Sustained cognitive and functional effects of pro-cognitive interventions for bipolar disorder: a systematic review of randomised controlled trials
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
A substantial proportion of individuals with bipolar disorder (BD) experience considerable cognitive deficits. Existing systematic reviews have evaluated the efficacy of pro-cognitive interventions in BD, but have not established whether any cognitive benefits translate into functional improvements, with evidence for sustained functional effects remaining limited. A systematic search was conducted on MEDLINE, EMBASE, PsycINFO and Cochrane Library from inception until 21 May 2026. Eligible studies were randomised controlled trials (RCTs) in BD reporting cognitive or functional outcomes at three or more months following a pro-cognitive intervention, or examining the translation of cognitive benefits into improvements in functional outcomes at any timepoint. Seven unique RCTs plus three secondary analyses of these trials (n = 615) met the inclusion criteria. Approximately 13% (7/55) of RCTs identified in the search of pro-cognitive interventions in adult BD assessed cognitive or functional outcomes at least 3 months after treatment end. Of the seven unique RCTs, most evaluated cognitive remediation (CR; k = 4). The average follow-up length was 4 months (range: 3–6 months). Three of the four RCTs examining CR reported cognitive benefits at 3 to 6 months, whereas only one CR RCT found consistent functional effects at 3 months. Evidence on the translation of cognitive benefits to functional improvements is scarce and inconsistent. Most trials examining pro-cognitive interventions do not examine whether potential benefits are sustained or whether they translate into improvements in real-world functioning. CR appears to be a promising intervention for achieving durable cognitive gains in BD, although evidence for sustained effects of other interventions is limited.
Date Issued
2026-12-01
Date Acceptance
2026-08-15
Citation
Journal of Affective Disorders, 2026, 414
ISSN
0165-0327
Publisher
Elsevier BV
Journal / Book Title
Journal of Affective Disorders
Volume
414
Copyright Statement
© 2026 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/42607892
PII: S0165-0327(26)01243-7
Subjects
Bipolar disorder
Cognitive functioning
Cognitive transfer
Pro-cognitive interventions
Psychosocial functioning
Systematic review
Publication Status
Published
Coverage Spatial
Netherlands
Article Number
122390
Date Publish Online
2026-08-17