40 research outputs found
Functional remediation for patients with bipolar II disorder: Improvement of functioning and subsyndromal symptoms
No full textThe authors thank the support of the Esther Koplowitz Centre (CEK) and of the Spanish Ministry of Economy and Competitiveness, Instituto de Salud Carlos III, CIBERSAM, the Spanish Ministry of Education and the Comissionat per a Universitats i Recerca del DIUE de la Generalitat de Catalunya to the Bipolar Disorders Group (2009 SGR 1022), the postdoctoral fellowship Beatriu de Pinós of the Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement de la Generalitat de Catalunya and the COFUND program of the Marie Curie Actions, the 7th Framework Programme of the European Community for research and technological development. Dr. Anabel Martinez-Aran's project is supported in part by a 2013 NARSAD, Independent Investigator Grant from the Brain and Behavior Research Foundation.Solé, B., Bonnin, C.M., Mayoral, M., Amann, B.L., Torres, I., González-Pinto, A., Jimenez, E., Crespo, J.M., Colom, F., Tabarés-Seisdedos, R., Reinares, M., Ayuso-Mateos, J.L., Soria, S., Garcia-Portilla, M.P., Ibañez, Á., Vieta, E., Martinez-Aran, A., Torrent, C., Alegría, A., Al-Halabi, S., Alonso-Lana, S., Anaya, C., Arango, C., Balanzá-Martínez, V., Barbeito, S., Bobes, J., Chiclana, G., Cerrillo, E., Correa, P., Custal, N., Fernández, P., Fernández, M., Fuentes-Durá, I., Galván, G., Isella, S., Landín-Romero, R., Menchón, J.M., Merchan-Naranjo, J., Ortiz-Gil, J., Pacchiarotti, I., Reyes, R., Rosa, A.R., Rapado, M., Rodao, J.M., Saiz, P.A., Sánchez-Moreno, J., Segura, B., Selva-Vera, G., Saiz-Ruiz, J., Soria, V., Subirá, M., Ugarte, A., Valle, J., Vega, P
Functional remediation in bipolar disorder: 1-year follow-up of neurocognitive and functional Outcome
No full textThis study was supported by an ETES grant from the Spanish Ministry of Economy and Competitiveness (PI080180 & PI08/90825, PI08/90327, PI08/90675, PI08/90224, PI08/90654, PI08/90189, PI08/90916, PI08/90416, PI08/90094). PI11/00637, PI12/00912, integrado en el Plan Nacional de I+D+I y cofinanciado por el ISCIII-Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER)’’, the CIBERSAM and the Comissionat per a Universitats i Recerca del DIUE de la Generalitat de Catalunya to the Bipolar Disorders Group (2014 SGR 398)Bonnin, C.M., Torrent, C., Arango, C., Amann, B.L., Solé, B., González-Pinto, A., Crespo, J.M., Tabarés-Seisdedos, R., Reinares, M., Ayuso-Mateos, J.L., García-Portilla, M.P., Ibañez, Á., Salamero, M., Vieta, E., Martinez-Aran, A., Alegría, A., Al-Halabi, S., Alonso-Lana, S., Anaya, C., Valle, J., Balanzá-Martínez, V., Colom, F., Barbeito, S., Bobes, J., Calvo, A., Cerrillo, E., Correa, P., Custal, N., Fernández, P., Fernández, M., Fuentes-Durá, I., Galván, G., Isella, S., Landín-Romero, R., Mayoral, M., Menchón, J., Merchan-Naranjo, J., Jiménez, E., Ortiz-Gil, J., Pacchiarotti, I., Rosa, A.R., Rapado-Castro, M., Rodao, J.M., Saiz, P.A., Sánchez-Moreno, J., Segura, B., Selva, G., Saiz-Ruiz, J., Subirá, M., Torres, I., Ugarte, A., Vega, P
Effects of functional remediation on neurocognitively impaired bipolar patients: enhancement of verbal memory
No full textBackground: 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 [F 2,158 = 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 (F 2,158 = 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
Do patients with bipolar disorder and subsyndromal symptoms benefit from funcional remediation? A 12-month follow-up study
No full textWe analyzed the efficacy of functional remediation, in a sample of patients with bipolar disorder who presented with subsyndromal symptoms. From a total sample of 239 patients with bipolar I and II disorder, according to DSM-IV-TR diagnostic criteria, entering a randomized clinical trial, those patients who presented with subsyndromal symptoms were selected based on a method already described by Berk and colleagues was applied. It consists of using the Clinical Global Impression-Bipolar version (CGI-BP) to establish the scores of the Hamilton Depression Rating Scale (HAM-D) and of the Young Mania Rating Scale (YMRS) that correspond with 1 in the CGI-BP. Functional outcome and mood symptoms were assessed at 6 and at 12-month follow-up. A total of 99 patients were selected for this post-hoc analysis, allocated as follows: functional remediation (n=33); psychoeducation (n=37) and treatment as usual (TAU,n=29). The repeated-measures analyses at 12-month follow-up revealed a significant group x time interaction in favour of the patients who received functional remediation when compared to psychoeducation and TAU (F=2.93; p=0.02) at improving psychosocial functioning. Finally, mood symptoms did not significantly change in any of the three groups at any time of follow-up, as shown by the non-significant group x time interaction effect in HAM-D scores (F=1.57; p=0.18) and YMRS scores (F=1.51; p=0.20). Bipolar patients with subsyndromal symptoms improve their functional outcome when exposed to functional remediation regardless of the persistence of mood symptomatology
The impact of sex in the effectiveness of functional remediation in bipolar disorder.
