The effect of self-monitoring on Wisconsin Card Sorting Test performance in euthymic patients with bipolar disorder: a pilot study.

OBJECTIVES: Euthymic patients with bipolar disorder (BD) show executive impairment. Assisting cognitive function with non-pharmacological strategies has not been widely explored in BD. In schizophrenia, concomitant verbalisation (self-monitoring) during executive tests improved performance. The present pilot study assesses the effects of self-monitoring whilst completing the Wisconsin Card Sorting Test (WCST) in BD patients.

METHODS: Thirty-six euthymic BD patients and 42 healthy controls participated. Twenty patients with BD and 20 controls received standard administration and 16 patients and 22 controls used self-monitoring during the test.

RESULTS: ANCOVA revealed a significant "group by administration" interaction. Patients who received the standard administration were significantly worse than healthy controls (trials administered: p = .012, η p (2) = 0.17; trials to first category: p = .046, η p (2) = 0.11; failure to maintain set: p = .003, η p (2) = 0.23). BD patients who self-monitored performed significantly better than patients receiving the standard administration (trials to first category: p = .020, η p (2) = 0.17) and showed no significant differences in performance compared to controls.

CONCLUSION: Self-monitoring deserves further investigation as a tool that may be helpful for patients with BD. Further exploration of the utility, generalisability, and stability of the effects of self-monitoring is needed.