Disorders - Psychosis Disorders
Marshall, M., Barrowclough, C., Drake, R., Husain, N., Lobban, F., Lovell, K., Wearden, A., Bradshaw, T., Day, C., Fitzsimmons, M., Pedley, R., Piccuci, R., Picken, A., Larkin, W., Tomenson, B., Warburton, J., Gregg, L.,
Background: Schizophrenia represents a substantial cost to the NHS
and society because it is common (lifetime prevalence around 0.5 - 1%); it begins in adolescence or early adulthood and often causes lifelong
impairment. The first 3 years are a 'critical period' in which the course of the illness is determined. Hence under the NHS Plan, specialist early
intervention in psychosis services were established to care for people who develop psychosis between the ages of 14 and 35 years for the first 3
years of their illness. However, there has been a lack of evidence-based treatments specifically designed for the early years. This is important
because emerging evidence has shown that in the critical period it is vital to avoid relapse and prevent deterioration in physical health, as both
can drastically reduce the chances of a full recovery.; Objectives: To develop and evaluate three phase-specific interventions to prevent relapse
and/or deterioration in physical health in people with first-episode psychosis. The interventions were (1) cognitive remediation (CR) to improve
meta-cognition and insight and enhance engagement in cognitive therapy [evaluated in the IMproving PArticipation in Cognitive Therapy (IMPACT)
trial]; (2) a healthy-living intervention to control weight in people taking antipsychotic medication after a first episode of psychosis [evaluated
in the INTERvention to Encourage ACTivity, Improve Diet, and Reduce Weight Gain (InterACT trial)]; and (3) integrated motivational interviewing and
cognitive - behavioural therapy (MiCBT) to reduce cannabis use [evaluated in the Rethinking Choices After Psychosis (ReCAP) trial]. The trials were
conducted to explore the case for larger definitive trials with relapse as a primary outcome measure. However, as small trials do not have sufficient
power to detect significant reductions in relapse, each was focused on a relevant primary outcome for which there was sufficient power to detect a
significant difference. In all three trials relapse was a secondary outcome in the hope of detecting trends towards lower relapse rates in the
presence of effective interventions or a general trend across all three studies towards lower relapse rates.; Design: Three exploratory randomised
controlled trials (RCTs) accompanied by qualitative work employing grounded theory and framework analysis to inform the interventions and determine
acceptability (InterACT and ReCAP trials).; Setting: Five early-intervention services in the north-west of England.; Participants: Early-intervention
service users aged 16 - 35 years who had recently experienced a first episode of psychosis. Participants in the IMPACT trial were drawn from a
waiting list of people referred for routine CBT; those in the InterACT trial were required to have a body mass index (BMI) of =?25?kg/m(2) (or =?24?
kg/m(2) for service users from the South Asian community); and those in the ReCAP trial met Diagnostic and Statistical Manual of Mental Disorders -
Fourth Edition (DSM-IV) criteria for cannabis abuse or dependence.; Interventions: The IMPACT trial involved 13 sessions of CR over 12 weeks; the
InterACT trial involved eight face-to-face sessions plus optional group activities over 12 months; and the ReCAP trial involved MiCBT in brief (12
sessions over 4.5 months) and long (24 sessions over 9 months) forms.; Main Outcome Measures: The primary outcome in the IMPACT trial was psychotic
symptoms assessed by the Psychotic Symptom Rating Scales (PSYRATS). BMI was the primary outcome in the InterACT trial and cannabis use (measured by
timeline follow-back) was the primary outcome in the ReCAP trial. Relapse was a secondary outcome across all three trials.; Results: In the IMPACT
trial there was no beneficial effect of CR on psychotic symptoms; however, the amount of CBT required was significantly less after CR. In the
InterACT trial a small reduction in BMI in the intervention group was not statistically significant. For participants taking olanzapine or clozapine
the effect size was larger although not significan . Outcome data from the ReCAP trial are not yet available. Retention in all three trials was good,
indicating that the interventions were acceptable.; Conclusions: Early-intervention services provided a good setting to conduct trials. The IMPACT
trial found that CR delivered by relatively unskilled workers improved the efficiency of subsequent CBT. Across the three trials there was little
evidence that any intervention reduced relapse.; Trial Registration: Current Controlled Trials ISRCTN17160673 (IMPACT); Current Controlled Trials
ISRCTN22581937 (InterACT); Current Controlled Trials ISRCTN88275061 (ReCAP).; Funding: This project was funded by the NIHR Programme Grants for
Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 3, No. 2. See the NIHR Journals Library
website for further project information.; Copyright © Queen's Printer and Controller of HMSO 2015. This work was produced by Marshall et al. under
the terms of a commissioning contract issued by the Secretary of State for Health. This issue may be freely reproduced for the purposes of private
research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made
and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals
Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science
Park, Southampton SO16 7NS, UK.
