Mental health system funding of cognitive enhancement interventions for schizophrenia: Summary and update of the New York Office of Mental Health expert panel and stakeholder meeting.

McGurk, Susan R.; Mueser, Kim T.; Covell, Nancy H.; Cicerone, Keith D.; Drake, Robert E.; Silverstein, Steven M.; Medialia, Alice; Myers, Robert W.; Bellack, Alan S.; Bell, Morris D.; Essock, Susan M.

doi:10.1037/prj0000020

Cited by 49 publications

(43 citation statements)

References 96 publications

(168 reference statements)

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“…This includes psychosocial functioning and the economic impact to the country through job loss by patients with schizophrenia (Rosenheck et al, 2006). Programs to enhance social rehabilitation, and facilitate work functioning for patients with schizophrenia have increased in number and in sophistication (Bond et al, 2012; McGurk et al, 2013; McGorry et al, 2013; Mueser et al, 2013). …”

Section: Introductionmentioning

confidence: 99%

A 20-Year multi-followup longitudinal study assessing whether antipsychotic medications contribute to work functioning in schizophrenia

Harrow

Jobe

Faull

et al. 2017

Psychiatry Research

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To assess the long-term effectiveness of antipsychotic medications in facilitating work functioning in patients with schizophrenia we conducted longitudinal multi followup research on 139 initially psychotic patients. The 70 patients with schizophrenia and 69 initially psychotic mood disordered control patients were followed up 6 times over 20 years. We compared the influence on work functioning of patients with schizophrenia continuously prescribed antipsychotics with patients with schizophrenia not prescribed antipsychotics, using statistical controls for inter-subject differences. While antipsychotics reduce or eliminate flagrant psychosis for most patients with schizophrenia at acute hospitalizations, four years later and continually until the 20 year followups, patients with schizophrenia not prescribed antipsychotics had significantly better work functioning. The work performance of the patients who were continuously prescribed antipsychotics was at a low rate and did not improve over time. Multiple other factors also interfere with work functioning. The data suggest that some patients with schizophrenia not prescribed antipsychotics for prolonged periods can function relatively well. Multiple other factors are associated with poor post-hospital work performance. The longitudinal data raise questions about prolonged treatment of schizophrenia with antipsychotic medications.

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Section: Introductionmentioning

confidence: 99%

A 20-Year multi-followup longitudinal study assessing whether antipsychotic medications contribute to work functioning in schizophrenia

Harrow

Jobe

Faull

et al. 2017

Psychiatry Research

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“…These interventions target cognitive impairments with the ultimate goal of improving real-world role functioning (Medalia & Choi, 2009). Numerous studies have demonstrated that cognitive remediation (CR) can improve cognitive and role functioning in individuals with schizophrenia (McGurk et al, 2013; McGurk, Twamley, Sitzer, McHugo, & Mueser, 2007; Twamley, Vella, Burton, Heaton, & Jeste, 2012; Wykes, Huddy, Cellard, McGurk, & Czobor, 2011), with recent meta-analyses of the CR literature indicating medium-sized effects of CR on cognition and small-to-medium effects on psychosocial functioning.…”

Section: Introductionmentioning

confidence: 99%

Visual perceptual remediation for individuals with schizophrenia: Rationale, method, and three case studies.

