- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04577508
A Trial of Functional Remediation in Patients With Bipolar Disorder
Efficacy of Functional Remediation on Cognitive and Psychosocial Functioning in Patients With Bipolar Disorder: a Randomized Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The main objective of this randomized, rater-blind controlled trial is to evaluate the efficacy of Functional Remediation (FR) in improving functional, clinical and cognitive outcomes in euthymic and clinically stable patients with Bipolar Disorder.
FR is a novel group-based intervention, based on a neurocognitive-behavioural approach, making use of ecological techniques, specifically developed for patients with Bipolar Disorder and aimed at restoring psychosocial functioning in this population.
The study will involve subjects recruited from outpatient clinics (residential or semi-residential care) within the Department of Mental Health and Addiction Services of ASST Spedali Civili, Brescia, Italy.
Study participants will be assigned via central randomization to either FR or treatment as usual, the latter consisting of evidence-based drug treatment and case management.
Pharmacological treatment will be maintained stable during the course of the trial, but no restriction will be applied in terms of access to evidence-based non-pharmacological interventions.
Efficacy of the study intervention (lasting 6 months) will be assessed at post-treatment, and later investigated at 6-months follow-up.
The study will be conducted in accordance with the ethical principles of the Declaration of Helsinki and Good Clinical Practice. It will take place within an experimental project related to the "PhD Course in Biomedical Sciences and Translational Medicine", curriculum "Neuroscience" of the University of Brescia, Italy.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Antonio Vita, Prof
- Phone Number: +39 0303995233
- Email: antonio.vita@unibs.it
Study Contact Backup
- Name: Vivian Accardo, Psy
- Phone Number: +39 3474892946
- Email: v.accardo@unibs.it
Study Locations
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-
BS
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Brescia, BS, Italy, 25133
- Department of Mental Health and Addiction Services
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Contact:
- Vivian Accardo, Psy
- Phone Number: +39 3474892946
- Email: v.accardo@unibs.it
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with a clinical diagnosis of Bipolar Disorder, type I or II, as referred from treating psychiatrist, confirmed at recruitment using the Structured Clinical Interview for Disorder for DSM-5, Clinical Version (SCID-5-CV);
- Clinically stable (in euthymic phase, defined as Y-MRS <= 6 points + HAM-D <= 8 points) for at least 2 months;
- Aged from 18 to 55 years, with no restriction in terms of gender or ethnicity
- With a minimum education level of 8 years;
- Fluent in Italian language;
- Giving written informed consent to study participation.
Exclusion Criteria:
- Intellectual disability (according to DSM-5 criteria);
- Any medical condition that may affect neuropsychological performance (such as neurological diseases);
- Any comorbid psychiatric condition (including current alcohol and/or drug abuse - up to 3 months before screening)
- Pregnancy;
- Inability to provide informed consent/ withdrawal of consent.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Functional Remediation
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Functional Remediation is a manualized, group-based psychosocial intervention built on a neurocognitive-behavioural approach, involving modeling techniques, role-playing tasks, self-instruction, positive reinforcement and metacognitive cues (Vieta E et al, Cambridge University Press, 2014).
It consists of 21 90-min weekly sessions, in which a trained therapist and co-therapist work with 10-12 patients: the first 3 sessions are dedicated to psychoeducation on neurocognitive deficits; then 13 sessions of neurocognitive training sequentially target attention, memory and executive functions domains, comprising exercises carried out individually, in pairs or in small groups; the last 5 sessions focus on skills training (communication, interpersonal relationships, autonomy, stress management).
Content of the sessions involves ecological tasks adapted to real-world situations, and to-be-performed in two contexts (clinical and daily).
Homework is assigned, collected and discussed each time.
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Other: Control
Treatment as usual
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Standard care for bipolar disorders according to good clinical practice, including drug therapy and individual case management.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Psychosocial functioning
Time Frame: Baseline to post-treatment (6 months)
|
Functional outcome will be rated using the Functioning Assessment Short Test (FAST) - Italian Version (Barbato et al., 2013)
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Baseline to post-treatment (6 months)
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Psychosocial functioning
Time Frame: Baseline to follow-up (12 months)
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Functional outcome will be rated using the Functioning Assessment Short Test (FAST) - Italian Version (Barbato et al., 2013)
|
Baseline to follow-up (12 months)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Neurocognitive performance
Time Frame: Baseline to post-treatment (6 months)
|
Neurocognitive performance will be tested using a complete neuropsychological battery specifically developed for patients with bipolar disorder: the Brief Assessment of Cognition in Affective Disorders (BAC-A) (Keefe et al., 2014), Italian normative data (Rossetti et al. 2019)
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Baseline to post-treatment (6 months)
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Neurocognitive performance
Time Frame: Baseline to follow-up (12 months)
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Neurocognitive performance will be tested using a complete neuropsychological battery specifically developed for patients with bipolar disorder: the Brief Assessment of Cognition in Affective Disorders (BAC-A) (Keefe et al., 2014), Italian normative data (Rossetti et al. 2019)
|
Baseline to follow-up (12 months)
|
Socio-cognitive performance/Emotional processing
Time Frame: Baseline to post-treatment (6 months)
|
Social cognition will be evaluated using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), Italian version (Curci et al, 2003)
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Baseline to post-treatment (6 months)
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Socio-cognitive performance/Emotional processing
Time Frame: Baseline to follow-up (12 months)
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Social cognition will be evaluated using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), Italian version (Curci et al, 2003)
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Baseline to follow-up (12 months)
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Subthreshold manic symptoms
Time Frame: Baseline to post-treatment (6 months)
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Manic symptoms will be evaluated using the Young Mania Rating Scale (Y-MRS) (Young et al, 1978).
Euthymia will be defined by a score of Y-MRS <= 6 points.
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Baseline to post-treatment (6 months)
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Subthreshold manic symptoms
Time Frame: Baseline to follow-up (12 months)
|
Manic symptoms will be evaluated using the Young Mania Rating Scale (Y-MRS) (Young et al, 1978).
Euthymia will be defined by a score of Y-MRS <= 6 points.
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Baseline to follow-up (12 months)
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Subthreshold depressive symptoms
Time Frame: Baseline to post-treatment (6 months)
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Depressive symptoms will be evaluated using the Hamilton Depression Rating Scale (HAM-D) (Hamilton et al, 1960).
Euthymia will be defined by a score of HAM-D <= 8 points.
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Baseline to post-treatment (6 months)
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Subthreshold depressive symptoms
Time Frame: Baseline to follow-up (12 months)
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Depressive symptoms will be evaluated using the Hamilton Depression Rating Scale (HAM-D) (Hamilton et al, 1960).
Euthymia will be defined by a score of HAM-D <= 8 points.
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Baseline to follow-up (12 months)
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Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- NP 3976
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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