Advances in Cognitive Remediation Training in Schizophrenia: A Review

Abstract

Cognitive Remediation Training (CRT) in schizophrenia has made great strides since its introduction in the 1990s. CRT was developed with the aim of improving the everyday functioning of individuals living with cognitive impairment. MEDLINE, PsychINFO, and Google Scholar were searched to extract peer-reviewed randomized controlled trials to produce the current review article. The aim of the present review is to summarize CRT effects on addressing cognitive changes in patients undergoing CRT as defined by the Cognitive Remediation Experts Workshop and to describe the areas of greatest impact in specific cognitive domains. Another area of this review aims to summarize the modalities of intervention (paper and pencil; computerized; home bound), the persistence of improvements, and their generalization to other domains of functioning. Finally, this review delineates barriers for wider dissemination of CRT, such as the transfer of research findings into clinical everyday practice and future developments of CRT.

THINC-Integrated Tool (THINC-it): A Brief Measurement of Changes in Cognitive Functioning and Its Correlation with the Life Quality of Patients with Schizophrenia and Related Disorders—A Pilot Study

“…Improvements in cognitive functions have been associated with increased activation of the inferior frontal gyrus, and increased activation in the frontal, parietal, inferior frontal junction, and visual cortex [ 20 ]. These findings were replicated by separate groups who also observed increases in left lateral prefrontal activation [ 21 , 22 ]. Improvement of the medial prefrontal activation pattern was also observed after cognitive remediation with word generalization tasks and recognition tasks.…”

“…Despite several attempts to develop novel drugs for the treatment of cognitive impairment in schizophrenia in the last years [ 19 ], still, no pharmacological treatment is registered for this indication. Emerging evidence indicates that cognitive remediation may be capable of improving measures of cognitive functions in persons living with schizophrenia [ 20 , 21 ]. Improvements in cognitive functions have been associated with increased activation of the inferior frontal gyrus, and increased activation in the frontal, parietal, inferior frontal junction, and visual cortex [ 20 ].…”

The importance of improving cognitive flexibility in adolescents with anorexia nervosa: The case for cognitive remediation therapy

“…CRT programs have demonstrated efficacy in improving targeted EF skills with lasting improvements (Fitapelli & Lindenmayer, 2022).…”

“…Ongoing interest in the use of CRT to improve cognitive functioning was seen in the 1970s for use in individuals with schizophrenia (Boake, 1989). Given the robust literature supporting CRT in schizophrenia (Fitapelli & Lindenmayer, 2022), it is not surprising that it began to be used as an adjunctive treatment for other psychiatric conditions in which EF impairments are found (e.g., depression; Bowie et al, 2013).…”

“…CRT programs have demonstrated efficacy in improving targeted EF skills with lasting improvements (Fitapelli & Lindenmayer, 2022). Despite that, there has been some criticism that skills may not be transferred to everyday functioning or to other domains (Mendella et al, 2015).…”