CREST.BD Cognition & Bipolar Disorder Slides
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The document outlines a webinar series focused on cognitive dysfunction in individuals with bipolar disorder (BD), highlighting the importance of understanding and managing cognitive skills for improved quality of life. It discusses cognitive challenges associated with BD, factors influencing cognition, and strategies for cognitive rehabilitation, including remediation techniques, compensatory strategies, and adaptive approaches. The document also provides resources and tools for cognitive training and emphasizes the need for communication and structured activities to mitigate cognitive issues.
CREST.BD Cognition & Bipolar Disorder Slides
- 1. 1 CREST.BDBipolar Wellness Center Webinars Connect. Learn. Engage.
- 2. 2 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Cognition
- 3. 3 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BDCREST.BD Featuring: Dr. Ivan Torres CREST.BD Member and Clinical Associate Professor, Department of Psychiatry, University of British Columbia Cognition
- 4. 4 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Defining cognition Cognition and BD Why cognition is important to your QoL Tools and resources Webinar focus
- 5. 5 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Defining cognition Refers to thinking skills, eg., the ability to pay attention, remember, process information, solve problems and plan1 We’re all born with different cognitive capabilities Cognitive skills can change over time, e.g.: • worsen with illness, injury or age • also be strengthened or improved 1 Medalia, A., Revheim, N. (2002). Dealing with Cognitive Dysfunction Associated with Psychiatric Disabilities. New York State Office of Mental Health.
- 6. 6 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Cognition and BD BD can be associated with decreases in learning, verbal memory, planning, decision-making and/or ability to focus attention2 Or, may not be associated with any cognitive problems at all3 Cognitive problems most obvious during mood episodes, especially severe depression or mania4 • can continue even when not experiencing mood symptoms Primary symptom of BD, not just related to mood symptoms1 1 Medalia, A., Revheim, N. (2002). Dealing with Cognitive Dysfunction Associated with Psychiatric Disabilities. New York State Office of Mental Health. 2 Sole, B., Bonnin, C.M., Torrent, C et al. (2012). Neurocognitive impairment across the bipolar spectrum. CNC Neurosciences & Therapeutics, 18: 194-200. 3 Osuji, I.J., Cullum, C.M. (2005). Cognition in BD Psychiatr Clin North Am, 28(2): 427-41 4 Torres, I.J., Malhi, G.S. (2010). Neurocognitive in BD. Chapter 8 in Yatham LN & Maj M (eds), BD: clinical and neurobiological foundations, 2010, John Wiley & Sons: 71.
- 7. 7 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Age Recreational drugs, alcohol or substance misuse Medications Sleep problems Cognition and BD Factors contributing to cognition in BD:
- 8. 8 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Why is cognition important to QoL? Cognitive skills are necessary for success in many QoL areas, e.g.: independent living and everyday functioning work and education leisure activities maintaining social relationships and roles Research has linked cognitive function to QoL in people with BD5 5 Mackala, S.A., Torres, I.J., Kozicky, J., Michalak, E.E., Yatham, L.N. (2014). Cognitive performance and QoL early in the course of BD. J Affect Disord. 2014 Jul 2, 168C: 119-124.
- 9. 9 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD How you can take action Pay attention to cognitive changes or problems Track changes in memory, attention, alertness and thinking Be vigilant for cognitive changes with different medications or mood phases1 Engage others, such as a family member or healthcare professionals to help track changes 1 Medalia, A., Revheim, N. (2002). Dealing with Cognitive Dysfunction Associated with Psychiatric Disabilities. New York State Office of Mental Health.
- 10. 10 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD How you can take action Report any changes to your doctor and healthcare team Empowers you to work with your healthcare team to explore medication changes that could help Be open with your healthcare team about recreational substance use, other medications you’re taking or changes in the way you’re taking them
- 11. 11 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Cognitive rehabilitation strategies Refers to activities that help restore cognition to a healthy state Includes managing cognitive problems via 3 different methods1 1. Remediation techniques 2. Compensatory strategies 3. Adaptive approaches An assessment by a healthcare professional can help you decide which unique approach may be most helpful 1 Medalia, A., Revheim, N. (2002). Dealing with Cognitive Dysfunction Associated with Psychiatric Disabilities. New York State Office of Mental Health.
- 12. 12 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Remediation techniques Research on remediation techniques is in its infancy, but shows promise for cognitive training in people with mood disorders, including some (but not all) people with BD6 While you may improve your results on the specific tasks you practice, it’s still uncertain how helpful this will be to your overall functioning7 Remediation techniques: • focus on improving thinking with drills and exercises (may involve computers, paper and pencil, or group activities) • don’t offer a quick fix: progress takes time and effort 6 Bowie, C.R., Gupta, M., Holshausen, K. (2013). Cognitive remediation therapy for mood disorders: rationale, early evidence, and future directions. Canadian Journal of Psychiatry, 58: 319-325. 7 Owen, A., Hampshire, A., Grahn, J.A., Stenton, R., Dajani, S., Burns, A.S., Howard, R., Ballard, C.G. (2010). Putting Brain Training to the Test. Nature, 465(7299):775-55.
- 13. 13 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Compensatory strategies helping identify different ways to accomplish goals by ‘compensating’ for cognitive challenges cognitive strengths can be used to override cognitive weaknesses e.g., can learn mnemonics (or ‘memory aids’) to help you remember things Focus on:
- 14. 14 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Adaptive approaches Focus on: changes to your environment e.g., recording devices to help you keep track of important information, or reminders
- 15. 15 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Final Tips Keep communication and activities simple, direct, short Keep activities to one thing at a time; avoid multi-tasking Rest; fatigue can make cognitive problems worse Limit distractions Balance activities so that you have a blend of physical, mental and social activities to keep your interest up and prevent fatigue Keep activities and tasks structured and organized
- 16. 16 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Tools and Resources
- 17. 17 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Resources CogniFit This online cognitive training program provides tools to measure cognitive skills, and build on these skills through entertaining games and tracking one’s progress. Caveat: The efficacy of these resources has yet not been evaluated in people with BD https://www.cognifit.com/
- 18. 18 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Resources Lumosity This is a similar online cognitive training website, using interactive games to “train memory and attention” through a “personalized training program.” Caveat: The efficacy of these resources has yet not been evaluated in people with BD www.lumosity.com
- 19. 19 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Resources Dealing with Cognitive Dysfunction Associated with Psychiatric Disabilities A handbook for families and friends of individuals with psychiatric disorders, written by Alice Medalia, Ph.D.and Nadine Revheim, Ph.D. https://www.omh.ny.gov/omhweb/cogdys_manual/CogDysHndbk.htm
- 20. 20 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD For more information and resources, visit our Bipolar Wellness Center at: http://www.bdwellness.com/ To assess your quality of life, visit our QoL tool at: http://www.bdqol.com/
- 21. 21 Bipolar Wellness Center Webinars Connect. Learn. Engage.CREST.BD Acknowledgments