No full text20.500.12530/87858Functional recovery remains a core clinical objective for patients with bipolar disorder (BD). Sociodemographic, clinical, and neurocognitive variables are associated with long-term functional impairment, yet the impact of sex differences is unclear. Functional remediation (FR) is a validated intervention aimed at achieving functional recovery in BD. The present study assessed the effect of sex differences of FR on psychosocial functioning at post-treatment (6-months) and 12-month follow-up (FUP). To the best of our knowledge, this is the first study to explore the role of sex as a factor in the efficacy of FR. 157 participants with BD were randomly assigned to either FR (N = 77) or treatment as usual group (80). Clinical, sociodemographic, neuropsychological, and functional data were obtained using a comprehensive assessment battery. Sex differences were explored via a general linear model (GLM) for repeated measures to compare the effect of sex on the intervention over time (6 months and FUP). Results demonstrated that FR benefits both sexes, males (p = 0.001; d' = 0.88) and females (p = 0.04; d' = 0.57), at 6 months suggesting a generalized functional improvement. Conversely, at 12-month FUP sex differences were observed only in males (p = 0.005; d' = 0.68). FR is a beneficial intervention for males and females after treatment, suggesting that there are no relevant distinct needs. Females may benefit from ongoing psychosocial functioning booster sessions after the intervention to maintain original improvements. Future research exploring sex differences could help to identify strategies to offer personalized FR intervention approaches in individuals with BD
Do patients with bipolar disorder and subsyndromal symptoms benefit from functional remediation? A 12-month follow-up study
No full textSanchez-Moreno, J., Bonnín, C., González-Pinto, A., Amann, B.L., Solé, B., Balanzá-Martínez, V., Arango, C., Jimenez, E., Tabarés-Seisdedos, R., Garcia-Portilla, M.P., Ibáñez, A., Crespo, J.M., Ayuso-Mateos, J.L., Vieta, E., Martinez-Aran, A., Torrent, C., Anaya, C., Barbeito, S., Bobes, J., Chiclana, G., Cerrillo, E., Colom, F., Correa, P., Custal, N., Fernández, P., Fernández, M., Fuentes-Durá, I., Galván, G., González-Ortega, I., Isella, S., Landín-Romero, R., Manuel Menchón, J., Merchan-Naranjo, J., Ortiz-Gil, J., Pacchiarotti, I., Reyes, R., Rosa, A.R., Reyes, R., Rapado-Castro, M., Maria Rodao, J., Saiz, P.A., Segura, B., Selva-Vera, G., Saiz-Ruiz, J., Soria, V., Subirá, M., Ugarte, A., Valle, J., Valls, E., Varo, C
Factors associated with poor functional outcome in bipolar disorder: Sociodemographic, clinical, and neurocognitive variables
No full textThis work was supported by grants from the Spanish Ministry of Economy, Industry and Competitiveness grant numbers (PI080180, PI08/90825, PI08/90327, PI08/90675, PI08/90224, PI08/90654, PI08/90189, PI08/90916, PI08/90416, PI08/90094, PI11/00637, PI12/00912, PI15/00330, PI15/00283) PN 2008-2011, Instituto de Salud Carlos III, Subdireccion General de Evaluacion y Fomento de la Investigacion, Fondo Europeo de Desarrollo 151 Regional. Union Europea, 'Una manera de hacer Europa', CIBERSAM; and the Comissionat per a Universitats i Recerca del DIUE de la Generalitat de Catalunya (2017 SGR 1365 to the Bipolar Disorders Group).Sanchez-Moreno, J., Bonnin, C.M., González-Pinto, A., Amann, B.L., Solé, B., Balanzá-Martinez, V., Arango, C., Jiménez, E., Tabarés-Seisdedos, R., Garcia-Portilla, M.P., Ibáñez, A., Crespo, J.M., Ayuso-Mateos, J.L., Martinez-Aran, A., Torrent, C., Vieta, E., Alegría, A., Al-Halabi, S., Alonso-Lana, S., Anaya, C., López, P., Bobes, J., Chiclana, G., Cerrillo, E., Correa, P., Custal, N., Fernández, P., García, S., Fuentes-Durá, I., Galván, G., González-Ortega, I., Isella, S., Landín-Romero, R., Menchón, M., Merchan-Naranjo, J., Ortiz-Gil, J., Pacchiarotti, I., Reyes, R., Rapado-Castro, M., Reinares, M., Rodao, M., Saiz, P.A., Segura, B., Selva-Vera, G., Saiz-Ruiz, J., Soria, V., Zorrilla, I., Valle, J., Valls, E., Varo, C., CIBERSAM Functional Remediation Grou
