Cognitive enhancement therapy for early-course schizophrenia: effects of a two-year randomized controlled trial.

نویسندگان

  • Shaun M Eack
  • Deborah P Greenwald
  • Susan S Hogarty
  • Susan J Cooley
  • Ann Louise DiBarry
  • Debra M Montrose
  • Matcheri S Keshavan
چکیده

OBJECTIVE The early application of cognitive rehabilitation may afford long-term functional benefits to patients with schizophrenia. This study examined the two-year effects of an integrated neurocognitive and social-cognitive rehabilitation program, cognitive enhancement therapy (CET), on cognitive and functional outcomes in early-course schizophrenia. METHODS Early-course outpatients (mean+/-SD illness duration=3.19+/-2.24 years) with schizophrenia or schizoaffective disorder were randomly assigned to CET (N=31) or enriched supportive therapy (EST) (N=27), an illness management intervention utilizing psychoeducation and applied coping strategies, and treated for two years. Multivariate composite indexes of cognitive, social adjustment, and symptom domains were derived from assessment batteries administered annually by computer-based tests and raters not blind to treatment assignment. RESULTS Of the 58 participants who were randomly assigned and treated, 49 and 46 completed one year and two years of treatment, respectively. Intent-to-treat analyses showed significant differential effects favoring CET on social cognition, cognitive style, social adjustment, and symptomatology composites during the first year of treatment. After two years, moderate effects (d=.46) were observed favoring CET for enhancing neurocognitive function. Strong differential effects (d>1.00) on social cognition, cognitive style, and social adjustment composites remained at year 2 and also extended to measures of symptomatology, particularly negative symptoms. CONCLUSIONS CET appears to be an effective approach to the remediation of cognitive deficits in early schizophrenia that may help reduce disability in this population. The remediation of such deficits should be an integral component of early intervention programs treating psychiatrically stable schizophrenia outpatients.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Neuroprotective effects of cognitive enhancement therapy against gray matter loss in early schizophrenia: results from a 2-year randomized controlled trial.

CONTEXT Cognitive rehabilitation has shown efficacy in improving cognition in patients with schizophrenia but the underlying neurobiologic changes that occur during these treatments and support cognitive improvement are not well known. OBJECTIVE To examine differential changes in brain morphology in early course schizophrenia during cognitive rehabilitation vs supportive therapy. DESIGN Ran...

متن کامل

A Randomized Clinical Trial of Group Cognitive-Rehabilitation Therapy for Patients with Schizophrenia Resistant to Medication

Objectives: Against the background of evidence-based treatments for schizophrenia resistant to medication, the implementation of cognitive-Rehabilitation therapy (CRT) becomes more important, especially about patients who don’t response to medication. There is less evidence for group format and face to face structure of CRT and also for resistant to medication patients. This research investigat...

متن کامل

Mechanisms of functional improvement in a 2-year trial of cognitive enhancement therapy for early schizophrenia.

BACKGROUND Cognitive rehabilitation has emerged as an effective treatment for addressing cognitive impairments and functional disability in schizophrenia; however, the degree to which changes in various social and non-social cognitive processes translate into improved functioning during treatment remains unclear. This research sought to identify the neurocognitive and social-cognitive mechanism...

متن کامل

One-year durability of the effects of cognitive enhancement therapy on functional outcome in early schizophrenia.

Cognitive rehabilitation is an effective intervention for addressing cognitive impairments in patients with schizophrenia. Previous research has shown that the early application of Cognitive Enhancement Therapy (CET) can improve neurocognitive and social-cognitive deficits in the early course of the disorder, and ultimately reduce the substantial functional disability that these patients experi...

متن کامل

Independent and Social Living Skills Training for People with Schizophrenia in Iran: a Randomized Controlled Trial

Objectives: Schizophrenia is responsible for a significant proportion of burden of mental diseases in Iran. Lack of a follow-up system has resulted in the repeated hospitalizations. In this study it is hypothesized that standardized living skills training delivered to participants with schizophrenia in outpatient and inpatient centers can be effective compared to a  control group (with occ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Psychiatric services

دوره 60 11  شماره 

صفحات  -

تاریخ انتشار 2009