Randomised controlled cognition trials in remitted patients with mood disorders published between 2015 and 2021: A systematic review by the International Society for Bipolar Disorders Targeting Cognition Task Force
DOKPE
- Miskowiak, Kamilla W. ORCID University of Copenhagen, Denmark
- Seeberg, Ida University of Copenhagen, Denmark
- Jensen, Mette B. Copenhagen University Hospital, Denmark
- Balanzá‐Martínez, Vicent University of Valencia, Spain
- del Mar Bonnin, Caterina University of Barcelona, Spain
- Bowie, Christopher R. ORCID Queen’s University, Kingston, Canada
- Carvalho, Andre F. ORCID Deakin University, Geelong Vic., Australia
- Dols, Annemieke ORCID Amsterdam Public Health Research Institute, The Netherlands
- Douglas, Katie ORCID University of Otago, Christchurch, New Zealand
- Gallagher, Peter Newcastle University, Newcastle-upon-Tyne, UK
- Hasler, Gregor ORCID University of Fribourg
- Lafer, Beny ORCID Universidade de São Paulo, Brazil
- Lewandowski, Kathryn E. ORCID Harvard Medical School, Boston, Massachusetts, USA
- López‐Jaramillo, Carlos Universidad de Antioquia, Medellín, Colombia
- Martinez‐Aran, Anabel University of Barcelona, Spain
- McIntyre, Roger S. ORCID University of Toronto, Canada
- Porter, Richard J. ORCID University of Otago, Christchurch, New Zealand
- Purdon, Scot E. University of Alberta, Edmonton, Canada
- Schaffer, Ayal ORCID University of Toronto
- Stokes, Paul ORCID King’s College London, UK
- Sumiyoshi, Tomiki ORCID National Center of Neurology and Psychiatry, Tokyo, Japan
- Torres, Ivan J. University of British Columbia, Vancouver, Canada
- Van Rheenen, Tamsyn E. University of Melbourne, Carlton, Australia
- Yatham, Lakshmi N. University of British Columbia, Vancouver, Canada
- Young, Allan H. King’s College London, UK
- Kessing, Lars V. ORCID Copenhagen University Hospital, Denmark
- Burdick, Katherine E. ORCID Harvard Medical School, Boston, Massachusetts, USA
- Vieta, Eduard ORCID University of Barcelona, Spain
- 2022
Published in:
- Bipolar Disorders. - Hoboken, New Jersey, USA : John Wiley & Sons. - 2022, vol. 24, no. 4, p. 354-374
ISBD Task Force
bipolar disorder
cognitive impairment
intervention
major depressive disorder
randomised controlled trials
recommendations
systematic review
English
Background: Cognitive impairments are an emerging treatment target in mood disorders, but currently there are no evidence-based pro-cognitive treatments indicated for patients in remission. With this systematic review of randomised controlled trials (RCTs), the International Society for Bipolar Disorders (ISBD) Targeting Cognition Task force provides an update of the most promising treatments and methodological recommendations.
Methods: The review included RCTs of candidate pro-cognitive interventions in fully or partially remitted patients with major depressive disorder or bipolar disorder. We followed the procedures of the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) 2020 statement. Searches were conducted on PubMed/MEDLINE, PsycInfo, EMBASE and Cochrane Library from January 2015, when two prior systematic reviews were conducted, until February 2021. Two independent authors reviewed the studies with the Revised Cochrane Collaboration's Risk of Bias tool for Randomised trials.
Results: We identified 16 RCTs (N = 859) investigating cognitive remediation (CR; k = 6; N = 311), direct current or repetitive magnetic stimulation (k = 3; N = 127), or pharmacological interventions (k = 7; N = 421). CR showed most consistent cognitive benefits, with two trials showing improvements on primary outcomes. Neuromodulatory interventions revealed no clear efficacy. Among pharmacological interventions, modafinil and lurasidone showed early positive results. Sources of bias included small samples, lack of pre-screening for objective cognitive impairment, no primary outcome and no information on allocation sequence masking.
Conclusions: Evidence for pro-cognitive treatments in mood disorders is emerging. Recommendations are to increase sample sizes, pre-screen for impairment in targeted domain(s), select one primary outcome, aid transfer to real-world functioning, investigate multimodal interventions and include neuroimaging.
Methods: The review included RCTs of candidate pro-cognitive interventions in fully or partially remitted patients with major depressive disorder or bipolar disorder. We followed the procedures of the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) 2020 statement. Searches were conducted on PubMed/MEDLINE, PsycInfo, EMBASE and Cochrane Library from January 2015, when two prior systematic reviews were conducted, until February 2021. Two independent authors reviewed the studies with the Revised Cochrane Collaboration's Risk of Bias tool for Randomised trials.
Results: We identified 16 RCTs (N = 859) investigating cognitive remediation (CR; k = 6; N = 311), direct current or repetitive magnetic stimulation (k = 3; N = 127), or pharmacological interventions (k = 7; N = 421). CR showed most consistent cognitive benefits, with two trials showing improvements on primary outcomes. Neuromodulatory interventions revealed no clear efficacy. Among pharmacological interventions, modafinil and lurasidone showed early positive results. Sources of bias included small samples, lack of pre-screening for objective cognitive impairment, no primary outcome and no information on allocation sequence masking.
Conclusions: Evidence for pro-cognitive treatments in mood disorders is emerging. Recommendations are to increase sample sizes, pre-screen for impairment in targeted domain(s), select one primary outcome, aid transfer to real-world functioning, investigate multimodal interventions and include neuroimaging.
- Faculty
- Faculté des sciences et de médecine
- Department
- Master en médecine
- Language
-
- English
- Classification
- Pathology, clinical medicine
- License
- CC BY
- Open access status
- gold
- Identifiers
-
- DOI 10.1111/bdi.13193
- ISSN 1398-5647
- Persistent URL
- https://folia.unifr.ch/unifr/documents/327402
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