Functional remediation for bipolar disorder

Anabel Martínez-Arán, Carla Torrent, Brisa Solé, C Mar Bonnín, Adriane R Rosa, José Sánchez-Moreno, Eduard Vieta, Anabel Martínez-Arán, Carla Torrent, Brisa Solé, C Mar Bonnín, Adriane R Rosa, José Sánchez-Moreno, Eduard Vieta

Abstract

Neurocognitive impairment constitutes a core feature of bipolar illness. The main domains affected are verbal memory, attention, and executive functions. Deficits in these areas as well as difficulties to get functional remission seem to be increased associated with illness progression. Several studies have found a strong relationship between neurocognitive impairment and low functioning in bipolar disorder, as previously reported in other illnesses such as schizophrenia. Cognitive remediation strategies, adapted from work conducted with traumatic brain injury patients and applied to patients with schizophrenia, also need to be adapted to individuals with bipolar disorders. Early intervention using functional remediation, involves neurocognitive techniques and training, but also psychoeducation on cognition-related issues and problem-solving within an ecological framework.

Keywords: Neurocognition; bipolar disorder.; functional remediation.

Figures

Fig. (1)
Fig. (1)
Functional remediation tries to cover the gap between normal functioning and low functioning associated with illness progression. Functioning probably would be higher before illness onset, and some mild difficulties would be appreciated in the prodromal phase. Moderate difficulties in functioning are observed after the first manic episode since patients get clinical remission but most of them do not achieve premorbid functional recovery. A higher number of relapses would have a negative impact on the general functioning of bipolar patients.

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