Cognitive remediation can improve negative symptoms and social functioning in first-episode schizophrenia: A randomized controlled trial

SCHIZOPHRENIA RESEARCH

卷:203

Article

Ventura, Joseph¹  Subotnik, Kenneth L.¹  Gretchen-Doorly, Denise¹  Casaus, Laurie¹  Boucher, Michael¹  Medalia, Alice³  Bell, Morris D.⁴  Hellemann, Gerhard S.¹  Nuechterlein, Keith H.^1,2 

[1] Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA

[2] Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA USA

[3] Columbia Univ, Dept Psychiat, Med Ctr, New York, NY USA

[4] Yale Univ, Dept Psychiat, New Haven, CT 06520 USA

关键词: First episode schizophrenia;    Cognitive remediation;    Negative symptoms;    Social functioning;    Randomized controlled trial;    Outcomes;   

DOI  :  10.1016/j.schres.2017.10.005

来源: Elsevier

【 摘 要 】

Background: Meta-analyses have reported that the effects of cognitive remediation might go beyond improvement in cognition to include unexpected benefits for schizophrenia patients such as negative symptomreduction and improvements in functioning. In addition, some evidence indicated that these potentially beneficial effects are also present in the initial course of schizophrenia, but work in this area is still developing. Method: A RCT compared Cognitive Remediation (CR) to Healthy Behaviors Training (HBT) in 80 patients (78% male) with a mean age of 21.9 years and mean education of 12.3 years who had a first psychotic episode within two years of study entry. Participants were trained using CR programs or received HBT involving 50 sessions over 6 months and then booster sessions over the next 6 months. The SANS and BPRS were used to assess symptoms. The UCLA Social Attainment Survey assessed social functioning. Results: Using GLMM, improvements over 12 months were found favoring CR for SANS Expressive Symptoms (p < 0.01), which was composed of Affective Flattening (p < 0.01) and Alogia (p = 0.04), and for SANS Experiential Symptoms, composed of Avolition/Apathy (p = 0.04) and Anhedonia/Asociality (p < 0.01). CR was associated with improvements in social functioning (p = 0.05) as compared to HBT. Conclusions: We confirmed that the beneficial effects of CR appear to extend beyond cognition to improvements in negative symptoms and social functioning in early course schizophrenia patients. These results suggest that cognitive remediation might have an impact when the reduction of risk factors for chronicity is most critical for promoting recovery. (C) 2017 Elsevier B.V. All rights reserved.

【 授权许可】

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