221. Cognitive Remediation for Individuals With Psychosis: Efficacy and Mechanisms of Treatment Effects
Year: 2017
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Background: While numerous trials have reported on the efficacy of cognitive remediation (CR), it is still not considered an evidence-based treatment and very little is known about mechanisms through which it may exert effects on functioning, as well as what variables predict a positive treatment response. In the current study, we evaluated both proximal and distal effects of CR, and examined predictors and potential mechanisms of treatment effects. Methods: Seventy-five individuals with psychosis were randomized to a combination of strategy-based and drill-and-practice cognitive remediation (CR) or Treatment as Usual (TAU), with assessments of training task performance, neurocognition, functional capacity, symptoms and functioning at baseline, end of the 2-month intervention, and 2-month follow-up (FU). Results: Compared to TAU, CR was associated with large post-training improvements on training tasks targeting attention, visuospatial memory, and verbal learning and memory, with group differences persisting over the FU period. These gains generalized to sustained, mostly large improvements on neuropsychological measures of visuospatial memory, verbal learning and memory, delayed verbal memory, and verbal working memory. While there were no CR-associated improvements on measures of functional capacity, symptoms, or a self-report measure of independent living skills, there was a durable effect on an interviewer-rated measure of functioning (Quality-of-Life Scale), which appeared primarily driven by the Intrapsychic Foundations subscale. For those randomized to CR, there were significant though nonspecific medium-sized correlations between changes on most of the significantly improved training tasks, neuropsychological and functioning measures. The impact of baseline demographic and illness characteristics on training task, neurocognitive and functional improvements is also reported. Conclusion: Our findings suggest a complex, multifactorial relationship between CR, cognitive and functional change.
Source: Schizophrenia Bulletin
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2598189698