Improving social function with real-world social-cognitive remediation in schizophrenia: Results from the RemedRugby quasi-experimental trial

Abstract

Background. Functional capacity (FC) has been identified as a key outcome to improve real-world functioning in schizophrenia. FC is influenced by cognitive impairments, negative symptoms, self-stigma and reduced physical activity (PA). Psychosocial interventions targeting FC are still under-developed. Methods. we conducted a quasi-experimental study evaluating the effects of an exercise-enriched integrated social cognitive remediation (SCR) intervention (RemedRugby [RR]) compared with an active control group practicing Touch Rugby (TR). To our knowledge, this is the first trial to date evaluating the effectiveness of such a program provided in a real-life environment. Results. Eighty-seven people with schizophrenia were included and allocated to either the RR group (n = 57) or the TR group (n = 30) according to the routine clinical practice of the recruiting center. Outcomes were evaluated at baseline and post-treatment in both groups and after 6 months of follow-up in the RR group using standardized scales for symptom severity, social functioning, self-stigma, and a large cognitive battery. After treatment we observed moderate to large improvements in social function (Personal and Social Performance Scale [PSP], p < 0.001, d = 1.255), symptom severity (Positive and Negative Syndrome Scale [PANSS] negative, p < 0.001, d = 0.827; PANSS GP, p < 0.001, d = 0.991; PANSS positive, p = 0.009, d = 0.594), verbal abstraction (p = 0.008, d = 0.554), aggression bias (p = 0.008, d = 0.627), and self-stigma (stereotype endorsement, p = 0.019, d = 0.495; discrimination experiences, p = 0.047; d = 0.389) that were specific to the RR group and were not observed in participants playing only TR. Effects were persistent over time and even larger between post-treatment and follow-up. Conclusions. Exercise-enriched integrated SCR appears promising to improve real-life functioning in schizophrenia. Future research should investigate the potential effects of this intervention on neuroplasticity and physical fitness.

Overlap and Mutual Distinctions Between Clinical Recovery and Personal Recovery in People With Schizophrenia in a One-Year Study

“…person-centered, strengths-based, and supporting hope, empowerment, and goal-striving behaviors) 58 in mental health facilities should be encouraged. 59 Peer-supported self-management interventions as well as recovery-oriented psychoeducation and family psychoeducation help to reduce self-stigma and protect against insight-related depression 7,39,60,61 and therefore facilitate personal recovery in people with SSD. 59 In addition, cognitive remediation could indirectly contribute to personal recovery and full recovery through improved executive functioning, improved stigma resistance, and increased use of adaptive coping strategies.…”

“…quality of life, self-esteem, low self-stigma, stigma resistance, hope, and wellbeing). 1,[5][6][7] Personal recovery could protect against insight-related depression, self-stigma, and suicidal ideation. 8,9 Personal recovery involves redefining a positive identity extending beyond mental illness and finding meaning in psychosis-related disruption to a person's life.…”

Mediation Effects of Social Cognition on the Relationship between Neurocognition and Social Functioning in Major Depressive Disorder and Schizophrenia Spectrum Disorders

“…The ACSo has been developed for a wide range of mental illnesses characterized by impaired cognition and has shown to be a useful psychometric tool in studies of patients with schizophrenia, schizoaffective disorder, bipolar disorder, and autism spectrum disorder. A growing number of studies have used ACSo for evaluating patients with psychiatric illnesses [49][50][51]. The Perceived Deficits Questionnaire (PDQ) has been developed as a tool for the subjective assessment of neurocognitive impairment [52].…”

A Retrospective Study on the Relationship Between Cognitive Function and Social Function in Patients With Schizophrenia

“…Several studies have investigated the cognitive and social functioning of patients with schizophrenia. Improvements in cognitive function have been reported to affect social function in schizophrenia [11][12][13][14]. According to Green et al, functional prognosis in schizophrenia is influenced by cognitive functions, such as attention, language, memory, and information processing [15].…”