Effects of functional remediation on neurocognitively impaired bipolar patients: enhancement of verbal memory
No full textThis study was supported by an ETES grant from the Spanish Ministry of Economy and Competitiveness: PI080180, PI08/90825, PI08/90327, PI08/90675, PI08/90224, PI08/90654, PI08/90189, PI08/90916, PI08/90416, PI08/90094, PI11/00637, PI12/00912, integrated in the Plan Nacional de I + D + I and cofinanced by el Fondo Europeo de Desarrollo Regional (FEDER), the CIBERSAM and the Comissionat per a Universitats i Recerca del DIUE de la Generalitat de Catalunya to the Bipolar Disorders Group (2014 SGR 398).M.R.-C. was supported by a Sara Borrell Health Research Fellowship from the Institute of Health Carlos III, Spanish Ministry of Economy and Competitiveness, an Alicia Koplowitz Research Grant and an Alicia Koplowitz Grant for Short-Term Placements from the Alicia Koplowitz Foundation (Madrid, Spain). F. C. would like to thank the support and funding of the Spanish Ministry of Health, Instituto de Salud Carlos III, CIBERSAM. F. C. is also funded by the Spanish Ministry of Economy and Competitiveness, Instituto Carlos III, through a 'Miguel Servet' contract (CP08/00140) and the Fondo de Investigacion Sanitaria (FIS) (PI 12/00910). A.M.-A.'s project is supported in part by a 2013 NARSAD, Independent Investigator Grant from the Brain & Behavior Research Foundation. B.L.A. would like to thank the support and funding of the Spanish Ministry of Health, Instituto de Salud Carlos III, for a 'Miguel Servet' contract (CP06/00359) which has been extended in 2013 as a stabilization contract (CES 12/024)Bonnin, CM; Reinares, M; Martinez-Aran, A; Balanza-Martinez, V; Sole, B; Torrent, C; Tabares-Seisdedos, R; Garcia-Portilla, MP; Ibanez, A; Amann, BL; Arango, C; Ayuso-Mateos, JL; Crespo, JM; Gonzalez-Pinto, A; Colom, F; Vieta, E
Cognitive Remediation in Bipolar (CRiB2): study protocol for a randomised controlled trial assessing efficacy and mechanisms of cognitive remediation therapy compared to treatment as usual
No full text\ua9 2023, The Author(s).Background: A substantial proportion of people with bipolar disorder (BD) experience persistent cognitive difficulties associated with impairments in psychosocial functioning and a poorer disorder course. Emerging evidence suggests that cognitive remediation (CR), a psychological intervention with established efficacy in people with schizophrenia, can also benefit people with BD. Following a proof-of-concept trial showing that CR is feasible and potentially beneficial for people with BD, we are conducting an adequately powered trial in euthymic people with BD to 1) determine whether an individual, therapist-supported, computerised CR can reduce cognitive difficulties and improve functional outcomes; and 2) explore how CR exerts its effects. Methods: CRiB2 is a two-arm, assessor-blind, multi-site, randomised controlled trial (RCT) comparing CR to treatment-as-usual (TAU). Participants are people with a diagnosis of BD, aged between 18 and 65, with no neurological or current substance use disorder, and currently euthymic. 250 participants will be recruited through primary, secondary, tertiary care, and the community. Participants will be block-randomised (1:1 ratio, stratified by site) to continue with their usual care (TAU) or receive a 12-week course of therapy and usual care (CR + TAU). The intervention comprises one-on-one CR sessions with a therapist supplemented with independent cognitive training for 30–40 h in total. Outcomes will be assessed at 13- and 25-weeks post-randomisation. Efficacy will be examined by intention-to-treat analyses estimating between-group differences in primary (i.e., psychosocial functioning at week 25 measured with the Functional Assessment Short Test) and secondary outcomes (i.e., measures of cognition, mood, patient-defined goals, and quality of life). Global cognition, metacognitive skills, affect fluctuation, and salivary cortisol levels will be evaluated as putative mechanisms of CR through mediation models. Discussion: This study will provide a robust evaluation of efficacy of CR in people with BD and examine the putative mechanisms by which this therapy works. The findings will contribute to determining the clinical utility of CR and potential mechanisms of action. Trial registration: Cognitive Remediation in Bipolar 2 (CRiB2): ISRCTN registry: https://www.isrctn.com/ISRCTN10362331 . Registered 04 May 2022. Overall trial status: Ongoing; Recruitment status: Recruiting
