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Tusconi M, Kätzel D, Sánchez-Gutiérrez T. Editorial: Reviews in psychiatry 2023: schizophrenia. Front Psychiatry 2024; 15:1444818. [PMID: 39026521 PMCID: PMC11255906 DOI: 10.3389/fpsyt.2024.1444818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024] Open
Affiliation(s)
| | - Dennis Kätzel
- Institute of Applied Physiology, Faculty of Medicine, University of Ulm, Ulm, Germany
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Primavera D, Migliaccio GM, Garau V, Orrù G, Scano A, Perra A, Pinna S, Tusconi M, Carta MG, Sancassiani F. Improving Quality of Life in Bipolar Disorders with an Immersive Virtual Reality Remediation Training Randomized Controlled Trial (RCT). J Clin Med 2024; 13:3886. [PMID: 38999451 PMCID: PMC11242424 DOI: 10.3390/jcm13133886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 06/26/2024] [Accepted: 06/29/2024] [Indexed: 07/14/2024] Open
Abstract
Background: Health-related quality of life (H-QoL) is a critical measure in bipolar disorder (BD). Recent trials using virtual reality (VR) have shown potential in improving H-QoL. However, VR's effect on the H-QoL of people with BD needs to be further explored. Methods: This study involved a secondary analysis of a feasibility randomized controlled trial, focusing on "quality of life". Participants (aged 18-75) diagnosed with bipolar disorder were randomized into two groups. The experimental group used the CEREBRUM VR app, while the control group received the usual care. Quality of life was assessed using the Short-Form Health Survey (SF-12). Results: A total of 39 individuals in the experimental group and 25 in the control group represent the final samples. The results showed a greater improvement in the SF-12 total score in the experimental group (8.7%) compared to the control group (F = 66.851 p < 0.0001), specifically in the dimension of physical activity limitation, emotional impact, concentration, pain, calmness, energy levels, discouragement, and social activities. Conclusions: This study demonstrated an improvement in QoL for individuals with BD following a VR intervention. As a feasibility study, this secondary outcome needs to be confirmed by further phase III studies. If confirmed, VR could offer valuable rehabilitation tools and insights into the pathogenesis and treatment of BD.
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Affiliation(s)
- Diego Primavera
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy
| | - Gian Mario Migliaccio
- Department Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, 00118 Rome, Italy
| | - Valentino Garau
- School of Dentistry, University of Cagliari, 09042 Cagliari, Italy
| | - Germano Orrù
- Department of Surgical Sciences, University of Cagliari, Cittadella Universitaria, Blocco I, Asse Didattico Medicina P2, Monserrato (CA), 09042 Cagliari, Italy
| | - Alessandra Scano
- Department of Surgical Sciences, University of Cagliari, Cittadella Universitaria, Blocco I, Asse Didattico Medicina P2, Monserrato (CA), 09042 Cagliari, Italy
| | - Alessandra Perra
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy
| | - Samantha Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy
| | | | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy
| | - Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy
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3
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Sancassiani F, Perra A, Kurotschka PK, Kalcev G, Galetti A, Zaccheddu R, Locci A, Piludu F, Di Natale L, De Lorenzo V, Fornaro M, Nardi AE, Primavera D. Improving Social and Personal Rhythm Dysregulation in Young and Old Adults with Bipolar Disorder: Post-Hoc Analysis of a Feasibility Randomized Controlled Trial Using Virtual Reality-Based Intervention. J Clin Med 2024; 13:3786. [PMID: 38999351 PMCID: PMC11242709 DOI: 10.3390/jcm13133786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/14/2024] Open
Abstract
Introduction: Rehabilitative interventions employing technology play a crucial role in bipolar disorder (BD) treatment. The study aims to appraise the virtual reality (VR)-based cognitive remediation (CR) and the interpersonal rhythm approaches to treatment outcomes of BD across different age groups. Methods: Post-hoc analysis of a 12-week randomizedcontrolled cross-over feasibility trial involving people with mood disorders (BD, DSM-IV) aged 18-75 years old: thirty-nine exposed to the experimental VR-based CR vs 25 waiting list controls. People with BD relapse, epilepsy or severe eye diseases (due to the potential VR risks exposure) were excluded. Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) was used to measure the outcome. Results: Cases and controls did not statistically significantly differ in age and sex distributions. Personal rhythm scores improved over the study follow-up in the experimental vs the control group (APC = 8.7%; F = 111.9; p < 0.0001), both in young (18-45 years) (APC = 5.5%; F = 70.46; p < 0.0001) and, to a lesser extent, older (>46 years) adults (APC = 10.5%; F = 12.110; p = 0.002). Conclusions: This study observed improved synchronization of personal and social rhythms in individuals with BD after a virtual reality cognitive remediation intervention, particularly in social activity, daily activities, and chronotype, with greater benefits in the younger population.
