Can IQ moderate the response to cognitive remediation in people with schizophrenia?

Cognitive Remediation Works But How Should We Provide It? An Adaptive Randomized Controlled Trial of Delivery Methods Using a Patient Nominated Recovery Outcome in First-Episode Participants

“… 55 , 56 Their pre morbid IQ, current IQ, and duration of untreated psychosis were almost identical to previous large UK EIS studies. 57 , 58 Our study sample showed a decrease from pre morbid (98.09) to current IQ (88.18) which is almost identical to changes noted in UK EI services 57 (pre morbid IQ 95.78, current IQ 88.17, 59 mean current IQ 84.16, pre morbid IQ 95.82), but also from an international sample of people with schizophrenia 60 (pre morbid IQ 95.82, current IQ 84.16).…”

Developmental trajectories of premorbid functioning predict cognitive remediation treatment response in first-episode schizophrenia

“…Developmental trajectories did not predict overall cognitive improvements nor verbal learning improvements but predicted processing speed improvements, suggesting that trajectories may not predict generalized cognitive improvements but may instead predict improvements in specific cognitive domains. Our findings build upon the most relevant prior work to date, which used cognitive trajectory classifications to predict cognitive remediation treatment response for executive functioning and working memory, and did not evaluate processing speed or verbal learning (Seccomandi et al, 2021). This earlier study indicated that a preserved cognitive trajectory (most similar to the stable-good trajectory in our study) was associated with increased gains in executive functioning and working memory as compared to the compromised trajectory (similar to the stable-poor trajectory in our study) and the deteriorated trajectory (similar to the deteriorating trajectory in our study) (Seccomandi et al, 2021).…”

“…These studies have generally used overall levels of premorbid functioning as predictors of treatment response, thereby masking changes in premorbid functioning across development and making it difficult to infer whether individual courses of premorbid functioning are associated with treatment response. The most informative work to date showed that individuals with schizophrenia can be classified into three trajectories based on changes between premorbid and current IQ (general cognitive ability): compromised, deteriorated, and preserved trajectories (Seccomandi et al, 2021). Notably, the preserved cognitive trajectory showed more gains in executive functioning and working memory than the other two trajectories.…”

“…Taken together, demographic and clinical factors associated with poor overall premorbid functioning predict larger cognitive remediation gains in the most recent meta-analysis (Vita et al, 2021), whereas initial work investigating differences between premorbid and current IQ indicates that stable-good premorbid cognitive trajectories predict better cognitive remediation treatment response than deteriorating or stable-poor cognitive trajectories (Seccomandi et al, 2021). The most relevant study to date defined premorbid trajectories as the change between premorbid and current IQ (Seccomandi et al, 2021), rather than evaluating multiple periods of premorbid development. As far as we are aware, no studies yet have investigated whether trajectories of premorbid functioning over successive developmental periods are associated with cognitive remediation outcomes.…”

Cognitive dysfunction in schizophrenia: An expert group paper on the current state of the art

“…Moreover, literature pointed out some possible unmodifiable predictors that may affect CR outcomes. In particular, current IQ could be a relevant moderator of CR benefits, since the change in IQ after the disease onset seems to affect patients' response to CR ( Seccomandi et al, 2021a ). Furthermore patients' age seems to be a factor limiting CR benefits in older people, specifically in the domain of executive functions ( Seccomandi et al, 2021b ).…”