Impact of an intervention of neuro-cognitive rehabilitation in treatment resistant schizophrenia (TRS) compared to schizophrenia responder patients

Abstract

IntroductionSchizophrenia is a condition with high impact in terms of disability, also because between 30% and 60% affected individuals do not respond to treatment. It has been proposed that cognitive functioning is strongly impaired in schizophrenia and even more in TRS patients. Cognitive dysfunctions are regarded to worsen psychopathology, psychosocial functioning, and overall course of the illness.ObjectivesTo investigate the impact of Cognitive Remediation (CR) on psychopathology and psychosocial functioning in TRS vs. schizophrenia responder patients.AimsTo determine whether a CR intervention could improve functional outcomes in TRS patients.MethodsWe evaluated proximal and distal effects of CR on approximately 20 schizophrenia responders and 20 TRS patients. Patients in each group were randomized to receive CR or not. Patients were assessed in training task performance, neurocognition, functional capacity, symptoms and psychosocial functioning. Evaluations were conducted at baseline, at the end of the 4-month intervention, and at 6-month, 1 and 2 year-follow-ups. The study is still in active recruitment phase.ResultsBoth TRS and schizophrenia responder patients exposed to CR exhibited a significant improvement in specific neurocognitive domains, and in psychosocial functioning as assessed by either rating scales (SLOF and PSP) and performance-based measures (UPSA) at the 4-month time-point.ConclusionsCR improved psychosocial functioning in both group of patients, however, they were more pronounced in TRS patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.