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Affiliation(s)
- Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Alessandra Perra
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Peter K Kurotschka
- Department of General Practice, University Hospital Würzburg, 12459 Würzburg, Germany
| | - Goce Kalcev
- The National Alliance for Neuromuscular Diseases and Neuroscience GANGLION Skopje, 1000 Skopje, North Macedonia
| | - Alessia Galetti
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Rosanna Zaccheddu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Aurora Locci
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Federica Piludu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Lorenzo Di Natale
- IDEGO Digital Psychology Society, 00197 Rome, Italy
- CEREBRUM VR, 00197 Rome, Italy
| | - Valerio De Lorenzo
- CEREBRUM VR, 00197 Rome, Italy
- Department of Systems Medicine, University of Tor Vergata, 00133 Rome, Italy
| | - Michele Fornaro
- Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, 80138 Naples, Italy
| | - Antonio Egidio Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil
| | - Diego Primavera
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
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Perra A, Sancassiani F, Cantone E, Pintus E, D’Oca S, Casula A, Littarru S, Zucca S, Tumolillo D, Pinna I, Primavera D, Cossu G, Nardi AE, Kalcev G, Carta MG. An e-Health Psychoeducation Program for Managing the Mental Health of People with Bipolar Disorder during the COVID-19 Pandemic: A Randomized Controlled Study. J Clin Med 2024; 13:3468. [PMID: 38929997 PMCID: PMC11204713 DOI: 10.3390/jcm13123468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Social rhythm dysregulation has been identified as a determining factor in bipolar disorder (BD) relapses. It directly impacts individuals' quality of life (QoL). This study aims to present preliminary data on the efficacy of an e-health psychoeducational intervention for BD for improving clinical outcomes. Methods: This study used an open-label, crossover, randomized controlled trial design. The inclusion criteria consisted of a BD diagnosis, affiliation with the Consultation Psychiatry and Psychosomatic Center at the University Hospital in Cagliari, Italy, age over 18, and the obtaining of informed consent. Anxiety and depressive symptoms, QoL, and social and biological rhythms were measured using standardized instruments validated in Italian. Results: A total of 36 individuals were included in the experimental group (EG) and 18 in the control group (CG). The final sample consisted of 25 in the EG and 14 in the CG. A statistically significant improvement in QoL was found in the EG post-treatment (p = 0.011). Significant correlations were found between QoL and the dysregulation of biorhythms in the EG at T0 (p = 0.0048) and T1 (p = 0.0014). Conclusions: This study shows that, during extreme distress, an e-health group psychoeducation intervention for people with BD could significantly improve the perception of QoL. The results must be confirmed by studies conducted with larger-sized samples.
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Affiliation(s)
- Alessandra Perra
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Elisa Cantone
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Elisa Pintus
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Silvia D’Oca
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Alessio Casula
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Sara Littarru
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Sara Zucca
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Davide Tumolillo
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Irene Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Diego Primavera
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Antonio Egidio Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rua Visconde de Piraja 407/702, Rio de Janeiro 21941-972, Brazil;
| | - Goce Kalcev
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
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Dark FL, Amado I, Erlich MD, Ikezawa S. International Experience of Implementing Cognitive Remediation for People With Psychotic Disorders. Schizophr Bull 2024:sbae071. [PMID: 38758086 DOI: 10.1093/schbul/sbae071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND Cognitive remediation (CR) is an effective therapy for the cognitive impact of mental illness, especially schizophrenia. Global efforts are being made to implement CR into routine mental health services with the aim of improving functional outcomes for the population of people recovering from mental illness. Implementation and dissemination of CR in heterogeneous settings require knowledge gleaned from formal implementation research and pragmatic experiential learning. This article describes cross-cultural approaches to CR implementation, focusing on initiatives in France, the United States, Australia, and Japan. METHOD Key leaders in the implementation of CR in France, the United States, Australia, and Japan were asked to describe the implementation and dissemination process in their settings with respect to the categories of context, implementation, outcomes, facilitators, and barriers. RESULTS All 4 sites noted the role of collaboration to leverage the implementation of CR into mental health rehabilitation services. In France, high-level, government organizational backing enhanced the dissemination of CR. Academic and clinical service partnerships in the United States facilitated the dissemination of programs. The advocacy from service users, families, and carers can aid implementation. The support from international experts in the field can assist in initiating programs but maintenance and dissemination require ongoing training and supervision of staff. CONCLUSIONS CR is an effective intervention for the cognitive impact of schizophrenia. Programs can be implemented in diverse settings globally. Adaptations of CR centering upon the core components of effective CR therapy enhance outcomes and enable programs to integrate into diverse settings.
