A feasibility study of two variants of a blended functional remediation programme for euthymic patients with bipolar I disorder

Background: Bipolar disorder (BD) is associated with reduced psychosocial functioning, partly due to cognitive impairments. Functional remediation (FR), aimed at ameliorating daily functioning, is based on psychoeducation and strategies to cope with cognitive problems. Given the limited number of studies in patients with BD, more studies are needed to evaluate different FR programmes. Methods: A total of 29 euthymic patients with BD-I followed a 12-session FR programme consisting of both group and individual sessions, offered in two variants: one in-person and one online (video conferencing). Both variants were supported by E-health modules. Feasibility was the primary outcome, as measured with dropout rates and attendance, as well as questionnaires about patients' experiences with the programme. The secondary aim was to explore effects on psychosocial functioning. Results: Results show an acceptable dropout rate. Attendance was good as 83% visited at least 10 sessions. Analyses of participants' experiences revealed gain of insight and implementation of learned strategies in daily life. Independently working with the E-health modules did not appear feasible. Exploratory analyses showed a significant improvement in psychosocial functioning for both variants. Limitations: The results of the effect analysis are preliminary, due to a small sample and lack of a control group. Conclusions: This FR programme showed good feasibility for both the in-person and online variant. Online treatment has advantages as it can reach out to a larger group of participants. Effect analyses indicated reduction in psychosocial impairments in both variants. Larger controlled studies are needed to investigate the treatment effects of the current FR programme.