Programme Grants for Applied Research
Journal, :
- Year: 2015
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: First episode (psychosis only)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive remediation
therapy
McEwen, S., Ventura, J., Subotnik, K. L., Sturdevant, Y., Turner, L., Ghermezi, L., Nuechterlein, K. H.
Background: Depressive symptoms are a common feature in schizophrenia and are associated with increased rates of
suicide and relapse, poorer social functioning, low motivation, and poor adherence to psychosocial interventions. Recently, there has been a growing
interest in the impact of physical exercise on mental health. Studies suggest exercise may be an effective adjunctive treatment to combat depression
during the early phase of schizophrenia. Additionally, exercise has few side effects and is an intervention method that is low cost, simple to
implement, and less demanding of staff training compared to many other psychosocial interventions. Methods: Sixteen patients with a recent first
episode of schizophrenia from the UCLA Aftercare Research Program were randomly assigned to cognitive training (CT, N=8) or to cognitive training
plus exercise (CT&E, N=8). Both groups completed computer-based neurocognitive and social cognitive training 4 hours/week. The CT&E group completed 2
hours/week of exercise in the clinic and two 30-min exercise sessions per week at home. To examine acute changes in mood we used the self-report
Positive and Negative Affect Scale (PANAS, Likert Scale: 1-5) before and after a single exercise session (CT&E group) or before and after a cognitive
training session (CT group) in the clinic. To examine the long-term outcome effects of exercise on mood, the Brief Psychiatric Rating Scale (BPRS,
Scale: 1-7) was completed by a clinician at study baseline and at 8-week follow-up. Results: Patients in the CT&E group experienced increased
positive affect after their exercise session (M=+3.9, SD=7.0), whereas the CT group experienced decreased positive affect after a cognitive training
session (M=-2.1, SD=5.6) (Cohen's d effect size=.94). Patients in the CT&E group also experienced a greater decrease in negative affect (M=-2.8,
SD=5.3) than the CT group (M=0.0, SD=2.4) (Cohen's d=-.74). Regarding tonic mood states, the CT&E group had a greater reduction in depressive
symptoms (M=-1.38, SD=1.69) than the CT group (M=-.13, SD=.99) (Cohen's d=-.90) at 2-month follow-up. Conclusion: These results indicate that
regular physical exercise leads to acute increases in positive affect and reductions in negative affect. These preliminary data suggest that exercise
is a low risk, non-pharmacological means of producing clinical improvements in mood in first-episode schizophrenia patients. This study is ongoing at
the UCLA Aftercare Research Program.
Schizophrenia Bulletin, 41 : S182-S183
- Year: 2015
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: First episode (psychosis only)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Cognitive remediation
therapy, Physical activity, exercise
Mendella, P. D., Burton, C. Z., Tasca, G.
A., Roy, P., St-Louis, L., Twamley, E. W.
Cognitive training or remediation now has multiple studies and
meta-analyses supporting its efficacy in improving cognition and functioning in people with schizophrenia. However, relatively little is known about
cognitive training outcomes in early psychosis. We conducted a pilot randomized controlled trial of Compensatory Cognitive Training (CCT) compared to
Treatment as Usual (TAU) in 27 participants with first-episode psychosis who had received treatment for psychosis for less than six months.
