Cognitive remediation for severe mental illness: state of the field and future directions

Bowie, Christopher R.

doi:10.1002/wps.20660

Cited by 28 publications

(20 citation statements)

References 10 publications

(10 reference statements)

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“…First, results showed a satisfactory adherence rate, with almost 70% of the participants completing the entire course of the protocol and adhering to over 80% of the prescribed sessions and outcome measures, suggesting that subjects did not seem to find the time commitment, the assessments, or the training burdensome. These completion rates are comparable with some studies (15,(28)(29)(30) and in contrast with other ones conducted so far (31), showing a higher attrition rate. Nevertheless, the present study adopted several measures to sustain adherence, mostly by strengthening the relationship with the therapist that has been shown to have a fundamental role in ensuring participants' completion of the training modules (32) and providing social cues to improve patients' self-esteem and motivation, supporting the use of strategies, motivation, or reinforcement and helping to develop metacognition, which is thought to be a key component for improving transfer from cognitive change to functional development (33,34).…”

Section: Discussionsupporting

confidence: 89%

“…The second one (14) evaluates CR treatment effect on cognitive, functional, and clinical outcomes in patients with SCZ from 67 studies and found significant improvements with small-to-moderate effect sizes in CR treatment on all of the three outcome domains and suggests that cognitive gains trigger improvement in both clinical symptoms and psychosocial functioning. Thus, some discrepancies across studies about SCZ (15) were noticed regarding the improvement in community functioning and SC following CR, while an improvement in cognition seems to be commonly reported.…”

Section: Introductionmentioning

confidence: 98%

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Effects of Cognitive Remediation on Cognition, Metacognition, and Social Cognition in Patients With Schizophrenia

et al. 2021

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We aimed to evaluate in a sample of outpatients with schizophrenia (SCZ) the effectiveness of a cognitive remediation (CR) program (through the use of the Cogpack software) [computer-assisted CR (CACR)] in addition to standard therapy on cognitive outcomes as compared with that in a control active group (CAG) and to highlight a possible effect on social cognition (SC), metacognition, symptomatology, and real-world functioning. Of the 66 subjects enrolled, 33 were allocated to CACR and 33 to the CAG. Twenty-three patients in the CACR group and 25 subjects in the CAG completed at least 80% of the 48 prescribed CACR sessions, performed twice a week, for a total of 24 weeks of treatment. A significant time × group interaction was evident, suggesting that patients undergoing CACR intervention improved in specific metacognitive sub-functions (understanding others' mind and mastery), some cognitive domains (verbal learning processing speed, visual learning, reasoning, and problem solving) (h2 = 0.126), depressive symptoms, SC, awareness of symptoms, and real-world functioning domains (community activities and interpersonal relationships) more significantly than did patients undergoing CAG. The most noticeable differential improvement between the two groups was detected in two metacognitive sub-functions (understanding others' mind and mastery), in verbal learning, in interpersonal relationship, and in depressive symptomatology, achieving large effect sizes. These are encouraging findings in support of the possible integration of CACR in rehabilitation practice in the Italian mental health services.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 98%

Effects of Cognitive Remediation on Cognition, Metacognition, and Social Cognition in Patients With Schizophrenia

et al. 2021

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“…For future study with similar population of young people with schizophrenia, an effect size assumption of 0.25 to 0.30 would be more appropriate. In considering a suitable sample size, it is also necessary to take note of the potentially high attrition rate in cognitive remediation program ( Bowie, 2019 ), although the attrition rate in this study tends to be low (11.1%). Third, there is a need to re-consider the use of some outcome measures.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a computer-assisted cognitive remediation program for young people with psychosis: A pilot study

Siu

Poon

et al. 2021

Schizophrenia Research: Cognition

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Background People with psychosis have a range of neuropsychological impairments that impact their functional abilities and rehabilitation outcomes. We designed a Computer-Assisted Cognitive Remediation (CACR) program to help young people with psychosis to restore their cognitive function. The program combines the drill-and-practice approach and the strategic approach to remediation, with sixteen sessions of computerized cognitive training, two sessions of psychoeducation, and four session of coaching on applying cognitive skills to daily life. Method This was a randomized, single-blind, controlled study in which the outcomes of the CACR program were compared with outcomes of a treatment-as-usual (TAU) control group. Pre-intervention and post-intervention measures were compared. Results When compared with the control group, the intervention group had significant increases in their MCCB neurocognitive composite scores, and specifically in the areas of verbal learning and speed of processing at posttest. They also had significant increases in their secondary outcome measures of mental well-being and perceived occupational competence. There were no significant differences in functional status between the two groups at post-test. Conclusions The CACR program was effective in improving overall cognitive function and in the specific domains of verbal learning, speed of processing, and effect sizes were small. Participants also experienced positive changes in mental well-being and perceived competence.

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“…Studies of eating disorders have shown an association between cognitive flexibility and eating disorders, particularly anorexia nervosa [101,102] and a role for cognitive remediation therapy (CRT) for these disorders [103,104]. Although CRT has been studied in schizophrenia [105], its role in addressing disordered eating in schizophrenia has not, to our knowledge, been examined. Future research should explore the role for CRT in the different disordered eating in SSD.…”

Section: Discussionmentioning

confidence: 99%

Disordered Eating among People with Schizophrenia Spectrum Disorders: A Systematic Review

Sankaranarayanan

Johnson²,

Mammen³

et al. 2021

Nutrients

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Disordered eating, or abnormal eating behaviours that do not meet the criteria for an independent eating disorder, have been reported among people with schizophrenia. We aimed to systemati-cally review literature on disordered eating among people with schizophrenia spectrum disorder (SSD). Seven databases were systematically searched for studies that described the prevalence and correlates of disordered eating among patients with SSD from January 1984 to 15 February 2021. Qualitative analysis was performed using the National Institutes of Health scales. Of 5504 records identified, 31 studies involving 471,159 subjects were included in the systematic review. The ma-jority of studies (17) rated fair on qualitative analysis and included more men, and participants in their 30s and 40s, on antipsychotics. The commonest limitations include lack of sample size or power calculations, poor sample description, not using valid tools, or not adjusting for con-founders. The reported rates were 4.4% to 45% for binge eating, 16.1% to 64%, for food craving, 27% to 60.6% for food addiction, and 4% to 30% for night eating. Positive associations were re-ported for binge eating with antipsychotic use and female gender, between food craving and weight gain, between food addiction and increased dietary intake, and between disordered eating and female gender, mood and psychotic symptoms. Reported rates for disordered eating among people with SSD are higher than those in the general population. We will discuss the clinical, treatment and research implications of our findings.

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Cognitive remediation for severe mental illness: state of the field and future directions

Cited by 28 publications

References 10 publications

Effects of Cognitive Remediation on Cognition, Metacognition, and Social Cognition in Patients With Schizophrenia

Effects of Cognitive Remediation on Cognition, Metacognition, and Social Cognition in Patients With Schizophrenia

Evaluation of a computer-assisted cognitive remediation program for young people with psychosis: A pilot study

Disordered Eating among People with Schizophrenia Spectrum Disorders: A Systematic Review

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