Factors Associated With Response and Resistance to Cognitive Remediation in Schizophrenia: A Critical Review

Barlati, Stefano; Deste, Giacomo; Galluzzo, Alessandro; Perin, Anna Paola; Valsecchi, Paolo; Turrina, Cesare; Vita, Antonio

doi:10.3389/fphar.2018.01542

Cited by 24 publications

(23 citation statements)

References 94 publications

(219 reference statements)

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“…Similarly, Addington and Addington (2005) found an association between poor premorbid adjustment, increased negative symptoms and poorer social functioning (Quality of Life Scale) two years after the onset of schizophrenia. Barlati et al (2018) found in their review that cognitive remediation interventions seem to be more effective in schizophrenia patients with the following features: younger age, shorter duration of illness, few disorganized symptoms, greater pretreatment cognitive reserve and lower doses antipsychotics in their current treatment. This study support that higher CR is associated with greater response to cognitive rehabilitation.…”

Section: Premorbid Adjustmentmentioning

confidence: 99%

Influence of cognitive reserve in schizophrenia: A systematic review

Herrero¹,

Contador

Stern

et al. 2020

Neuroscience & Biobehavioral Reviews

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To perform a systematic review of the influence of sociobehavioural indicators of cognitive reserve (CR) in the risk of schizophrenia, the clinical manifestations of the disease, and cognitive intervention programs (CRT) carried out with these patients. Method: A cross search was made by two independent reviewers in Pubmed and PsycINFO databases using keywords "schizophrenia" and "cognitive reserve." Twenty-one studies which analyzed different CR proxies were selected and the level of evidence was classified according to the Oxford Centre for Evidence-Based Medicine.Result: People with higher CR may have a lower risk of developing schizophrenia and a later onset of disease. In addition, they present better neuropsychological and functional performance in the illness course. However, the suspected influence of CR on the effectiveness of CRT in patients with schizophrenia is currently unresolved. Conclusion: Our findings suggest that higher CR delays the clinical diagnosis threshold and severity of the symptoms in patients with schizophrenia. However, effect of singular sociobehavioral measures on clinical expression and benefits of intervention program need further investigation.

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Section: Premorbid Adjustmentmentioning

confidence: 99%

Influence of cognitive reserve in schizophrenia: A systematic review

Herrero¹,

Contador

Stern

et al. 2020

Neuroscience & Biobehavioral Reviews

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“…Indeed, the shared decision-making approach, taking into account patient's preferences, increases the motivation to treatment and, consequently, treatment adherence ( 174 – 183 ). In addition, it has been demonstrated that strong therapeutic relationships with a good therapeutic alliance are related to a decrease of symptom severity, hospitalizations, drop-out rates and to an increase in treatment adherence ( 48 , 183 , 184 ), while poor therapeutic relationships have been shown to increase the risk for non-adherence ( 40 , 43 , 185 ).…”

Section: Adherence To Treatmentmentioning

confidence: 99%

“…Different modalities and combinations of psychosocial interventions have been developed with the aim to address the complex individualized needs of patients ( 38 , 40 , 45 ), including the management of negative symptoms and cognitive dysfunctions ( 38 – 41 , 46 – 48 ), to improve patient's reintegration in the community, promote recovery, and support patients and their families ( 38 , 40 , 41 , 49 , 50 ). Some psychosocial interventions, such as psychoeducation and cognitive behavioral therapy (CBT), allow patients to gain knowledge about their illness; others, such as cognitive remediation, social skills training, and supported employment may enhance adaptive skills ( 45 ).…”

Section: Introductionmentioning

confidence: 99%

Factors influencing the outcome of integrated therapy approach in schizophrenia: A narrative review of the literature

