Cognitive, creative, functional, and clinical symptom improvements in schizophrenia after an integrative cognitive remediation program: a randomized controlled trial

Agurne Sampedro,Mikel Tous-Espelosin,Pedro Sánchez,Nagore Iriarte-Yoller,Cristóbal Pavón,Ainara Gómez-Gastiasoro,Javier Peña,Natalia Ojeda,Naroa Ibarretxe-Bilbao

doi:10.1038/s41537-021-00181-0

Agurne Sampedro, Mikel Tous-Espelosin + Show 7 more

Open Access

https://doi.org/10.1038/s41537-021-00181-0

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Abstract

This study analyzed the effectiveness of an integrative cognitive remediation program (REHACOP) in improving neurocognition, social cognition, creativity, functional outcome, and clinical symptoms in patients with schizophrenia. In addition, possible mediators predicting improvement in functional outcomes were explored. The program combined cognitive remediation with social cognitive training and social and functional skill training over 20 weeks. The sample included 94 patients, 47 in the REHACOP group and 47 in the active control group (occupational activities). Significant differences were found between the two groups in change scores of processing speed, working memory, verbal memory (VM), inhibition, theory of mind, emotion processing (EP), figural creative strengths, functional competence, disorganization, excitement, and primary negative symptoms. A mediational analysis revealed that changes in VM, inhibition, and EP partially explained the effect of cognitive remediation on functional competence improvement. This study provides initial evidence of the effect of integrative cognitive remediation on primary negative symptoms and creativity.

Highlights

Schizophrenia is considered to be one of the most disabling diseases in the world[1]
People who suffer from it have a high level of dependency in multiple functional domains at very early ages[2,3], and this functional disability has a major impact on the quality of life of both patients and caregivers or relatives[4]
Statistical analyses between receiving cognitive remediation and functional outcome were performed with the 94 randomized patients, following the improvement

Summary

Introduction

Schizophrenia is considered to be one of the most disabling diseases in the world[1]. It has been suggested that other positive personal resources such as creative capacity may have an influence on the functional outcome of people with this disease[9,17,18]. All these findings suggest that interventions aimed at improving these factors could improve functional outcomes. In the last two decades, various meta-analyses have concluded that cognitive remediation is effective in improving neurocognition and social cognition, and clinical symptoms and functional outcomes of people with schizophrenia[19,20,21,22,23]

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