CompletedInterventional

A trial of ‘cognitive remediation therapy’ to improve thinking skills and everyday functioning for people with bipolar disorder

Bipolar disorder causes significant changes in mood and energy. However, many people also face lasting difficulties with memory, concentration, and planning, even when their mood is stable. These thinking challenges can make work, relationships, and everyday activities much harder. This study, led by King's College London, tests a psychological programme called cognitive remediation therapy (CRT). CRT uses mental exercises and problem-solving techniques to help strengthen thinking skills. In total, 250 adults with bipolar disorder will take part. Half will receive 12 weeks of CRT alongside their regular care, while the other half will continue with their usual care alone. Researchers will assess thinking skills, everyday functioning, and well-being before the study, right after the 12 weeks, and three months later. The aim is to see whether CRT provides meaningful, long-term support for daily life.

At a glance

Status

Completed

Sponsor

King's College London

Enrolment target

250

Start

01 Apr 2022

Estimated completion

30 Jun 2025

Bipolar disorder

What is this study about?

Bipolar disorder is well known for causing shifts between high, low, or mixed moods. What is less talked about is that many people also experience ongoing problems with thinking skills. These can include trouble concentrating, remembering everyday information, or planning ahead. Even when mood is settled, these difficulties can hold people back at work, strain relationships, and affect quality of life. Current medical care usually focuses on steadying mood swings, meaning thinking difficulties are often left unaddressed.

A psychological approach called cognitive remediation therapy (CRT) has already proved successful for people with other mental health conditions, such as schizophrenia. CRT uses guided exercises, computer tasks, and real-world strategies to help retrain the brain and improve day-to-day functioning. Smaller early trials suggest that CRT might bring similar benefits to people with bipolar disorder, but a larger, definitive study is needed to be sure.

Researchers at King's College London, funded by the National Institute for Health Research (NIHR) and working alongside the charity Bipolar UK, have set up this study to test CRT properly. By comparing people who receive CRT with those receiving standard NHS care, the team hopes to prove whether this therapy can improve daily living and work prospects, and learn how it creates positive change.

Key takeaways

Tests whether brain-training therapy (CRT) improves memory, concentration, and daily life for people with bipolar disorder.
Open to adults aged 18 to 65 with bipolar disorder whose mood has been stable for at least one month.
Participants are randomly chosen to receive 12 weeks of CRT alongside usual care, or to continue usual care alone.
Involves memory tests and questionnaires at the start, at 12 weeks, and 3 months later (lasting about 25 weeks total).
Funded by the NIHR and run by King's College London in partnership with Bipolar UK.

Who may be eligible?

You may be able to join this trial if you are between 18 and 65 years old and have a confirmed diagnosis of bipolar disorder (either Type I or Type II). To take part, your mood must have been stable for at least one month, meaning you are not currently experiencing a high (mania) or low (depression) episode. You must also be able to use a computer or smartphone and be able to travel regularly to study appointments.

This study is not suitable for everyone. You cannot take part if you are currently having active thoughts of suicide, have a diagnosis of alcohol or drug dependence, or have an intellectual disability or brain disorder that impairs thinking.

You also will not be able to join if you have had cognitive remediation therapy before, are already having another psychological therapy, or are planning major changes to your mental health treatment soon. Finally, you must be able to speak fluent English and provide contact details for a UK healthcare professional, such as your GP or psychiatrist.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

I am aged between 18 and 65.
I have a formal diagnosis of bipolar disorder (Type I or Type II).
My mood has been stable (no mania or depression) for at least the past month.
I can comfortably use a smartphone or computer.
I am not currently receiving another talking therapy or planning sudden treatment changes.
I can travel to regular study appointments over a 25-week period.

Answer every question to see your result.

What does participation involve?

If you join the study, you will be placed into one of two groups by chance (like flipping a coin). One group will receive 12 weeks of cognitive remediation therapy alongside their normal care, while the other group will continue with their usual NHS care as normal. You will not be asked to stop taking your regular medications.

The study lasts around 25 weeks in total. Everyone will attend research visits to complete thinking tasks, memory puzzles, and questionnaires about everyday life. These checks happen before the 12-week period starts, immediately after it finishes, and once more three months later. Researchers may also look at stress hormone levels and mood patterns to understand how the therapy works.

Potential risks and benefits

Taking part might not help you directly, especially if you are placed in the usual care group. However, if you receive the therapy, it may help you develop useful strategies for managing your memory, attention, and daily routine. Doing the thinking tests could also give you a clearer sense of your own strengths. The main downside is the time required to attend visits. Some people might also find the thinking tests a little tiring or frustrating if tasks feel difficult. Your participation is completely voluntary, and you are free to leave the trial at any time without your regular NHS care being affected in any way.

Locations (4)

King's College London
Approximate
London, England
Birmingham University
Approximate
Birmingham, England
Oxford University
Approximate
Oxford, England
Newcastle University
Approximate
Newcastle, England

Common questions

Will I have to change my current medications?

No. You will continue taking your prescribed bipolar medication and receiving your usual NHS care throughout the trial.

What happens during cognitive remediation therapy (CRT)?

CRT involves guided mental exercises, problem-solving activities, and discussions with a therapist to help you find practical ways to manage memory and concentration in daily life.

Do I have to pay to take part?

No. Taking part in this NHS-funded research trial is entirely free.

Can I choose which group I am in?

No. A computer puts you into a group at random. This ensures the trial results are fair and reliable.

What if I decide I want to stop?

You can leave the study at any point without giving an explanation. Leaving will not change your relationship with your doctors or affect your normal treatment.

How to find out more

Dimosthenis Tsapekos

dimosthenis.tsapekos@kcl.ac.uk n/a Official trial record

Always speak to your GP or specialist before deciding to take part in a study.