Free Thyroxine Concentrations Moderate the Response to a Cognitive Remediation Therapy in People With Early Psychosis: A Pilot Randomized Clinical Trial
Abstract:Introduction
Cognitive deficits are a cause of functional disability in psychotic disorders. Cognitive remediation therapy (CRT) might be applied to improve these deficits. We conducted a pilot study to explore whether thyroid hormones might predict the response to CRT in patients with recent-onset psychosis (ROP).
Methods
Twenty-eight stable ROP outpatients (9 women) were randomized to receive computerized CRT (N=14) or treatment as usual (TAU) (N=14), over three month… Show more
“…In addition, quantitative information was collected at baseline and post-therapy, including sociodemographic information, cognitive assessments (CANTAB tests assessing executive functioning, memory and learning memory, attention and working memory; Estrada et al, 2020), familiarity with technology (Sedgwick et al, 2021), symptoms using the PANSS (Kay et al, 1987) and functioning using the time use survey (Cella et al, 2016). The results of these assessments are reported elsewhere (Cella et al, n.d.).…”
Objectives:
Cognitive remediation (CR) can reduce the cognitive difficulties experienced by people with psychosis. Adapting CR to be delivered remotely provides new opportunities for extending its use. However, doing so requires further evaluation of its acceptability from service users’ views. We evaluate the acceptability of therapist-supported remote CR from the perspectives of service users using participatory service user-centred methods.
Method:
After receiving 12 weeks of therapist-supported remote CR, service users were interviewed by a service user researcher following a semi-structured 18-question interview guide. Transcripts were analysed using reflexive thematic analysis with themes and codes further validated by a Lived Experience Advisory Panel and member checking.
Results:
The study recruited 26 participants, almost all of whom reported high acceptability of remote CR, and some suggested improvements. Four themes emerged: (1) perceived treatment benefits, (2) remote versus in-person therapy, (3) the therapist’s role, and (4) how it could be better.
Conclusions:
This study used comprehensive service user involvement methods. For some participants, technology use remained a challenge and addressing these difficulties detracted from the therapy experience. These outcomes align with existing research on remote therapy, suggesting that remote CR can expand choice and improve access to treatment for psychosis service users once barriers are addressed. Future use of remote CR should consider technology training and equipment provision to facilitate therapy for service users and therapists.
“…In addition, quantitative information was collected at baseline and post-therapy, including sociodemographic information, cognitive assessments (CANTAB tests assessing executive functioning, memory and learning memory, attention and working memory; Estrada et al, 2020), familiarity with technology (Sedgwick et al, 2021), symptoms using the PANSS (Kay et al, 1987) and functioning using the time use survey (Cella et al, 2016). The results of these assessments are reported elsewhere (Cella et al, n.d.).…”
Objectives:
Cognitive remediation (CR) can reduce the cognitive difficulties experienced by people with psychosis. Adapting CR to be delivered remotely provides new opportunities for extending its use. However, doing so requires further evaluation of its acceptability from service users’ views. We evaluate the acceptability of therapist-supported remote CR from the perspectives of service users using participatory service user-centred methods.
Method:
After receiving 12 weeks of therapist-supported remote CR, service users were interviewed by a service user researcher following a semi-structured 18-question interview guide. Transcripts were analysed using reflexive thematic analysis with themes and codes further validated by a Lived Experience Advisory Panel and member checking.
Results:
The study recruited 26 participants, almost all of whom reported high acceptability of remote CR, and some suggested improvements. Four themes emerged: (1) perceived treatment benefits, (2) remote versus in-person therapy, (3) the therapist’s role, and (4) how it could be better.
Conclusions:
This study used comprehensive service user involvement methods. For some participants, technology use remained a challenge and addressing these difficulties detracted from the therapy experience. These outcomes align with existing research on remote therapy, suggesting that remote CR can expand choice and improve access to treatment for psychosis service users once barriers are addressed. Future use of remote CR should consider technology training and equipment provision to facilitate therapy for service users and therapists.
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