Abstract
Objective: Early intervention in patients with first episode psychosis (FEP) can improve cognitive abilities, with both short- and long-term benefits. In this paper, we describe the implementation and review of cognitive remediation training (CRT) in an Asian FEP population. The outcomes of the training are also evaluated and discussed.Methods: This naturalistic paper describes in detail the real-life implementation and conduct of CRT in an early psychosis intervention service. One hundred and nine patients with FEP underwent a 24-session CRT programme, using Cogpack and Neuropsychological Educational Approach to Remediation. The program is evaluated with pre- and post-CRT assessment scores which included Montreal Cognitive Assessment and Brief Assessment of Cognition in Schizophrenia. The rates of improvement on these cognitive assessments were evaluated using paired t-tests, with statistical significance set at p ≤ 0.05.Results: Of the 109 patients who underwent CRT, a total of 92 (84.4%) completed all 24 sessions. Paired t-tests between pre- and post-CRT assessments scores revealed that participants significantly improved on majority of the measures, including verbal memory, digit sequencing, and symbol coding.Conclusion: As with other cognitive remediation programmes, CRT has shown to improve cognitive functioning in patients with FEP. The results support the use of CRT in an Asian context and may serve as guidance for the implementation of similar training programmes in other Asian early psychosis intervention services.
Highlights
Schizophrenia and other psychotic disorders belong to a spectrum of primary psychotic disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) [1], and patients with psychosis present with neuropsychiatric disturbances including hallucinations, delusions, thought disorders, abnormal psychomotor behaviours, negative symptoms, cognitive impairments, and emotional disturbance [2]
This study aimed to describe the conduct of cognitive remediation training (CRT) in an Asian early psychosis intervention service and evaluate the outcomes of CRT on individuals with first episode psychosis (FEP), by comparing pre- and post-CRT cognitive assessment scores
Out of the 109 patients who participated in CRT from 2012 to 2019, a total of 92 (84.4%) completed the full 24-session therapy
Summary
Schizophrenia and other psychotic disorders belong to a spectrum of primary psychotic disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) [1], and patients with psychosis present with neuropsychiatric disturbances including hallucinations, delusions, thought disorders, abnormal psychomotor behaviours, negative symptoms, cognitive impairments, and emotional disturbance [2]. Life expectancy is reduced by 10–20 years as compared to the general population [8, 9], largely due to increased cardiovascular-related morbidity and mortality [10], and contributed in part by an increased risk of suicide [11] and violence [12]. These are the main reasons why this relatively infrequent disorder is responsible for the 6th largest share of disability adjusted life years (DALYs) in adults in Europe, and the 3rd largest of all brain disorders worldwide [13]. In England, schizophrenia was found to cost society 11.8 billion pounds per year, equating to an average annual cost to society of about 60 thousand pounds per person [14]
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