Response to Cognitive Rehabilitation in Older Versus Younger Persons with Severe Mental Illness

McGurk, Susan R.; Mueser, Kim T.

doi:10.1080/15487760701853136

Cited by 53 publications

(44 citation statements)

References 28 publications

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“…This effect is in opposite to the results of studies evaluating other cognitive remediation approaches for middle-aged and older patients. 10,16 Both of these approaches did not support group dynamics as it is explicitly used in IPT technology. In contrast to drill and practice exercises within the use of computer programs, 16 IPT puts emphasis on strategy learning tasks, which may have the stronger impact on cognitive functioning.…”

Section: Discussionmentioning

confidence: 99%

“…10,16 Both of these approaches did not support group dynamics as it is explicitly used in IPT technology. In contrast to drill and practice exercises within the use of computer programs, 16 IPT puts emphasis on strategy learning tasks, which may have the stronger impact on cognitive functioning. 36 Both authors of the two other studies concluded that cognitive remediation therapy methods have to be adapted to elderly people due to small effects.…”

Section: Discussionmentioning

confidence: 99%

“…This result may be due to better psychiatric (standard) treatments for younger patients than for elderly people. 10,16 On the other hand, the results may be influenced by a longer experience of failure in the treatment of older patients, which makes it harder to motivate them by the use of standard treatment tools. At least, there was some evidence that older patients are less treatment motivated in work rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

“…15 All of these approaches improved functioning successfully. Furthermore, two cognitive remediation therapy approaches (CRT) have already been evaluated in samples of middle-aged and older patients: McGurk and Mueser 16 used a computer program (Cogpack, Marker software) in combination with work rehabilitation, and Wykes and colleagues 10 administered the classic cognitive remediation therapy. 17 However, in both studies middle-aged and older patients showed only minimal improvements in cognitive functioning compared to significant improvements in younger schizophrenia patients.…”

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confidence: 99%

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Integrated Psychological Therapy: Effectiveness in Schizophrenia Inpatient Settings Related to Patients' Age

Mueller¹,

Schmidt²,

Roder³

2013

The American Journal of Geriatric Psychiatry

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Objective: Elderly people with schizophrenia often suffer from cognitive impairments, which affect their social functioning. Today, only few therapy approaches for middleaged and older patients are available. The Integrated Psychological Therapy (IPT) combines neurocognitive and social cognitive interventions with social skills approaches. The aim of this study was to evaluate (1) whether IPT is effective in younger patients (age<40 years) and middle-aged patients (age≥40 years), and (2) whether control conditions (CC: treatment as usual or unspecific group activities) reveal some change in outcome depending on age. Method: A total of 15 controlled IPT studies with 632 schizophrenia inpatients were included into a standard meta-analytic procedure. Studies were categorized into two age-categories. Results: Significant medium to high effect sizes (ES) were evident for IPT independent of age on the global cognitive score (mean score of all cognitive variables), on neurocognition, social cognition, social functioning, psychopathology, and on the global therapy effect (mean of all variables). The IPT effects in middleaged patients were significantly higher on the global cognitive score, on neurocognition and on social cognition compared to younger patients. Opposite results could be observed in CC. Only younger patients participating in the CC showed small but significant ES on these variables, but almost middle-aged control patients did not. However, none of the differences in CC were significant between the two age-categories. A moderator analysis obtained no evidence for a strong impact of IPT variations, therapy setting, patient characteristics and methodological rigor of the research design. Conclusions: These results support evidence for the efficacy of IPT independent of age. Results further indicate the need of goal-oriented specific psychological interventions for middle-aged and older schizophrenia patients.Keywords: Schizophrenia, aged, middle-aged, elderly, cognition, therapy, integrated therapy, cognitive remediation, meta-analysis 3 There is evidence for a gradual aging of the population in developed countries all over the world, and also an increase of middle-aged and elderly schizophrenia patients. 1 Therefore, research focusing on the impact of the age on schizophrenia features as well as on the successful treatment of these features becomes important. During the last decades, a large bulk of data was published addressing younger people suffering from schizophrenia, but the needs of older schizophrenia patients were often neglected. Recent reviews of published data on the rehabilitation goals for older people with serious mental illness summarized that poor outcome in social functioning and lower quality of life are strongly associated with social isolation, depression, cognitive impairment, and chronic medical illness. 1,2 The authors concluded that specific interventions are needed with regard to these specific features associated with social functioning and quality of life in older patient...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Integrated Psychological Therapy: Effectiveness in Schizophrenia Inpatient Settings Related to Patients' Age

Mueller¹,

Schmidt²,

Roder³

2013

The American Journal of Geriatric Psychiatry

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“…Thus, regarding cognitive treatments for depression, there is good evidence that optimal treatment selection depends on factors such as age of illness onset (Jarrett et al, 2001), current and historical symptom severity (Bockting et al, 2005;Fournier et al, 2011), and patient preference for pharmacological or psychosocial intervention (Kocsis et al, 2009). Similarly, in the schizophrenia domain, a patient's age at treatment initiation appears to moderate the effects of cognitive rehabilitation (CR) interventions, such that younger patients (< 40) benefit more than older patients from receiving CR (McGurk & Mueser, 2008;Wykes et al, 2009).…”

Section: Which Treatments For Whom?mentioning

confidence: 99%

Rebooting Psychotherapy Research and Practice to Reduce the Burden of Mental Illness

Kazdin

Blase

2011

Perspect Psychol Sci

1,128

839

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Psychological interventions to treat mental health issues have developed remarkably in the past few decades. Yet this progress often neglects a central goal-namely, to reduce the burden of mental illness and related conditions. The need for psychological services is enormous, and only a small proportion of individuals in need actually receive treatment. Individual psychotherapy, the dominant model of treatment delivery, is not likely to be able to meet this need. Despite advances, mental health professionals are not likely to reduce the prevalence, incidence, and burden of mental illness without a major shift in intervention research and clinical practice. A portfolio of models of delivery will be needed. We illustrate various models of delivery to convey opportunities provided by technology, special settings and nontraditional service providers, self-help interventions, and the media.

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Cognitive remediation for older community‐dwelling individuals with schizophrenia: a pilot and feasibility study

Golas

Kalache

Tsoutsoulas

et al. 2015

Int J Geriat Psychiatry

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Response to Cognitive Rehabilitation in Older Versus Younger Persons with Severe Mental Illness

Cited by 53 publications

References 28 publications

Integrated Psychological Therapy: Effectiveness in Schizophrenia Inpatient Settings Related to Patients' Age

Integrated Psychological Therapy: Effectiveness in Schizophrenia Inpatient Settings Related to Patients' Age

Rebooting Psychotherapy Research and Practice to Reduce the Burden of Mental Illness

Cognitive remediation for older community‐dwelling individuals with schizophrenia: a pilot and feasibility study

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