Giordano

Brando²,

Pezzella³

et al. 2022

Front. Psychiatry

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The integration of pharmacotherapy with psychosocial interventions has an important role to play in the improvement of functional outcome of subjects with schizophrenia (SCZ), in all stages of the disorder. It is essential for the adequate management of unmet therapeutic needs, such as negative symptoms and cognitive dysfunctions which account for most of the functional impairment of subjects with SCZ and do not respond to available antipsychotics. Enhancing the knowledge on factors involved in the effectiveness of integrated treatment plans is an important step forward for SCZ care. This review aims to identify factors that might influence the impact of integrated treatments on functional outcome. Most studies on the impact of psychosocial treatments on functional outcome of subjects with SCZ did not control for the effect of prescribed antipsychotics or concomitant medications. However, several factors relevant to ongoing pharmacological treatment might influence the outcome of integrated therapy, with an impact on the adherence to treatment (e.g., therapeutic alliance and polypharmacotherapy) or on illness-related factors addressed by the psychosocial interventions (e.g., cognitive dysfunctions or motivational deficits). Indirect evidence suggests that treatment integration should consider the possible detrimental effects of different antipsychotics or concomitant medications on cognitive functions, as well as on secondary negative symptoms. Cognitive dysfunctions can interfere with participation to an integrated treatment plan and can be worsened by extrapyramidal or metabolic side effects of antipsychotics, or concomitant treatment with anticholinergics or benzodiazepines. Secondary negative symptoms, due to positive symptoms, sedation, extrapyramidal side effects or untreated depression, might cause early drop-out and poor adherence to treatment. Researchers and clinicians should examine all the above-mentioned factors and implement appropriate and personalized integrated treatments to improve the outcome of SCZ.

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“…Furthermore, it is possible that our sample was specific due to sociodemographic characteristics and prevalence of clinical symptoms (e.g., negative symptomatology, lack of insight) that can interfere with CR outcomes (for review see [58]). As we did not measure clinical symptoms during the intervention and our assumption is based merely on observation of the present therapist, we cannot draw any conclusions.…”

Section: Cognitive Assessmentmentioning

confidence: 99%

Cognitive Remediation in Virtual Environments for Patients with Schizophrenia and Major Depressive Disorder: A Feasibility Study

Plechatá

Hejtmánek

Bednářová³

et al. 2021

IJERPH

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Standard approaches to cognitive remediation can suffer from limited skill transferability to patients’ life. Complex virtual environments (VEs) enable us to create ecologically valid remediation scenarios while preserving laboratory conditions. Nevertheless, the feasibility and efficacy of these programs in psychiatric patients are still unknown. Our aim was to compare the feasibility and efficacy of a novel rehabilitation program, designed in complex VEs, with standard paper–pencil treatment in patients with schizophrenia and major depressive disorder. We recruited 35 participants to complete a VE rehabilitation program and standard treatment in a crossover pilot study. Twenty-eight participants completed at least one program, 22 were diagnosed with schizophrenia and 6 with major depressive disorder. Participant’s performance in the representative VE training task significantly improved in terms of maximum achieved difficulty (p ≤ 0.001), speed (p < 0.001) and efficacy (p ≤ 0.001) but not in item performance measure. Neither the standard treatment nor the VE program led to improvement in standardized cognitive measures. Participants perceived both programs as enjoyable and beneficial. The refusal rate was higher in the VE program (8.6%) than in the standard treatment (0%). But in general, the VE program was well-accepted by the psychiatric patients and it required minimal involvement of the clinician due to automatic difficulty level adjustment and performance recording. However, the VE program did not prove to be effective in improving cognitive performance in the standardized measures.

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Factors Associated With Response and Resistance to Cognitive Remediation in Schizophrenia: A Critical Review

Cited by 24 publications

References 94 publications

Influence of cognitive reserve in schizophrenia: A systematic review

Influence of cognitive reserve in schizophrenia: A systematic review

Factors influencing the outcome of integrated therapy approach in schizophrenia: A narrative review of the literature

Cognitive Remediation in Virtual Environments for Patients with Schizophrenia and Major Depressive Disorder: A Feasibility Study

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