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Validation of a Cognitive Remediation Program for Bipolar Disorders

Not Applicable
Recruiting
Conditions
Bipolar Disorder
Interventions
Other: CRT program
Other: ECo program
Other: Supportive psychotherapy
Registration Number
NCT02698696
Lead Sponsor
Centre hospitalier de Ville-Evrard, France
Brief Summary

This study evaluates the effect of a new cognitive remediation program designed for patients suffering from a bipolar disorder, on cognitive functions, psychosocial functioning and neural processes. In this double-blind (patient, outcomes assessor) controlled randomized trial the investigators compare patients receiving the ECo program for bipolar disorders, to patients benefiting from the broadly used cognitive remediation program CRT and to patients receiving supportive psychotherapy. Patients are treated for 3 months and monitored for 9 months.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
60
Inclusion Criteria
  1. Type I or type II Bipolar Disorder diagnosis, according to DSM-IV-TR criteria
  2. No Manic or Major Depressive episode during the last three months
  3. No or few residual depressive symptoms (HDRS-17 ≤ 12)
  4. No or few residual manic symptoms (YMRS ≤ 8)
  5. Stable dose of medication for the last two months
  6. Cognitive complaint expressed by the patient and impairment observed by the patient's regular psychiatrist
  7. Informed consent form read, initialed and signed
  8. Patient registered on the social welfare system
Exclusion Criteria
  1. Other diagnosis than Bipolar Disorder on axis I of the DSM-IV-TR
  2. Rapid Cycling Bipolar Disorder diagnosis
  3. Addiction or substance abuse (except tobacco) during the twelve last months
  4. Physical or neurological disorder that can lead to cognitive impairment
  5. Engagement in a research protocol either currently or over the last month
  6. Neuropsychological assessment or Rorschach Inkblot Test evaluation during the last six months
  7. Ineligibility for Magnetic Resonance Imaging [MRI] (e.g. claustrophobia, metallic implants, pace-maker, etc.)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
CRT programCRT programObjective: problem-solving skills training through exercises, in order to use strategies in daily life Duration: three months Frequency: two one-hour individual sessions and one hour of at-home training per week Modalities: pen and paper exercises Modules: Cognitive Flexibility, Working Memory, Planning
ECo programECo programObjective: to inform the patient about cognitive impairments and their repercussions; to train the patient in problem-solving skills through exercises; to implement strategies in daily life Duration: three months Frequency: two one-hour individual sessions and one hour of at-home training per week Modalities: pen and paper exercises, tools (tokens, cards, maps, chessboard) Modules: Psychoeducation, Attention, Memory, Executive Functions, Functional Impairments
Supportive psychotherapySupportive psychotherapyIndividual psychotherapy sessions focussing on autonomy in daily life, management of mood disorders' cognitive and functional impact, social skills, and the regulation of sleep and daily activities.
Primary Outcome Measures
NameTimeMethod
Change from baseline Perceptual Reasoning Index at 3 monthsbaseline and 3 months

Composite score of the Wechsler Adult Intelligence Scale - fourth edition

Change from 3-months Perceptual Reasoning Index at 9 months3 months and 9 months

Composite score of the Wechsler Adult Intelligence Scale - fourth edition

Secondary Outcome Measures
NameTimeMethod
Emotion Hexagonbaseline, 3 months and 9 months

Task from the Facial Expressions of Emotion: Stimuli and Tests scale, assessing the recognition of emotions on faces

Key Search Testbaseline, 3 months and 9 months

Task from the Behavioral Assessment of the Dysexecutive Syndrome scale, assessing planing abilities

Hamilton Depression Rating Scale15 days before baseline, 3 months and 9 months
Young Mania Rating Scale15 days before baseline, 3 months and 9 months
Functional Repercussions Scalebaseline, 3 months and 9 months

Self-assessment scale evaluating the consequences of cognitive impairments in daily life

Social Desirability Scalebaseline, 3 months and 9 months

Self-assessment scale

Social Relationships Scalebaseline, 3 months and 9 months

Self-assessment scale

Self-Appraisal of Illness Questionnairebaseline, 3 months and 9 months

Self-assessment scale

Rorschach Inkblot Testbaseline, 3 months and 9 months
Change from baseline Event-Related Potentials [ERP] P300 at 3 months during an Oddball taskbaseline and 3 months

Assessed for the first third of included patients

Change from baseline Event-Related Potentials [ERP] N2/P3 complex at 3 months during an emotional Stroop taskbaseline and 3 months

Assessed for the first third of included patients

Change from baseline serum Brain-Derived Neurotrophic Factor [BDNF] level (ng/mL) at 3 monthsbaseline and 3 months

Assessed for the second third of included patients

Change from baseline functional Magnetic Resonance Imaging frontal activation at 3 months during an emotion recognition taskbaseline and 3 months

Assessed for the last third of included patients

Processing Speed Indexbaseline, 3 months and 9 months

Composite score of the Wechsler Adult Intelligence Scale - fourth edition

Working Memory Indexbaseline, 3 months and 9 months

Composite score of the Wechsler Adult Intelligence Scale - fourth edition

Cardebat's Verbal Fluenciesbaseline, 3 months and 9 months

Neuropsychological test

Rey Auditory Verbal Learning Testbaseline, 3 months and 9 months

Neuropsychological test assessing verbal memory

Stroop Color Word Testbaseline, 3 months and 9 months

Neuropsychological test assessing inhibition abilities

Trial Locations

Locations (1)

Unité de Recherche Clinique, EPS Ville Evrard

🇫🇷

Neuilly-sur-Marne, France

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