de Siqueira Rotenberg Luisa, Curvello Renata, Nardini Clara, da Silva Franco Milene, Carozzino Maria Eduarda, Biazus Taís Boeira, Campanha Thuani, Garrudo Guirado Alia, O'Malley Grace, Stamm Thomas J, Lafer Beny
Bipolar Disorder Research Program (PROMAN), Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil.
Psychother Psychosom. 2025;94(2):71-88. doi: 10.1159/000542091. Epub 2025 Jan 13.
Impairments in social cognition in bipolar disorder (BD) have been extensively described in the last decade but few treatment strategies have been studied to address this issue. This study presents findings from a randomized controlled trial (RCT) investigating the efficacy of metacognitive training for bipolar disorder (MCT-BD) compared to Treatment as Usual (TAU) among individuals with BD in remission. The aim was to determine whether MCT-BD could improve social cognition and overall functioning in this population.
Participants (N = 56) were recruited via social media and an internal database at the University of São Paulo Medical School. Inclusion criteria included a confirmed BD diagnosis, current state of remission, and the presence of social functioning impairments. Exclusion criteria included any impairments that could hinder neuropsychological testing. Patients were randomly assigned to either MCT-BD or TAU, with assessments conducted at baseline and follow-up. The MCT-BD program consisted of nine sessions.
The overall attendance rate across all MCT-BD intervention sessions was 96.6%. The MCT-BD program demonstrated added value in improving social cognition, specifically in emotion recognition reaction time. However, no significant changes were found in theory of mind, psychosocial functioning, or quality of life.
This RCT provides preliminary evidence for the efficacy of MCT-BD in improving emotion recognition latency, emphasizing the importance of targeted interventions in social cognition outcomes for individuals with BD. The study's strengths include high completion rates and comprehensive cognitive assessments. Future studies should explore long-term effects and personalized treatment approaches aiming to improve social-cognitive deficits in this population.
在过去十年中，双相情感障碍（BD）患者的社会认知障碍已得到广泛描述，但针对这一问题的治疗策略研究较少。本研究呈现了一项随机对照试验（RCT）的结果，该试验调查了双相情感障碍元认知训练（MCT - BD）与常规治疗（TAU）相比，在缓解期双相情感障碍患者中的疗效。目的是确定MCT - BD是否能改善该人群的社会认知和整体功能。
通过社交媒体和圣保罗大学医学院的内部数据库招募参与者（N = 56）。纳入标准包括确诊的双相情感障碍诊断、当前的缓解状态以及存在社会功能障碍。排除标准包括任何可能妨碍神经心理学测试的障碍。患者被随机分配到MCT - BD组或TAU组，在基线和随访时进行评估。MCT - BD项目包括九个疗程。
所有MCT - BD干预疗程的总体出勤率为96.6%。MCT - BD项目在改善社会认知方面显示出附加价值，特别是在情绪识别反应时间方面。然而，在心理理论、心理社会功能或生活质量方面未发现显著变化。
这项随机对照试验为MCT - BD改善情绪识别潜伏期的疗效提供了初步证据，强调了针对双相情感障碍患者社会认知结果进行有针对性干预的重要性。该研究的优势包括高完成率和全面的认知评估。未来的研究应探索长期效果和个性化治疗方法，旨在改善该人群的社会认知缺陷。