Assessments of cognition (MATRICS Consensus Cognitive Battery; MCCB) and functional capacity (UCSD Performance-Based Skills Assessment-Brief; UPSA-B)
were administered at baseline and following the 12-week treatment. The CCT condition, compared to TAU, was associated with significant improvements
on the MCCB composite score, as well as MCCB subtests measuring processing speed (Trail Making) and social cognition (Mayer-Salovey-Caruso Emotional
Intelligence Test), with large effects on these three outcome measures. There were no significant CCT-associated effects on the UPSA-B or on
positive, negative, or depressive symptoms. CCT treatment of cognitive impairments in first-episode schizophrenia is feasible and can result in large
effect size improvements in global cognition, processing speed, and social cognition. (PsycINFO Database Record (c) 2015 APA, all rights reserved)
(journal abstract).
Schizophrenia Research, 162(1-3) : 108-111
- Year: 2015
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: First episode (psychosis only)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive remediation
therapy
Schmidt, S., Schultze-Lutter, F., Schimmelmann, B., Maric, N., Salokangas, R., Riecher-Rossler, A., vanderGaag, M., Meneghelli, A., Nordentoft, M., Marshall, M., Morrison, A., Raballo, A., Klosterkotter, J., Ruhrmann, S.
This guidance paper from the European Psychiatric Association (EPA) aims to provide evidence-based recommendations on early
intervention in clinical high risk (CHR) states of psychosis, assessed according to the EPA guidance on early detection. The recommendations were
derived from a meta-analysis of current empirical evidence on the efficacy of psychological and pharmacological interventions in CHR samples.
Eligible studies had to investigate conversion rate and/or functioning as a treatment outcome in CHR patients defined by the ultra-high risk and/or
basic symptom criteria. Besides analyses on treatment effects on conversion rate and functional outcome, age and type of intervention were examined
as potential moderators. Based on data from 15 studies (n = 1394), early intervention generally produced significantly reduced conversion rates at 6-
to 48-month follow-up compared to control conditions. However, early intervention failed to achieve significantly greater functional improvements
because both early intervention and control conditions produced similar positive effects. With regard to the type of intervention, both psychological
and pharmacological interventions produced significant effects on conversion rates, but not on functional outcome relative to the control conditions.
Early intervention in youth samples was generally less effective than in predominantly adult samples. Seven evidence-based recommendations for early
intervention in CHR samples could have been formulated, although more studies are needed to investigate the specificity of treatment effects and
potential age effects in order to tailor interventions to the individual treatment needs and risk status. (PsycINFO Database Record (c) 2015 APA, all
rights reserved) (journal abstract).
European Psychiatry, 30(3) : 388-404
- Year: 2015
- Problem: Psychosis Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Service Delivery & Improvement, Psychological Interventions
(any)
Smesny, S., Milleit, B., Schaefer, M. R., Hipler, U. C., Milleit, C., Wiegand, C., Hesse, J., Klier, C. M., Holub, M., Holzer, I., Berk, M., McGorry, P. D., Sauer, H., Amminger, G. P.
Background: Oxidative
stress and impaired antioxidant defenses are reported in schizophrenia and are associated with disturbed neurodevelopment, brain structural
alterations, glutamatergic imbalance, increased negative symptoms, and cognitive impairment. There is evidence that oxidative stress predates the
onset of acute psychotic illness. Here, we investigate the effects of omega-3 PUFA on the vitamin E and glutathione antioxidant defense system
(AODS). Method: In 64 help-seeking UHR-individuals (13-25 years of age), vitamin E levels and glutathione were investigated before and after 12 weeks
of treatment with either 1.2 g/d omega-3 (PUFA-E) or saturated fatty acids (SFA-E), with each condition also containing 30.4 mg/d alpha-tocopherol to
ensure absorption without additional oxidative risk. Results: In multivariate tests, the effects on the AODS (alpha-tocopherol, total glutathione)
were not significantly different (p=0.13, p=0.11, respectively) between treatment conditions. According to univariate findings, only PUFA-E caused a
significant alpha-tocopherol increase, while PUFA-E and SFA-E caused a significant gamma- and delta-tocopherol decrease. Total glutathione (GSHt) was
decreased by PUFA-E supplementation. Conclusion: Effects of the PUFA-E condition on the vitamin E and glutathione AODS could be mechanisms underlying
its clinical effectiveness. In terms of the vitamin E protection system, PUFA-E seems to directly support the antioxidative defense at membrane
level. The effect of PUFA-E on GSHt is not yet fully understood, but could reflect antioxidative effects, resulting in decreased demand for
glutathione. It is still necessary to further clarify which type of PUFA/antioxidant combination, and in which dose, is effective at each stage of
psychotic illness.
