Combined social cognitive and neurocognitive rehabilitation strategies in schizophrenia: neuropsychological and psychopathological influences on Theory of Mind improvement

Abstract

Background. Neurocognitive and social cognitive impairments represent important treatment targets in schizophrenia, as they are significant predictors of functional outcome. Different rehabilitative interventions have recently been developed, addressing both cognitive and psychosocial domains. Although promising, results are still heterogeneous and predictors of treatment outcome are not yet identified. In this study we evaluated the efficacy of two newly developed social cognitive interventions, respectively based on the use of videotaped material and comic strips, combined with domainspecific Cognitive Remediation Therapy (CRT). We also analysed possible predictors of training outcome, including basal neurocognitive performance, the degree of cognitive improvement after CRT and psychopathological variables.Method. Seventy-five patients with schizophrenia treated with CRT, were randomly assigned to: social cognitive training (SCT) group, Theory of Mind Intervention (ToMI) group, and active control group (ACG).Results. ANOVAs showed that SCT and ToMI groups improved significantly in ToM measures, whereas the ACG did not. We reported no influences of neuropsychological measures and improvement after CRT on changes in ToM. Both paranoid and non-paranoid subjects improved significantly after ToMI and SCT, without differences between groups, despite the better performance in basal ToM found among paranoid patients. In the ACG only non-paranoid patients showed an improvement in non-verbal ToM. Conclusion.Results showed that both ToMI and SCT are effective in improving ToM in schizophrenia with no influence of neuropsychological domains. Our data also suggest that paranoid symptoms may discriminate between different types of ToM difficulties in schizophrenia.

Combining social cognitive treatment, cognitive remediation, and functional skills training in schizophrenia: a randomized controlled trial

“…Generally speaking, our study found positive results similar to other recently published integrative approaches, 9,12,14 including the previous trial with the first version of REHACOP. 13 Unfortunately, direct comparisons with these previous results with REHACOP are very difficult. The main reasons are different clinical profile of the patients, the different duration of both versions of the intervention, and differences between outcome measures (UPSA versus WHO-DAS).…”

“…More recently, some authors combined cognitive remediation with social cognitive remediation 9,12,13 obtaining better results than patients receiving cognitive remediation alone in several domains. There is additional evidence that the combination of different trainings reciprocally boosts the effects of the treatments.…”

Achieving recovery in patients with schizophrenia through psychosocial interventions: A retrospective study

“…All enrolled patients underwent 6 months of rehabilitation, including both computer‐assisted cognitive remediation therapy and standard rehabilitation therapy, detailed in previous studies . Of the 104 enrolled patients, 58 patients were treated also with sociocognitive rehabilitation programs that have been previously demonstrated to improve theory of mind (ToM) and are described in detail in previous studies . After these interventions, patients were followed naturalistically in different settings, mainly at the clinic as outpatients.…”

Cognition and Related Neural Findings on Methamphetamine Use Disorder: Insights and Treatment Implications From Schizophrenia Research

“…Bechi and colleagues (168) showed that combination of CRT and social cognitive or ToM training improved social cognitive abilities even further than CRT alone in people with schizophrenia (168). ToM training involves reading comic strips to be trained to recognize relevant details and collect and meaningful pieces of information such as place, time, characters' actions, and physical features.…”