Computer-aided neurocognitive remediation in schizophrenia: Durability of rehabilitation outcomes in a follow-up study

Abstract

Cognitive deficits in patients with schizophrenia constitute a limiting factor to the chances of rehabilitation of daily living abilities, like personal and relational autonomy and working ability. Cognitive Remediation Therapy (CRT) is a rehabilitative technique that aims at the recovery of single cognitive functions through the execution of massive exercises of impaired cognitive domains. This study aims to establish if the results achieved through an intensive deficit-specific neurocognitive treatment of three months duration, were maintained over time. The sample consists in 100 patients diagnosed with schizophrenia according to the criteria of DSM IV. Patients were assessed on cognitive and daily functioning at baseline, after 3 months of either CRT or placebo training added to their standard rehabilitation treatment, at 6 month and 12-month follow-up. Results showed significant changes that were maintained at follow-up for executive function, attention and psychomotor coordination. Moreover the significant improvement in daily functioning was maintained at 6 and 12-month follow-up. In conclusion improvements in cognitive functions and daily functioning achieved through the association of CRT and standard rehabilitation treatment persist over time after the conclusion of the training period.

A systematic review on improving cognition in schizophrenia: which is the more commonly used type of training, practice or strategy learning?

“…Though it is not the goal of our review, it is important to note that all articles with drill and strategy approaches to training reported between-group improvements of the targeted deficits. Furthermore, eight of the 17 studies with follow up measures at either three, four or six months also reported sustained gains in cognition [25,32,37,41,45,47,48,50],[64]. …”

“…However, we could not determine whether one specific domain of neurocognition was more easily retrained than another with drill and practice vs. drill and strategy procedures. Furthermore, most studies were of short duration and only a few had follow up measures (e.g., drill and strategy n = 8 [25,32,37,41,45,47-49]; drill and practice n = 7 [52,55,60,63-65,82]. This could be improved upon in future studies, since it is difficult under these circumstances to decide whether the observed effects are maintained over time or not.…”

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

“…To date, there is still no standard scale to evaluate recovery; however, several authors have agreed that occupational/vocational status, independent living, and social activities represent key domains . Given that the QLS explores all of these areas and that it has previously been used as a measure of daily functioning, in this study, QLS was used as a recovery rating scale. To evaluate recovery, we considered a score of 41.9 as a cut‐off of the QLS total score, based on the work of Ascher‐Svanum et al …”

Neuroscience‐informed computer‐assisted cognitive training in schizophrenia

“…In the first study, Lindenmayer et al found greater improvement in verbal learning and speed of processing in the cognitive-training group at posttraining. 66 In the second study, Cavallero et al 68 found significant gains on measures of attention, reasoning and problem solving, and functioning, as well as durability of gains at 6-and 12-month follow-up, 69 in the cognitive-training group relative to the control group.…”

“…Subjects who completed Cogpack showed gains in attention, reasoning and problem solving, and functioning, 68 and durability of gains at 6-and 12-month follow-up. 69 Both participants and staff who provided clinical ratings were blind to group assignment; however, cognitive assessors were not blind.…”