Prostaglandins Leukotrienes & Essential Fatty
Acids, 101 : 15-21
- Year: 2015
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Fish oil (Omega-3 fatty acids), Omega 3 fatty
acids (e.g. fish oil, flax oil), Vitamins and supplements
Masi, G., Milone, A., Veltri, S., Iuliano, R., Pfanner, C., Pisano, S.
The atypical antipsychotic quetiapine has been used
in different psychotic and non-psychotic disorders in children and adolescents in randomized clinical trials, open-label studies and chart reviews.
Most of these studies suggest that quetiapine may be a promising agent with a potential for use in young patients. The aim of this paper is to
critically review available literature on quetiapine in the treatment of children and adolescents with a variety of psychiatric disorders, including
psychotic disorders, bipolar disorders (manic and depressive episodes), conduct disorder, autism spectrum disorder, Tourette's syndrome and
personality disorders. Furthermore, we report on possible neurochemical pathways involved during treatment with quetiapine, and discuss some issues
that are clinically relevant in daily practice, such as titration strategies, safety and tolerability, and monitoring possible side effects.
Controlled studies support the short-term efficacy for treating psychosis, mania, and aggression within certain diagnostic categories. However,
although quetiapine seems well tolerated in various pediatric populations during acute and intermediate treatments, and hyper-prolactinemia and
extra-pyramidal side effects are consistently low among studies, weight gain and alterations in lipid profile need to be closely monitored.
Furthermore, the distal benefit/risk ratio during long-term treatment remains to be determined.
Pediatric Drugs, 17 : 125-140
- Year: 2015
- Problem: Bipolar Disorders, Psychosis Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), First episode (psychosis only)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation)
Privat, A. T., Baquero, D. B., Santacana, A. M., Sola, V. P.
Introduction: Some studies have shown that more than 40% of patients with first episode psychosis (FEP) are non - adherent and
treatment with long - acting antipsychotics (LAIs) may increase their compliance. However, studies on efficacy of LAIs versus oral antipsychotics for
preventing relapse among schizophrenia patients have produced conflicting results. Objectives: The aim of the present study is to assess in
naturalistic settings if patients with FEP treated with LAIs have a decreased incidence of readmission compared with patients in treatment with oral
antipsychotics over 6 months follow - up. Methods: 188 FEP patients had been consecutively admitted to Hospital del Mar since January 2008 to
September 2014. Psychometric assessment included: sociodemographic data, duration of untreated psychosis (DUP), diagnosis, substance use and clinical
data at baseline. At 6 - months follow - up, antipsychotic treatment and number of admissions and emergencies over 6 months were also recorded. We
investigated whether group treatments differ in readmission rates, attendance rates at emergencies services emergencies. Results: We found a
significant decreased incidence of readmission (p=0,000) and a lower number of emergencies (p=0,017) in the group of FEP patients treated with LAIs
versus the group treated with oral antipsychotics. Conclusion: In this naturalistic study, treatment with LAIs is associated with a reduced
readmission rate and a lower number of emergencies in patients with FEP. These findings are in agreement with the results of other studies showing a
significant reduced relapse rate and lowest risk of re - hospitalization in FEP patients treated with LAIs.
Current Psychopharmacology, 4(1) : 52-57
- Year: 2015
- Problem: Psychosis Disorders
- Type: Controlled clinical trials
-
Stage: First episode (psychosis only)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation), Service Delivery & Improvement, Other service delivery and improvement
interventions
Nordentoft, M., Melau, M., Iversen, T., Petersen, L., Jeppesen,
P., Thorup, A., Bertelsen, M., Hjorthoj, C. R., Hastrup, L. H., Jorgensen, P.