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Affiliation(s)
- Frances L Dark
- The University of Queensland Medical School, Brisbane, Australia
- Metro South Addiction and Mental Health Service, Brisbane, Australia
| | - Isabelle Amado
- Ressource Centre in Ile de France for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), GHU Paris Psychiatry Neurosciences, Paris, France
- Department for Cognitive Remediation and Rehabilitation, Paris Cité University
| | - Matthew D Erlich
- New York State Office of Mental Health, New York, NY, USA
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Satoru Ikezawa
- Department of Psychiatry, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
- Department of Psychiatry, National Centre of Neurology and Psychiatry, Tokyo, Japan
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Jespersen AE, Lumbye A, Vinberg M, Glenthøj L, Nordentoft M, Wæhrens EE, Knudsen GM, Makransky G, Miskowiak KW. Effect of immersive virtual reality-based cognitive remediation in patients with mood or psychosis spectrum disorders: study protocol for a randomized, controlled, double-blinded trial. Trials 2024; 25:82. [PMID: 38268043 PMCID: PMC10809611 DOI: 10.1186/s13063-024-07910-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/03/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Cognitive impairments are prevalent across mood disorders and psychosis spectrum disorders, but there is a lack of real-life-like cognitive training programmes. Fully immersive virtual reality has the potential to ensure motivating and engaging cognitive training directly relevant to patients' daily lives. We will examine the effect of a 4-week, intensive virtual reality-based cognitive remediation programme involving daily life challenges on cognition and daily life functioning in patients with mood disorders or psychosis spectrum disorders and explore the neuronal underpinnings of potential treatment efficacy. METHODS The trial has a randomized, controlled, double-blinded, parallel-group design. We will include 66 symptomatically stable outpatients with mood disorders or psychosis spectrum disorders aged 18-55 years with objective and subjective cognitive impairment. Assessments encompassing a virtual reality test of daily life cognitive skills, neuropsychological testing, measures of daily life functioning, symptom ratings, questionnaires on subjective cognitive complaints, and quality of life are carried out at baseline, after the end of 4 weeks of treatment and at a 3-month follow-up after treatment completion. Functional magnetic resonance imaging scans are performed at baseline and at the end of treatment. The primary outcome is a broad cognitive composite score comprising five subtasks on a novel ecologically valid virtual reality test of daily life cognitive functions. Two complete data sets for 54 patients will provide a power of 80% to detect a clinically relevant between-group difference in the primary outcome. Behavioural data will be analysed using linear mixed models in SPSS, while MRI data will be analysed with the FMRIB Expert Analysis Tool (FEAT). Treatment-related changes in neural activity from baseline to end of treatment will be investigated for the dorsal prefrontal cortex and hippocampus as the regions of interest. DISCUSSION The results will provide insight into whether virtual reality-based cognitive remediation has beneficial effects on cognition and functioning in symptomatically stable patients with mood disorders or psychosis spectrum disorders, which can aid future treatment development. TRIAL REGISTRATION ClinicalTrials.gov NCT06038955. Registered on September 15, 2023.
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Affiliation(s)
- Andreas E Jespersen
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, DK-2000, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | | | - Maj Vinberg
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Mental Health Services, The Early Multimodular Prevention and Intervention Research Institution (EMPIRI), Mental Health Centre, Northern Zealand, Copenhagen, Denmark
| | - Louise Glenthøj
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Merete Nordentoft
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Eva E Wæhrens
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Occupational Science, User Perspectives and Community-Based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Guido Makransky
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Virtual Learning Lab, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Kamilla W Miskowiak
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Frederiksberg Hospital, DK-2000, Copenhagen, Denmark.
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
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