Hatami S, Mirsepassi Z, Sedighnia A, Tehranidoost M, Masoomi M, Sharifi V. A Short Course Computer-assisted Cognitive Remediation in Patients with Schizophrenia Spectrum Disorders: A Randomized Clinical Trial. BCN 2021; 12 (4) :551-562
URL:
http://bcn.iums.ac.ir/article-1-2025-en.html
1- Department of Psychology, School of Education and Psychology, Islamic Azad University, Kurdistan, Iran.
2- Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
3- Department of Psychiatry, Research Center for Cognitive and Behavioral Sciences, Tehran University of Medical Sciences, Tehran, Iran.
Abstract:
Introduction: Cognitive Remediation Therapy (CRT) is used to improve cognitive functioning in patients with Schizophrenia Spectrum Disorders (SSDs). Most of the previous studies had incorporated a long rehabilitation program. This study aimed to evaluate the effects of a short and easy to implement computer-based CRT on cognitive performance in patients with SSDs using a randomized controlled trial design.
Methods: Sixty-Two patients with SSDs were enrolled in Roozbeh Hospital (Tehran City, Iran); they were randomized to either receive a CRT program added to the standard pharmacological treatment (n=31) or the standard treatment alone (n=31). The remediation consisted of 10 sessions of CRT provided 2-3 times a week applying the Cogpack software. The cognitive performance was assessed in attention, memory, and executive functions before and after the intervention using the respective tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB).
Results: This study did not demonstrate any significant improvement in attention and executive function between the experimental and control group. However, we observed modest improvements in some aspects of visual memory (first trial memory score, F=9.152, P<0.001, Cohen’s d=0.40; mean errors to success, F=6.991, P=0.011, Cohen’s d=0.14; stages completed on the first trial, F=7.155, P=0. 010, Cohen’s d=0.71; total errors, F=5.730, P=0.020, Cohen’s d=0.53).
Conclusion: We observed only modest improvements in the patients’ cognitive functioning after a short course of CRT. The short duration of the training and lack of a comprehensive rehabilitation plan may explain the obtained findings.
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● We observed only modest improvements in the patients’ cognitive functioning after short-course Cognitive Remediation.
● Psychiatrists should consider this intervention in planning a comprehensive rehabilitation program.
● The authors suggest conducting a Persian version of the Cogpack software for the Iranian population.
Plain Language Summary
Schizophrenia is a chronic mental illness with various presentations. Cognitive deficit is one of the core features that can affect patients' performance and quality of life. Despite the growth of knowledge, there is no established medication to improve cognitive performance in schizophrenia. Recently, Cognitive Remediation Therapy (CRT) has been used to improve cognitive functioning in these patients. Most of the previous studies had evaluated a long rehabilitation program. Due to limited resources in our country, this study aimed to assess the effects of a short and easy to implement computer-based cognitive remediation on cognitive performance in these patients. Sixty-two patients enrolled in Roozbeh Hospital (Tehran City, Iran); were randomized to either receive a CRT program added to the standard pharmacological treatment (n=31) or the standard treatment alone (n=31). The cognitive remediation program consisted of 10 sessions provided 2-3 times a week applying the Cogpack software. The cognitive performance was assessed before and after the intervention using the respective tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB). We observed modest improvements in some aspects of visual memory, not directly trainer-dependent. Therefore, the results of this study should be interpreted with caution. Although this is a limitation, it is an advantage too. Providing services by different trainers is similar to the provision of services in the community. We observed only modest improvements in the patients' cognitive functioning after this treatment. The authors believe that this intervention should be integrated into a comprehensive rehabilitation program for these patients. Employing well-trained and motivated therapists and planning regular supervision sessions, using interesting visual tasks, holding more rehabilitation sessions in prolonged duration, and providing this intervention in the early phase of the illness is recommended. The authors also suggest conducting a Persian version of the Cogpack software for the Iranian population.
Type of Study:
Original |
Subject:
Clinical Neuroscience Received: 2020/12/9 | Accepted: 2021/06/30 | Published: 2021/07/1