Executive function needs to be targeted to improve social functioning with Cognitive Remediation Therapy (CRT) in schizophrenia

Penadés, Rafael; Catalán, Rosa; Puig, Olga; Masana, Guillem; Pujol, Núria; Navarro, Vı́ctor; Guarch, Joana; Gastó, Cristòbal

doi:10.1016/j.psychres.2009.01.032

Cited by 73 publications

(36 citation statements)

References 34 publications

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“…Further, these positive outcomes remained present at the 6-month follow-up and CRT also had a positive, but nonsignificant, effect on symptomatology. 60 These results support the efficacy of CRT and it may be concluded that this treatment is useful in improving neurocognitive abilities such as attention, memory, and executive functioning.…”

supporting

confidence: 62%

“…A similar randomized controlled trial was conducted by Penades et al 60 In this study, the researchers examined the effects of a neurocognitive intervention in treating chronic schizophrenia outpatients in a clinical setting. They showed that CRT significantly improved neurocognition, particularly in verbal and nonverbal memory, and improved social and executive functioning.…”

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confidence: 99%

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Support management in schizophrenia: a systematic review of current literature

Pompili¹,

Montebovi²,

Forte³

et al. 2012

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Background: Schizophrenia is generally considered a chronic disorder characterized by psychotic symptoms and relatively stable neurocognitive and interpersonal deficits. Antipsychotic medication has proven beneficial in reducing psychotic symptoms, but is often not enough to treat cognitive or functional impairments. Residual cognitive impairments are barriers to a patient's full recovery from schizophrenia. Rehabilitation is an alternative and important approach which may be useful, and encompasses a variety of treatments including social skills training and psychoeducational and cognitive behavioral treatments. Objective: To investigate the efficacy of psychosocial treatments in schizophrenia, evaluating its effects in the short and long term, comparing psychosocial treatments with pharmacotherapy, and assessing the effects of treatment and the main indications for use in patients with schizophrenia. Methods: A careful MEDLINE ® , Excerpta Medica, PsycLIT ® , PsycINFO ® , and IndexMedicus search was performed to identify all papers and book chapters in English for the period 1970-2012. Results:Findings from the studies included in this qualitative analysis suggest that social skills therapy, cognitive behavioral therapy, family intervention therapy, cognitive remediation therapy, and other nonpharmacological therapeutic strategies may be beneficial for patients with significant functional and symptomatic impairments. Conclusion: Schizophrenic patients treated with nonpharmacological techniques have more rapid remission and relapse less frequently than patients treated only pharmacologically.

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supporting

confidence: 62%

mentioning

confidence: 99%

Support management in schizophrenia: a systematic review of current literature

Pompili¹,

Montebovi²,

Forte³

et al. 2012

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“…This includes patients suffering from their first psychotic episode [32,33,34] and those who are antipsychotic-naïve [35]; even the healthy relatives of schizophrenic patients have been found to have executive function impairments when compared with control subjects [36,37,38]. The importance of executive functions has also been noted in recent studies that have highlighted their relevance regarding functional outcomes [39,40,41,42] and suggested their potential use as diagnostic criteria for schizophrenia [43,44]. …”

Section: Introductionmentioning

confidence: 99%

Negative Symptoms and Executive Function in Schizophrenia: Does Their Relationship Change with Illness Duration?

et al. 2012

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Background: Negative symptoms and cognitive dysfunction are of crucial functional and prognostic importance in schizophrenia. However, the nature of the relationship between them and the factors that may influence it have not been well established. Aims: To investigate whether the relationship between negative symptoms and executive function changes according to the duration of illness in schizophrenia. Methods: The Positive and Negative Syndrome Scale was used to assess psychopathology and the Wisconsin Card Sorting Test (WCST) to evaluate executive function in a sample of 200 schizophrenic patients who were classified in 3 groups according to their duration of illness: up to 5 years (short duration group), 6-20 years (intermediate duration group) and over 20 years of illness (long duration group). Results: Medium-sized correlations were found between negative symptoms and WCST performance as assessed by the number of completed categories in all 3 groups. However, differences were found according to the duration of schizophrenia. For patients in the short duration group, negative symptoms correlated with WCST nonperseverative errors, but for those in the long duration group the correlation was with perseverative errors. Conclusion: We found a differential relationship between negative and cognitive symptoms in different stages of schizophrenia. Illness duration should be considered when studying the relationship between negative symptoms and cognition.

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“…Executive dysfunction causes functional impairments in patients with schizophrenia (Green, Kern, Braff, & Mintz, 2000) and is an important target for cognitive rehabilitation for the affected patients (Penadés et al., 2010). Executive function includes conflict control, the ability to select and execute a goal‐directed response to situations involving conflict produced by competing stimuli or responses (Botvinick, Braver, Barch, Carter, & Cohen, 2001).…”

Section: Introductionmentioning

confidence: 99%

Involvement of amygdala–prefrontal dysfunction in the influence of negative emotion on the resolution of cognitive conflict in patients with schizophrenia

et al. 2018

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IntroductionPatients with schizophrenia often have impaired cognition and abnormal conflict control. Conflict control is influenced by the emotional values of stimuli. This study investigated the neural basis of negative emotion interference with conflict control in schizophrenia.MethodsSeventeen patients with schizophrenia and 20 healthy controls underwent functional magnetic resonance imaging while performing the emotional Simon task, in which positive or negative emotional pictures were located in congruent or incongruent positions. Analysis was focused on identifying brain regions with the significant interaction among group, emotion, and conflict in whole brain voxel‐wise analysis, and abnormality in their functional connectivity in the patient group.ResultsThe regions showing the targeted interaction was the right amygdala, which exhibited significantly reduced activity in the negative congruent (t = −2.168, p = 0.036) and negative incongruent (t = −3.273, p = 0.002) conditions in patients versus controls. The right amygdala also showed significantly lower connectivity with the right dorsolateral prefrontal cortex in the cognitive and emotional loading contrast (negative incongruent—positive congruent) in patients versus controls (t = −5.154, p < 0.01), but not in the cognitive‐only or emotional‐only loading contrast.ConclusionsThese results suggest that negative emotion interferes with cognitive conflict resolution in patients with schizophrenia due to amygdala–dorsolateral prefrontal cortex disconnection. Based on these findings, interventions targeting conflict control under negative emotional influence may promote cognitive rehabilitation in patients with schizophrenia.

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Executive function needs to be targeted to improve social functioning with Cognitive Remediation Therapy (CRT) in schizophrenia

Cited by 73 publications

References 34 publications

Support management in schizophrenia: a systematic review of current literature

Support management in schizophrenia: a systematic review of current literature

Negative Symptoms and Executive Function in Schizophrenia: Does Their Relationship Change with Illness Duration?

Involvement of amygdala–prefrontal dysfunction in the influence of negative emotion on the resolution of cognitive conflict in patients with schizophrenia

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