Feasibility and effectiveness of a cognitive remediation programme with original computerised cognitive training and group intervention for schizophrenia: a multicentre randomised trial

Abstract

Devising new methods to improve neurocognitive impairment through cognitive remediation is an important research goal. We developed an original computer programme termed the Japanese Cognitive Rehabilitation Programme for Schizophrenia (JCORES) that provides cognitive practice across a broad range of abilities. The current study examined for the first time whether a cognitive remediation programme, including both computerised cognitive training using JCORES and group intervention such as enhancing meta-cognition and teaching strategies, is more effective than treatment as usual for improving neurocognitive and social functioning. Sixty-two outpatients with schizophrenia were randomised to either a cognitive remediation group or a control group. Participants engaged in two computerised cognitive training sessions and one group meeting per week for 12 weeks. The average number of total sessions attended (computerised cognitive practice + group intervention) was 32.3 (89.7%). The cognitive remediation group showed significantly more improvements in verbal memory, composite score of the Brief Assessment of Cognition in Schizophrenia, Japanese version (BACS-J), and general psychopathology on the Positive and Negative Syndrome Scale (PANSS) than the control group. These findings demonstrate that a cognitive remediation programme is feasible in Japan and is a more effective way to improve neurocognitive functioning and psychiatric symptoms.

Computer-assisted cognitive remediation therapy increases hippocampal volume in patients with schizophrenia: a randomized controlled trial

“…Fourth, we did not control for any potential antipsychotic drug effects. The synergistic effect of neurocognitive remediation combined with antipsychotic drugs is unknown [ 11 ], and some antipsychotics may affect cerebral parenchymal volume [ 33 ]. Thus, future studies should regulate medications as much as possible.…”

“…For 12 weeks, the CRT group completed twice-weekly, hour-long computerized training sessions and weekly, hour-long group sessions, the purposes of which were to help establish associations between the computerized CRT and daily life or work performance as well as to aid in setting and tracking each participant’s individualized community life and/or work goals [ 7 ]. This study’s VCAT-J training procedures were identical to those of our previous study [ 11 ]. Psychiatrists or psychologists with computer-assisted CRT [ 6 ] study experience monitored all VCAT-J sessions.…”

“…We developed a program called the Japanese Cognitive Rehabilitation Program for Schizophrenia (Jcores). Recent studies have shown that a 12-week CRT program using Jcores (Vocational Cognitive Ability Training by Jcores [VCAT-J]) improves neurocognitive performance [ 11 ].…”

Neural changes following cognitive remediation therapy for schizophrenia

“…assessed changes in the brain structure after Vocational Cognitive Ability Training by the Japanese Cognitive Rehabilitation Program for Schizophrenia (VCAT‐J) in 31 patients . VCAT‐J consists of both 24 h of computer‐based cognitive training and 12 h of group meetings for 12 weeks . Voxel‐based morphometry analysis resulted in increased right hippocampal GM volume in the VCAT‐J group compared with the control group.…”

“…Some top‐down methods emphasize that cognitive exercise should involve context associated with daily life or job, rather than training focusing on specific cognitive domains . Group sessions, which are generally conducted together with computer programs, are designed to facilitate connections between CRT and everyday life or business as well as to help to set and achieve each individual's goals …”