Butler

Thompson²,

Seitz³

et al. 2017

Psychiatric Rehabilitation Journal

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Objective Few studies have evaluated the effects of visual-remediation strategies in schizophrenia despite abundant evidence of visual-processing alterations in this condition. Here we report preliminary, case study-based evidence regarding the effects of visual remediation in this population. Methods We describe the implementation of a visual-perceptual training program called ULTIMEYES (UE) and initial results through three brief case studies of individuals with schizophrenia. UE targets broad-based visual function, including low-level processes (e.g., acuity, contrast sensitivity), as well as higher-level visual functions. Three inpatients, recruited from a research unit, participated in at least 38 sessions 3–4 times per week for approximately 25 minutes per session. Contrast sensitivity (a trained task), as well as acuity and perceptual organization (untrained tasks), were assessed before and after the intervention. Levels of progression through the task itself are also reported. Results UE was well-tolerated by the participants and led to improvements in contrast sensitivity, as well as more generalized gains in visual acuity in all three participants and perceptual organization in two participants. Symptom profiles were somewhat different for each participant, but all were actively symptomatic during the intervention. Despite this, they were able to focus on and benefit from the training. The adaptive nature of the training was well-suited to the slower progression of two participants. Conclusions and Implications for Practice These case studies set the stage for further research, such as larger, randomized controlled trials of the intervention that include additional assessments of perceptual function and measures of cognition, social cognition, and functional outcomes.

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“…Thus specific recommendations regarding cognitive remediation for other disorders would be premature, although studies of cognitive remediation for cognitive deficits in affective disorders show promise (41). It should also be noted that recently published consensus recommendations by McGurk and colleagues (42) describe the specific parameters of cognitive remediation programs that are likely to be successful in improving psychosocial functioning.…”

Section: Level Of Evidencementioning

confidence: 99%

Skill Building: Assessing the Evidence

Lyman¹,

Kurtz²,

Farkas³

et al. 2014

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Objective: Skill building for adults involves multiple approaches to address the complex problems related to serious mental illness. Individuals with schizophrenia are often the research focus. The authors outline key skillbuilding approaches and describe their evidence base. Methods: Authors searched meta-analyses, research reviews, and individual studies from 1995 through March 2013. Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, ERIC, and CINAHL. Authors chose from three levels of evidence (high, moderate, and low) on the basis of benchmarks for the number of studies and quality of their methodology. They also described the evidence of service effectiveness. Results: Over 100 randomized controlled trials and numerous quasi-experimental studies support rating the level of evidence as high. Outcomes indicate strong effectiveness for social skills training, social cognitive training, and cognitive remediation, especially if these interventions are delivered through integrated approaches, such as Integrated Psychological Therapy. Results are somewhat mixed for life skills training (when studied alone) and cognitive-behavioral approaches. The complexities of schizophrenia and other serious mental illnesses call for individually tailored, multimodal skill-building approaches in combination with other treatments. Conclusions: Skill building should be a foundation for rehabilitation services covered by comprehensive benefit plans that attend to the need for service packages with multiple components delivered in various combinations. Further research should demonstrate more conclusively the long-term effectiveness of skill building in real-life situations, alone and in various treatment combinations. Studies of diverse subpopulations are also needed. (Psychiatric Services 65:727-738, 2014; doi: 10.1176/appi.ps.201300251) D eveloping or regaining basic skills needed to function adaptively in real-world situations is essential for individuals who are struggling with serious mental illness, substance use disorders, or co-occurring mental and substance use disorders. The neurodevelopmental nature of certain severe mental illnesses (1)-in which multiple and complex skill deficits emerge early in development, persist through adulthood in the absence of targeted treatment, and affect virtually every aspect of life functioning-has led to a vast array of approaches to skill building. These approaches are typically applied in various combinations.The inherent complexity of skill building adds a high degree of challenge to assessing levels of evidence and effectiveness for such a diverse array of treatment modalities and methods. In this review, we examined four key components of skill building: social skills training (including life skills training), social cognitive training, cognitive remediation, and cognitivebehavioral therapies that target skills for coping with psychotic pr...

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Mental health system funding of cognitive enhancement interventions for schizophrenia: Summary and update of the New York Office of Mental Health expert panel and stakeholder meeting.

Cited by 49 publications

References 96 publications

A 20-Year multi-followup longitudinal study assessing whether antipsychotic medications contribute to work functioning in schizophrenia

A 20-Year multi-followup longitudinal study assessing whether antipsychotic medications contribute to work functioning in schizophrenia

Visual perceptual remediation for individuals with schizophrenia: Rationale, method, and three case studies.

Skill Building: Assessing the Evidence

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