Many people with severe mental illness (SMI), such as schizophrenia or bipolar disorder, experience problems in daily life. This can include household skills (shopping, cleaning) and the organization of daily life (keeping a schedule, managing finances). These problems can be so severe that they lose their independence and need to rely on forms of supported living. These daily life problems can be caused by cognitive problems. In this study, we examine whether the combination of two different treatments can lead to improvements in their cognitive and daily functioning.

Cognitive Remediation Training is a psychological intervention aimed at improving cognitive functions, such as attention, memory, and planning. By enhancing these cognitive abilities, the training also aims to improve daily functioning. The specific training we are investigating is the digital program CIRCuiTS (Computerised Interactive Remediation for Cognition and Thinking Skills, https://www.circuitstherapyinfo.com/). This program offers various exercises that help people gain insight into their cognitive abilities. They learn about both their strengths and areas for improvement. Additionally, they learn strategies to better manage their cognitive challenges and apply these strategies in daily life. Previous studies in other groups have shown that this form of cognitive remediation indeed helps people improve their daily functioning.

Furthermore, we are investigating whether adding mild brain stimulation (transcranial Direct Current Stimulation, tDCS) can enhance the effectiveness of the training. With tDCS, we stimulate specific brain areas important for learning new skills. We hope that this will help people learn the skills from CIRCuiTS faster and that the learning effects will last longer.

Following the successful HEADDSET pilot study (Poppe et al., submitted), funded by Stichting tot Steun, in which we investigated whether the combination of Cognitive Remediation and tDCS was feasible and acceptable, we are now starting a large multicenter trial called HEADDSET+ (HErstel bevorderen door ADDitieve effecten van hersenStimulatie En cognitieve remediatie Training). In this study, we examine whether Cognitive Remediation is effective for people with SMI and whether the combination of Cognitive Remediation and tDCS is more effective than Cognitive Remediation alone.

From the pilot study, we learned that setting goals in advance can be helpful, and we added other questionnaires and cognitive tests to gain better insight into cognitive and daily functioning. Additionally, multiple institutions (Cosis, GGZ Friesland, and Lentis) are participating, and we aim to include a larger group of participants (goal: 126).

This research is made possible by a grant from the Hersenstichting.

Project Partners:  

  • Rijksuniversiteit Groningen
  • Lentis
  • Cosis
  • GGZ Friesland
  • RGOc
  • De Hersenstichting

Involved GRIP researchers:  

  • Nienke Buist, MSc
  • Anika Poppe, MSc
  • Dr. Lisette van der Meer

Others involved:  

  • Prof. dr. Marieke Pijnenborg (Rijksuniversiteit Groningen en GGZ Drenthe) 
  • Dr. Branislava Curcic-Blake (Cognitive Neuroscience Center, Universitair Medisch Centrum Groningen)
  • Dr. Leonie Bais (formerly at Lentis Psychiatric Institute)
  • Dr. DaniĆ«lle van Duin (Kenniscentrum Phrenos)