Cognition is an umbrella term referring to our thinking skills such as the ability to focus our attention on something, to store information in our memory, to plan our schedule of activities, and to solve puzzles or problems. All these are essential abilities to deal with the challenges of our daily life and to remain functional in our jobs, our social activities, and our personal relationships.

People with bipolar disorder present great cognitive variability: some of them do not experience any cognitive difficulties, some of them only face challenges in certain cognitive abilities, while some others suffer from difficulties across all cognitive functions. Such problems commonly appear during phases of depression or mania, but for many people persist during times without any acute mood symptoms. More importantly, persisting cognitive difficulties are associated with impaired daily functioning, reduced capacity to work, and poor quality of life.    

There are several ways to tackle cognitive difficulties and, hence, improve daily life quality. CRT is a psychological therapy attempting to enhance cognition and functioning through intensively exercising cognitive skills and through teaching compensatory strategies to bypass cognitive challenges. In their CRT approach, King’s College London also highly emphasise building awareness around one’s cognitive strengths and shortcomings, as well as becoming more competent in recognising the cognitive requirements of a certain activity or a task. This form of CRT has not yet been investigated for people with bipolar disorder in a randomised trial but has shown many positive effects on thinking skills and quality of life for people with schizophrenia who also experience widespread cognitive difficulties.  

The Cognitive Remediation in Bipolar (CRiB) study is a randomised feasibility trial investigating CRT compared with treatment as usual in people not currently experiencing depression or mania. Eighty people with bipolar disorder (type I or II) are being recruited, of whom 40 will receive 20 – 40 hours of CRT over a 12-week period in addition to usual treatment, and another 40 will continue receiving their standard treatment alone. We hope that in the long-term CRT will advance the management of bipolar disorder by improving cognitive skills and transferring these new skills to everyday life activities. This may contribute to better overall functioning and reduced recurrence of mood episodes.

At the moment we have recruited 72 people and we are looking for 8 more to take part. The CRiB study is conducted at King’s College London, Institute of Psychiatry, Psychology and Neuroscience in South London. Interested potential participants are welcome to contact the research team for further information and discussion: Becci Strawbridge (study co-ordinator) or Dimosthenis Tsapekos (main study researcher), email: [email protected] kcl.ac.uk, or telephone number: 0207 848 5305.

This study has received funding from the National Institute for Health Research’s Research for Patient Benefit (RfPB) funding stream.


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