Exploring the influence of circulating endocannabinoids and nucleus accumbens functional connectivity on anorexia nervosa severity
No full textAnorexia nervosa (AN) is a severe psychiatric disorder characterized by a harmful persistence of self-imposed starvation resulting in significant weight loss. Research suggests that alterations in the nucleus accumbens (NAcc) and circulating endocannabinoids (eCBs), such as anandamide (AEA) and 2-arachidonoylglycerol (2-AG), may contribute to increased severity and maladaptive behaviors in AN, warranting an examination of the interplay between central reward circuitry and eCBs. For this purpose, we assessed NAcc functional connectivity and circulating AEA and 2-AG concentrations in 18 individuals with AN and 18 healthy controls (HC) to test associations between circulating eCBs, NAcc functional connectivity, and AN severity, as defined by body mass index (BMI). Decreased connectivity was observed between the NAcc and the right insula (NAcc-insula; pFWE < 0.001) and the left supplementary motor area (NAcc-SMA; pFWE < 0.001) in the AN group compared to HC. Reduced NAcc-insula functional connectivity mediated the association between AEA concentrations and BMI in the AN group. However, in HC, NAcc-SMA functional connectivity had a mediating role between AEA concentrations and BMI. Although no significant differences in eCBs concentrations were observed between the groups, our findings provide insights into how the interaction between eCBs and NAcc functional connectivity influences AN severity. Altered NAcc-insula and NAcc-SMA connectivity in AN may impair the integration of interoceptive, somatosensory, and motor planning information related to reward stimuli. Furthermore, the distinct associations between eCBs concentrations and NAcc functional connectivity in AN and HC could have clinical implications for weight maintenance, with eCBs being a potential target for AN treatment.This manuscript and research were supported by grants from Instituto de Salud Carlos III (ISCIII) (FIS PI20/00132) and co-funded by FEDER funds/European Regional Development Fund (ERDF), a way to build Europe. CIBERObn and CIBERSAM are both initiatives of ISCIII. Additional support was received from the Delegación del Gobierno para el Plan Nacional sobre Drogas (2021I031) and Ministerio de Ciencia e Innovación (grant PID2021-124887OB-I00). Additional funding was received by AGAUR-Generalitat de Catalunya (2021-SGR-00824), European Union’s Horizon 2020 research and innovation program under Grant agreement no. 847879 (PRIME/H2020, Prevention and Remediation of Insulin Multimorbidity in Europe) and the European Union’s Horizon Europe research and innovation program under grant agreement No 101080219 (eprObes). This work was partially supported by Instituto de Salud Carlos III through the grant CM21/00172 (IB) (co-funded by European Social Fund. ESF investing in your future). RG is supported by the Catalan Institution for Research and Advanced Studies (ICREA-Academia, 2021-Programme). TS is supported by a National Health and Medical Research Council (NHMRC)/Medical Research Future Fund (MRFF) Investigator Grant (MRF1193736), a Brain & Behavior Research Foundation (BBRF) Young Investigator Grant, and a University of Melbourne McKenzie Fellowship. The funders had no role in the study design, data collection, analysis, decision to publish, or preparation of the manuscript
