A systematic review and meta-analysis of cognitive remediation in early schizophrenia

Revell, Emily R.; Neill, Joanna C.; Harte, Michael K.; Khan, Zarshed; Drake, Richard

doi:10.1016/j.schres.2015.08.017

Cited by 172 publications

(126 citation statements)

References 38 publications

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“…More recent studies show that cognitive remediation in early psychosis has an impact on various aspects of schizophrenia such as cognition, functioning, and symptoms (41, 42). According to other works, cognitive remediation appears less effective in young populations than in patients with chronic conditions (43). …”

Section: Resultsmentioning

confidence: 92%

Rehabilitation Interventions to Promote Recovery from Schizophrenia: A Systematic Review

2017

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Only one out of seven patients recovers after a first episode of psychosis despite psychiatric care. Rehabilitation interventions have been developed to improve functional outcomes and to promote recovery. We conducted a systematic review of the effectiveness of the main psychiatric rehabilitation interventions following a search of the electronic databases Pubmed, ScienceDirect, and Google Scholar using combinations of terms relating to cognitive remediation, psychoeducation, cognitive-behavioral therapies, and schizophrenia. Eighty articles relevant to the topic of interest were found. According to results, cognitive remediation has been found to be effective in reducing the impact of cognitive impairment, social skills in the learning a variety of skills and to a lesser extent in reducing negative symptoms, psychoeducation in improving compliance and reducing relapses, and cognitive therapy in reducing the intensity of or distress related to positive symptoms. All psychosocial rehabilitation interventions should be considered as evidence-based practices for schizophrenia and need to become a major part of the standard treatment of the disease.

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Section: Resultsmentioning

confidence: 92%

Rehabilitation Interventions to Promote Recovery from Schizophrenia: A Systematic Review

2017

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“…A meta-analysis of CR in first episode patients (Revell, Neill, Harte, Khan, & Drake, 2015) found a similar pattern but lessor degree of improvement in cognition, symptoms and functioning than the Wykes et al (2011) meta-analysis found with older, chronic patients. However, a direct comparison of CR response in early versus chronic phase patients by Bowie et al (2014) found an inverse relationship between duration of illness and improvements in neurocognition and real-world skills following CR.…”

Section: Biological Characteristics As a Tailoring Variablementioning

confidence: 84%

Personalised treatment for cognitive dysfunction in individuals with schizophrenia spectrum disorders

Medalia

Saperstein

Hansen

et al. 2016

Neuropsychological Rehabilitation

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Cognitive deficits are a well-recognized issue for individuals diagnosed with schizophrenia spectrum disorders. Despite positive group findings for the use of cognitive remediation (CR) interventions, there are substantial individual differences in response to treatment. In addition, the aggregate CR literature reports low moderate effect sizes for cognitive and functional outcomes. Based on personalized medicine theory, this paper uses extant CR literature to examine the individual characteristics determined to predict treatment response. These characteristics, which fall into the broad categories of cognitive, psychological, and biological can be used as tailoring variables to personalize CR to an individual’s unique profile. Personalization through the use of these tailoring variables has the potential to improve the delivery of CR to maximize treatment outcomes.

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“…However, these subclinical deficits can be addressed at a young age through the development of social skills. These deficits can also be combatted using early preventive training programs (Maag, 2006) focusing on the attribution of emotional states or even possibly on the improvement of executive functions, similar to the cognitive remediation of schizophrenia (Revell et al, 2015). For further research, it is necessary to understand how different aspects of ToM deficits have psychological consequences: how they contribute to the difficulties an individual faces in adjusting to their social environment, an individual’s quality of life, and the alternative coping strategies used by people with high trait schizotypy.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Correlates of Different Mentalizing Abilities in Individuals with High and Low Trait Schizotypy: Findings from an Extreme-Group Design

et al. 2017

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Mentalizing or Theory of Mind (ToM) deficits in schizophrenia have been studied to great extent, but studies involving samples of trait schizotypy yield ambiguous results. Executive functions like cognitive inhibition, cognitive flexibility, and agency are all prerequisites of mentalizing, and it is assumed that the impairment of these functions contributes to ToM deficits in schizophrenia. Whether these impairments influence the ToM performance of people with high trait schizotypy remains unclear. Although impaired self-agency has repeatedly been identified in people with schizotypy, its role in mentalizing is yet to be investigated. The main aim of this study was to explore whether deficits in cognitive and affective ToM can be found in high trait schizotypy, and to identify in what way these deficits are related to the positive and negative dimensions of schizotypy. The secondary aim was to examine whether these deficits correlate with executive functions. Based on the dimensional view of the schizophrenia spectrum, an extreme-group design was applied to non-clinical volunteers demonstrating high (N = 39) and low (N = 47) trait schizotypy. Affective and cognitive ToM were investigated using the Movie for Assessment of Social Cognition, a sensitive and video-based measurement. Cognitive inhibition was assessed using the Stroop Test, and cognitive flexibility was analyzed using the Trail-Making Test. Agency was measured using a computerized self-agency paradigm. Participants in the high-schizotypy group performed significantly worse in the affective ToM task (d = 0.79), and their overall ToM performance was significantly impaired (d = 0.60). No between-group differences were found with regards to cognitive ToM, executive functions, and self-agency. Cognitive flexibility correlated negatively with positive schizotypy, and contributed to a worse overall and affective ToM. Impaired cognitive inhibition contributed to undermentalizing-type errors. It was found that non-clinical participants with high trait (positive) schizotypy – especially those with slight executive-function deficits – may have difficulties in understanding the emotional state of others and consequently in functioning in social situations.

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A systematic review and meta-analysis of cognitive remediation in early schizophrenia

Cited by 172 publications

References 38 publications

Rehabilitation Interventions to Promote Recovery from Schizophrenia: A Systematic Review

Rehabilitation Interventions to Promote Recovery from Schizophrenia: A Systematic Review

Personalised treatment for cognitive dysfunction in individuals with schizophrenia spectrum disorders

Cognitive Correlates of Different Mentalizing Abilities in Individuals with High and Low Trait Schizotypy: Findings from an Extreme-Group Design

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