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

Abstract

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.

Effect of computerized cognitive remediation therapy on mental time travel in patients with schizophrenia— a pilot randomized controlled trial

“…In addition, Garrido and Linke found that CCRT can improve the attention, memory, executive function and other cognitive fields of SCZ patients ( 26 , 27 ). CCRT improves working memory, attention and executive function and problem-solving abilities of patients with SCZ and thus improve the ability to recall the past and imagine the future ( 28 , 29 ).…”

Fully Immersive Virtual Reality-Based Cognitive Remediation for Adults with Psychosocial Disabilities: A Systematic Scoping Review of Methods Intervention Gaps and Meta-Analysis of Published Effectiveness Studies

“…Among others, cognitive remediation programs (CR) and physical activity are psychiatric and neurological rehabilitation interventions that showed to be effective in improving cognition, as the main outcome [ 6 , 21 , 22 , 23 , 24 ], as well as improving social and personal functioning outcome [ 25 , 26 , 27 ]. At the same time, physical activity and CR were proven to be effective to prevent cognitive decline in healthy populations [ 28 , 29 , 30 ].…”

Cognition and social functioning in first episode psychosis: A systematic review of longitudinal studies

“…This contrasts with the very low rates of recovery found in individuals treated for a FEP when recovery is defined not only in terms of psychotic episodes but, more generally, as social and clinical recovery lasting for at least 2 years (together with mild symptoms): the percentage of patients found to meet these criteria in a meta-analysis of outcome studies reach just to 13.5% ( 3 , 5 ). Therefore, and with such a definition for recovery in mind, many researchers focused recently in the social functioning and the real-world adjustment of the patient ( 6 ) to determine the factors that can afford protection as well as those that represent an improved prognosis in the patient’s social life, with a large number of studies on both aspects (protection and prognosis) having been published since the beginning of this century ( 2 ). One of the main factors explored is cognition, since cognitive deficits represent one of schizophrenia’s core features, which affect patients’ functioning and recovery, and seems to be related to high levels of functional disability, even more so than psychopathology ( 7 ), what has led recently to a “white paper” of recommendations for good practitioners in therapy and rehabilitation for FEP patients, developed by experts in cognitive remediation ( 8 ).…”