Combining social cognitive treatment, cognitive remediation, and functional skills training in schizophrenia: a randomized controlled trial

Abstract

This study examined the efficacy of an integrative cognitive remediation program (REHACOP) in improving cognition and functional outcome in patients with schizophrenia. The program combines cognitive remediation, social cognitive intervention, and functional skills training. Few studies have attempted this approach. One hundred and eleven patients diagnosed with schizophrenia were randomly assigned to either the cognitive remediation group (REHACOP) or an active control group (occupational activities) for 4 months (three sessions per week, 90 min). Primary outcomes were change on general neurocognitive performance and social cognition, including theory of mind (ToM), emotion perception (EP), attributional style, and social perception (SP). Secondary outcomes included changes on clinical symptoms (Positive and Negative Syndrome Scale) and functional outcome (UCSD Performance-Based Skills Assessment and the Global Assessment of Functioning). The trial was registered with clinicaltrials.gov (NCT02796417). No baseline group differences were found. Significant differences were found in the mean change between the REHACOP group and control group in neurocognition (ηp2=0.138), SP (ηp2=0.082), ToM (ηp2=0.148), EP (ηp2=0.071), negative symptoms (ηp2=0.082), emotional distress (ηp2=0.136), Global Assessment of Functioning (ηp2=0.081), and UCSD Performance-Based Skills Assessment (ηp2=0.154). The combination of cognitive remediation, social cognitive intervention, and functional skills training demonstrated statistically significant and clinically meaningful changes in neurocognition, social cognition, negative, and functional disability.

Social Cognition Training for People With a Psychotic Disorder: A Network Meta-analysis

“…The intra-class correlation of the ratings was .84, indicating good to excellent reliability. Six 9 , 20 , 53 , 54 , 66 , 86 of the 44 original publications (13%) were of adequate methodological quality (defined as CTAM ≥65). All studies used a convenience sample (eg, clinic attenders, referred patients).…”

Functional recovery in patients with schizophrenia: recommendations from a panel of experts

“…Patients with schizophrenia now have access to a wide variety of pharmacological agents and psychosocial therapies which may eventually meet the particular needs of each patient profile and, therefore, increase the chances of positive therapeutic outcomes [ 17 ]. The lack of standardized tools for the assessment of functional recovery prevents from drawing strong conclusions regarding the contribution of these interventions to functional recovery in patients with schizophrenia.…”

Gambling and Social Cognition: a Systematic Review

“…However, to our knowledge, no attempt at social cognitive therapy has been made to improve SC in GD patients. Nevertheless, it seems now important to add cognitive therapy that links cold and hot functioning as a complement to existing therapies [92][93][94]. Thus, the creation of this type of cognitive therapy focused on both neurocognition and SC could improve global cognitive functioning and social functioning, which may participate in the maintenance of abstinence.…”