Cognitive impairment contributes substantially to bipolar disorder (BD) illness morbidity and pro-cognitive therapeutic interventions are emerging to combat this. Patients with BD frequently experience deficits in attention, executive functions and memory during remission and these deficits correspond to poor psychosocial functioning. Ameliorating these impairments may improve patients’ quality of life in the short-term and could enhance wide ranging, longer-term illness trajectories thereby potentially reducing direct and indirect costs for the individual and society (e.g., through improving psychosocial and occupational outcomes). Pro-cognitive interventions are not currently available and the neurobiological basis of impaired cognition has not been fully elucidated. This project will advance the field towards translational benefits for patients via several important routes:
BD is associated with persistent alterations in measures of inflammatory and HPA-axis function even during euthymia. The project will aim to elucidate the dynamics of peripheral immune-biomarkers and cognitive change during cognitive remediation therapy (CRT).
Emerging evidence demonstrates that intervening early in the course of BD has the potential to facilitate improved long-term illness trajectories. The project will examine whether CRT could be a feasible and acceptable intervention specifically for people in the early stages of bipolar illness (shortly after diagnosis) to improve long term illness outcomes.
Sleep serves important physiological functions in cognition, particularly memory consolidation. Impaired sleep is common in BD and is associated with cognitive deficits. Markers of sleep quality and chronotype will be studied in relation to cognitive performance and therapy response.
- Strawbridge R, Tsapekos D, Hodsoll J, Mantingh T, Yalin N, McCrone P, Boadu J, Macritchie K, Cella M, Reeder C, Fish J. Cognitive remediation therapy for patients with bipolar disorder: A randomised proof‐of‐concept trial. Bipolar Disorders. 2021 Mar;23(2):196-208.
- Strawbridge R, Carter R, Saldarini F, Tsapekos D, Young AH. Inflammatory biomarkers and cognitive functioning in individuals with euthymic bipolar disorder: exploratory study. BJPsych Open. 2021 Jul;7(4).
- Ritter, P. S., Höfler, M., Wittchen, H. U., Lieb, R., Bauer, M., Pfennig, A., & Beesdo-Baum, K. (2015). Disturbed sleep as risk factor for the subsequent onset of bipolar disorder–data from a 10-year prospective-longitudinal study among adolescents and young adults. Journal of psychiatric research, 68, 76-82.
Skills/qualities required especially for this project:
- Background knowledge in the following areas would be desirable for these studies: neurobiology and brain immune-interactions, psychological therapies, neuropsychology, cognitive neuroscience, clinical trials.