Background: The early phases of psychosis have been hypothesized to
constitute a critical period, a window of opportunity. At the same time, the early phases of psychosis are associated with increased risk of unwanted
outcome, such as suicidal behaviour and social isolation. This was the background for the emergence of early intervention services, and in Denmark,
the OPUS trial was initiated as part of that process. Methods: Modified assertive community treatment, together with family involvement and social
skills training, constituted the core elements in the original programme. A total of 547 patients with first-episode psychosis were included in the
trial. Results: To summarize briefly the results of the OPUS trial: the OPUS treatment was superior to standard treatment in reducing psychotic and
negative symptoms and substance abuse, in increasing user satisfaction and adherence to treatment, and in reducing use of bed days and days in
supported housing. Moreover, relatives included in the OPUS treatment were less strained and had a higher level of knowledge about schizophrenia and
higher user satisfaction. Discussion: The OPUS treatment was implemented throughout Denmark. Training courses were developed and manuals and books
were published. Regional health authorities had access to national grants for implementing early intervention services; as a result, OPUS teams were
disseminated throughout the country. The content of the treatment is now further developed, and new elements are being tried out-such as individual
placement and support, lifestyle changes, cognitive remediation, specialized treatment for substance abuse and different kinds of user involvement.
(PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Early Intervention in Psychiatry, 9(2) : 156-162
- Year: 2015
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: First episode (psychosis only)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Skills training, Other Psychological Interventions, Other service delivery and improvement
interventions
Pawelczyk, T., Grancow, M., Kotlicka-Antczak, M., Pawelczyk, A.
Introduction: Omega-3 polyunsaturated fatty acids (n3-PUFA) are major
constituents of the neural membranes. N-3 PUFA take part in several neuronal mechanisms, including modulation and control of neurobiological
processes, such as ion channel and receptor activity, neurotransmitter release, synaptic plasticity, second messenger pathways and neuronal gene
expression. Deficiency in n-3 PUFA has been postulated in the etiology of schizophrenia. Intervention trials supplementing n-3 PUFA were conducted to
assess the efficacy of n-3 PUFA in reducing symptom severity in exacerbations of chronic schizophrenia and acute phase of first-episode
schizophrenia. The results were n-3 PUFA were found to prevent conversion to psychosis in clinical high risk populations. Objectives: To assess the
efficacy n-3 PUFA as add-on treatment in relapse prevention in first-episode schizophrenia patients. Methods: We conducted a randomized, double-
blind, placebo-controlled, parallel-group single-center 6 months augmentation trial of either 2,2 g per day of n-3 PUFA or placebo added on to an
adjustable dose of antipsychotic medication in first-episode schizophrenia patients. Intervention was composed of either 1320 mg/day of
eicosapentaenoic acid plus 880 mg/day of docosahexaenoic acid or placebo olive oil. The relapse rate was observed during a follow up period of 12
months. Results: 71 patients completed the study (41% female). Relapse was observed in 4 patients (11.4%) enrolled in n-3 PUFA group and 12 patients
(33.3%) in placebo group over a period of 12 months. The difference was statistically significant (log rank test, p=0.0225). Conclusions: The results
indicate, that n-3 PUFA add-on therapy can effectively prevent relapses in firstepisode schizophrenia patients.
European
Psychiatry, 30 : 1751
- Year: 2015
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: First episode (psychosis only), Relapse prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Fish oil (Omega-3 fatty acids), Omega 3 fatty
acids (e.g. fish oil, flax oil)
Pijnenborg, G., Timmerman, M., Derks, E., Fleischhacker, W., Kahn, R., Aleman, A.
Although antipsychotics are
widely prescribed, their effect of on improving poor illness insight in schizophrenia has seldom been investigated and therefore remains uncertain.
