Abstract
Computer-assisted cognitive remediation (CACR) is an economical, adjustable, and effective treatment for individuals with schizophrenia. The current randomized controlled study examined whether an individualized or generic exercise plan in CACR is superior in patients with multiple cognitive deficits compared to treatment-as-usual (TAU). Fifty-nine inpatients diagnosed with schizophrenia were randomly assigned to 1) TAU, 2) TAU plus an individualized exercise plan in CACR, or 3) TAU plus a generic exercise plan in CACR. Neuropsychological performance, psychopathology, and functional outcome were assessed at baseline and post-treatment. The results show a medium to large training effect for all neuropsychological performance measures. Contrary to our expectations the neuropsychological improvement over time did not differ between groups. Self-reported depression, global level of functioning, and activity and participation functioning showed a significant improvement from baseline to post-treatment. However no further group, time, or interaction effects for other psychopathology and functional outcome could be demonstrated. Possible implications for clinical use of CACR and future studies are discussed.
Highlights
The Cognitive Remediation Expert Working Group defines cognitive remediation as a “behavioral training intervention targeting cognitive deficits, using scientific principles of learning, with the ultimate goal of improving functional outcomes
They report significant small to medium treatment effects for attention, working memory, positive symptoms, and depressive symptoms. They questioned the generalization of treatment effects due to the absence of further significant effects on other neuropsychological measures as well as functional outcome and social cognition
In addition baseline assessment included psychopathology, neuropsychological performance, and functional outcome measures, which are described in more detail below
Summary
The Cognitive Remediation Expert Working Group defines cognitive remediation as a “behavioral training intervention targeting cognitive deficits (attention, memory, executive function, social cognition, or metacognition), using scientific principles of learning, with the ultimate goal of improving functional outcomes. Its effectiveness is enhanced when provided in a context (formal or informal) that provides support and opportunity for extending to everyday functioning” [1]. Konings [6] meta-analysis included 24 studies using CACR for improving cognitive functioning in schizophrenia. They report significant small to medium treatment effects for attention, working memory, positive symptoms, and depressive symptoms. They questioned the generalization of treatment effects due to the absence of further significant effects on other neuropsychological measures as well as functional outcome and social cognition
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