Does cognitive remediation for schizophrenia improve functional outcomes?

Abstract

The reviewed literature indicates that cognitive remediation is most likely to impact functional outcome when individuals are given opportunities to practice the cognitive skills in real-world settings. By integrating a cognitive remediation program with psychosocial rehabilitation programs, functional outcomes are enhanced. Cognitive remediation programs that do not solely rely on drill and practice, but instead incorporate strategy teaching and methods to address beliefs and motivation, are associated with better psychosocial outcomes.

Feasibility and acceptability of brief cognitive remediation targeting metacognition in acute inpatients with psychosis: a case series

“…Optimizing therapy gains transfer is a challenge in CR research (Dickinson et al, 2010) and this may be particularly difficult in inpatient psychiatric contexts where opportunities for generalization are limited (Medalia & Saperstein, 2013).…”

Combined social cognitive and neurocognitive rehabilitation strategies in schizophrenia: neuropsychological and psychopathological influences on Theory of Mind improvement

“…In recent years different integrated interventions have been developed, targeting both cognitive and psychosocial deficits (Bell et al 2001;Hogarty et al 2004;Galderisi et al 2010;Lindenmayer et al 2013;Medalia & Saperstein, 2013). Although still heterogeneous, results mainly show that combined rehabilitation programmes have a greater impact than single interventions on functional outcome, suggesting that social cognitive rehabilitation programmes in schizophrenia should also include neurocognitive interventions.…”

The use of clinical and biological characteristics to predict outcome following First Episode Psychosis

“…Secondly, by adding an early description of the individual's risk of progression to a specific illness stage, it may help the clinician to estimate the value of performing a specific investigation or to make utility-based judgments on treatment selection, thus personalizing the assessment and treatment process and optimizing overall efficiency of care (Hatcher, 1995;Owens et al, 1997;Simon et al, 2006;Sox et al, 2013;Werneke et al, 2012;Yokota and Thompson, 2004). Treatment choices informed by such risk may, for example, involve early clozapine initiation (Kaneda et al, 2010;Remington et al, 2013), targeted early provision of cognitive remediation training or cognitive enhancing treatments (Koike et al, 2013;Medalia and Saperstein, 2013;Wood et al, 2013), early specialized vocational rehabilitation (Killackey et al, 2008), specific neuroprotective strategies (Swerdlow, 2011), or targeted augmentation with anti-inflammatory medications (Sommer et al, 2014) or metabolic modifiers such as metformin (Correll et al, 2013;Guest et al, 2013aGuest et al, 2013b.…”