Personalized Cognitive Training in Unipolar and Bipolar Disorder: A Study of Cognitive Functioning

Abstract

Patients with unipolar depressive disorder and in the depressive phase of bipolar disorder often manifest psychological distress and cognitive deficits, notably in executive control. We used computerized cognitive training in an attempt to reduce psychological affliction, improve everyday coping, and cognitive function. We asked one group of patients (intervention group) to engage in cognitive training three times a week, for 20 min each time, for eight consecutive weeks. A second group of patients (control group) received standard care only. Before the onset of training we administered to all patients self-report questionnaires of mood, mental and psychological health, and everyday coping. We also assessed executive control using a broad computerized neurocognitive battery of tests which yielded, among others, scores in Working Memory, Shifting, Inhibition, Visuomotor Vigilance, Divided Attention, Memory Span, and a Global Executive Function score. All questionnaires and tests were re-administered to the patients who adhered to the study at the end of training. When we compared the groups (between-group comparisons) on the amount of change that had taken place from baseline to post-training, we found significantly reduced depression level for the intervention group. This group also displayed significant improvements in Shifting, Divided Attention, and in the Global executive control score. Further exploration of the data showed that the cognitive improvement did not predict the improvements in mood. Single-group data (within-group comparisons) show that patients in the intervention group were reporting fewer cognitive failures, fewer dysexecutive incidents, and less difficulty in everyday coping. This group had also improved significantly on the six executive control tests and on the Global executive control score. By contrast, the control group improved only on the reports of cognitive failure and on working memory.

A systematic review of cognitive rehabilitation for bipolar disorder

“…Table 1 al. 18 ) assigned participants to intervention or control groups using pairwise diagnosis matching.…”

“…17 Similarly, while most of the CR programs comprised a total of approximately 17 hours, they varied in terms of the number of session per week, from one 20 to three. 18 emotional recognition and emotional perception.…”

“…On the other hand, Preiss et al 18 assessed educational level using a 10-point scale and, while the authors stated that the intervention group did not differ from the control group in terms of educational level, they did not mention which scale was used. Only two of the studies controlled for baseline IQ and two studies did not report years of study.…”

“…Finally, three studies provided figures for withdrawals and dropouts. Deckersbach et al 17 reported five dropouts from 18 participants and Preiss et al 18 reported 21 dropouts out of 45 participants at study outset. Torrent et al 20 reported that 28.6% patients discontinued in the functional remediation group, 24.4% discontinued rehabilitation in BD are more likely to be published.…”

“…17 Figure 2 illustrates the total duration of interventions in weeks and the assessment points used in each study. 17 and Preiss et al 18 focused on psychosocial and daily life functioning. In contrast, both Lahera et al 19 and Torrent et al 20 focused specifically on cognitive functioning, but whereas the former emphasized social cognition and emotion recognition, the latter emphasized There were notable increases in social cognition, in the psychoeducation group, and 17.5% discontinued in the treatment-as-usual group.…”