107. Ten-Year Durability Effects of Cognitive Enhancement Therapy in Early Course Schizophrenia

Abstract

Abstract Background: The purpose of this investigation was to examine the long-term trajectories of cognitive, functional, and clinical outcomes following Cognitive Enhancement Therapy (CET) in early course schizophrenia. Methods: Schizophrenia outpatients from a 2-year randomized clinical trial of CET applied in the early course of the illness (Eack et al., 2009) are completing a 10-year post-treatment follow-up study. Currently, a total of 25 participants (CET: n = 14; EST: n = 11) from the original trial have completed a comprehensive battery of cognitive, functional, and clinical assessments identical to those in the original trial. Composite indexes were calculated for processing speed, neurocognition, social cognition, functioning, and symptomatology. Linear growth curve models were used to examine longitudinal durability differences in these five domains 10-years following treatment with either CET or an Enriched Supportive Therapy (EST) comparison treatment. Results: Social-cognitive ability favoring CET was stable across the 10-year follow-up period, with continued evidence of group separation (F = 2.76, P = .049) and no evidence of erosion of efficacy (t = 1.53, P = .130). Some reduction in functioning was observed in both groups after completing treatment (all P < .001), but after 10 years patients in CET retained a higher level of functioning over the follow-up period (F = 3.32, P = .025). To our surprise, both groups displayed a steady improvement in neurocognition over the 10-year period (all P < .001). As reported in the original trial, no impact on processing speed was observed among these previously early course patients who exhibited high levels of baseline speed of processing (F = .52, P = .673). Finally, group separation favoring CET in symptomatology continued to persist relative to EST over the course of 10-year follow-up (F = 4.25, P = .009). Conclusion: Although these data are considered preliminary, the results suggest that CET is an effective treatment that contributes to long-term and stable improvements in cognition and functional outcome in people with schizophrenia treated in the early course of the illness.Eack, S. M., Greenwald, D. P., Hogarty, S. S., Cooley, S. J., DiBarry, A. L., Montrose, D. M., & Keshavan, M. S. (2009). Cognitive enhancement therapy for early-course schizophrenia: effects of a two-year randomized controlled trial. Psychiatric Services, 60(11), 1468–1476.