognitive impairment compared with healthy peers, even between mood episodes. 1 In addition, lower global cognitive functioning has been associated with impairments in social functioning. 2 In the general population of older adults, as well as in patients with mild cognitive impairment or early-stage dementia, interventions aimed at stimulating physical exercise or cognitive training were effective in improving cognitive functioning. Similar positive effects were found in younger patients with BD (recent systematic review: 3 ), but these strategies are not yet available or tested for efficacy in OABD. Additionally, most cognitive remediation programs for bipolar disorder enroll patients with subjective cognitive complaints.However, objective cognitive impairment is not always accompanied or even preceded by subjective cognitive complaints. Thus, subjective cognitive complaints may not be the best inclusion criterion for cognitive remediation aimed at reducing future cognitive decline. Furthermore, it is difficult for patients to reliably report about their cognitive functioning, and OABD patients have been shown to overestimate their cognitive performances. For this pilot study, we used some degree of impaired objective cognitive and social functioning as inclusion criteria and target for treatment. | INTERVENTI ONBy combining cognitive remediation with moderately intensive physical exercise and social encounter with peers, we aimed to attract a majority of patients. This pilot study of "Braintrain" was conducted with the primary objective to evaluate the feasibility and patient satisfaction. The secondary objectives were to measure possible beneficial effects on cognitive functioning, physical strength, social participation, and mood symptoms. After having attained ethical approval by the institutional review board of the VU University Medical Center, Amsterdam, patients were enrolled from our observational dynamic cohort study (Dutch Older Bipolars: DOBi), in a period of 2 years (2017-2018). Patients were included according to the following criteria: (1) aged 50 years and over with a DSM-5 bipolar disorder type I or II diagnosis confirmed by MINI interview; (2) partially remitted or euthymic mood defined as CES-D < 16 (Center for Epidemiologic Studies Depression Scale [CES-D]) and YMRS <12 (Young Mania Rating Scale) allowing some degree of subclinical mood symptoms; (3) cognitive impairment of at least −1.0 SD in one or more cognitive domains at the neuropsychological examination; (4) Social and Occupational Functioning Assessment Scale (SOFAS) <60 to ensure some degree of social impairment; and (5) self-reported ability to walk at least 30 min. The cognitive remediation program consisted of 12 weekly group sessions each lasting one and a half hours and was based on the

Background: Psychoeducation (PE) for bipolar disorder (BD) has a first-line recommendation for the maintenance treatment phase of BD. Formats vary greatly in the number of sessions, whether offered individually or in a group, and with or without caregivers attending. Due to a large variation in formats in the Netherlands, a new program was developed and implemented in 17 outpatient clinics throughout the country. The current study investigated the feasibility of a newly developed 12-sessions PE group program for patients with BD and their caregivers in routine outpatient practice and additionally explored its effectiveness. Methods: Participants in the study were 108 patients diagnosed with BD, 88 caregivers and 35 course leaders. Feasibility and acceptance of the program were investigated by measures of attendance, and evaluative questionnaires after session 12. Preliminary treatment effects were investigated by pre-and post-measures on mood symptoms, attitudes towards BD and its treatment, levels of self-management, and levels of expressed emotion. Results: There was a high degree of satisfaction with the current program as reported by patients, caregivers, and course leaders. The average attendance was high and 83% of the patients and 75% of the caregivers completed the program. Analyses of treatment effects suggest positive effects on depressive symptoms and self-management in patients, and lower EE as experienced by caregivers. Conclusions: This compact 12-sessions psychoeducation group program showed good feasibility and was well accepted by patients, caregivers, and course leaders. Preliminary effects on measures of self-management, expressed emotions, and depressive symptoms were promising. After its introduction it has been widely implemented in mental health institutions throughout the Netherlands.