This paper examines the effects of low dose haloperidol, amisulpride, olanzapine, quetiapine, and ziprasidone on insight in first-episode
schizophrenia, schizoaffective disorder, or schizophreniform disorder. The effects of five antipsychotic drugs in first episode psychosis on insight
were compared in a large scale open randomized controlled trial conducted in 14 European countries: the European First-Episode Schizophrenia Trial
(EUFEST). Patients with at least minimal impairments in insight were included in the present study (n = 455). Insight was assessed with item G12 of
the Positive and Negative Syndrome Scale (PANSS), administered at baseline and at 1, 3, 6, 9, and 12 months after randomization. The use of
antipsychotics was associated with clear improvements in insight over and above improvements in other symptoms. This effect was most pronounced in
the first three months of treatment, with quetiapine being significantly less effective than other drugs. Effects of spontaneous improvement cannot
be ruled out due to the lack of a placebo control group, although such a large spontaneous improvement of insight would seem unlikely. (PsycINFO
Database Record (c) 2015 APA, all rights reserved) (journal abstract).
European
Neuropsychopharmacology, 25(6) : 808-816
- Year: 2015
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: First episode (psychosis only)
-
Treatment and intervention: Biological Interventions
(any), Typical Antipsychotics (first generation), Atypical Antipsychotics (second
generation)
Ray, P., Sinha, V. K., Tikka, S. K.
Background: Repetitive
transcranial magnetic stimulation (rTMS) has been found to be effective in reducing frequency and duration of auditory verbal hallucinations (AVH).
Priming stimulation, which involves high-frequency rTMS stimulation followed by low-frequency rTMS, has been shown to markedly enhance the neural
response to the low-frequency stimulation train. However, this technique has not been investigated in recent onset schizophrenia patients. The aim of
this randomized controlled study was to investigate whether the effects of rTMS on AVH can be enhanced with priming rTMS in recent onset
schizophrenia patients.Methods: Forty recent onset schizophrenia patients completed the study. Patients were randomized over two groups: one
receiving low-frequency rTMS preceded by priming and another receiving low-frequency rTMS without priming. Both treatments were directed at the left
temporo-parietal region. The severity of AVH and other psychotic symptoms were assessed with the auditory hallucination subscale (AHRS) of the
Psychotic Symptom Rating Scales (PSYRATS), the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression (CGI).Results: We
found that all the scores of these ratings significantly reduced over time (i.e. baseline through 1, 2, 4 and 6 weeks) in both the treatment groups.
We found no difference between the two groups on all measures, except for significantly greater improvement on loudness of AVH in the group with
priming stimulation during the follow-ups (F = 2.72; p < .05).Conclusions: We conclude that low-frequency rTMS alone and high-frequency priming of
low-frequency rTMS do not elicit significant differences in treatment of overall psychopathology, particularly AVH when given in recent onset
schizophrenia patients. Add on priming however, seems to be particularly better in faster reduction in loudness of AVH. (PsycINFO Database Record (c)
2015 APA, all rights reserved) (journal abstract).
Annals of General Psychiatry, 14 : ArtID
8
- Year: 2015
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Transcranial magnetic stimulation
(TMS)
Piskulic, D., Barbato, M., Liu, L., Addington, J.
Individuals at clinical high risk (CHR) of psychosis evidence cognitive deficits. Given suggestions that
deficits in cognition are related to poor functional outcome, cognition is a good treatment target. The aim of this study was to test the efficacy of
cognitive remediation therapy (CRT) in improving cognition of CHR individuals. Participants were tested at baseline, immediately following CRT and 9
months post-baseline. The mixed effects modelling demonstrated no differences in cognition between the experimental group and the control group at
any time point. For the experimental group, however, there was a trend towards improvement in speed of processing between baseline and 9-month
follow-up (t(29)=-2.91, P=0.06) and at post-CRT compared to 9-month follow-up (t(29)=-2.99, P<0.05). In the control group, significant improvements
in working memory were observed between post-CRT and 9-month follow-up (t(29)=-3.06, P<0.05). Despite significant improvements in social functioning
in the intervention group between baseline and 9-month follow-up (t(28)=-3.26, P<0.05), these improvements were not correlated with cognition. There
were trends towards improvement and no trends of decline in the two groups. While CRT may be valuable for individuals at CHR, the type of
intervention employed needs to be carefully considered.; Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Psychiatry Research, 225(1-2) : 93-
98
- Year: 2015
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive remediation
therapy