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Cognitive remediation in schizophrenia: efficacy and effectiveness in patients with early versus long‐term course of illness
Author(s) -
Bowie Christopher R.,
Grossman Michael,
Gupta Maya,
Oyewumi L. Kola,
Harvey Philip D.
Publication year - 2014
Publication title -
early intervention in psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.087
H-Index - 45
eISSN - 1751-7893
pISSN - 1751-7885
DOI - 10.1111/eip.12029
Subject(s) - neurocognitive , cognitive remediation therapy , psychology , schizophrenia (object oriented programming) , cognition , clinical psychology , executive functions , competence (human resources) , psychiatry , social psychology
Aim We examined the efficacy and effectiveness (transfer to functional competence and everyday functioning) of cognitive remediation in early‐course (within 5 years of first episode) and long‐term (more than 15 years of illness) schizophrenia. Methods Treatment lasted 12 weeks and included computerized exercises, strategic monitoring and methods to transfer cognition to behaviour. Assessments included a standard battery of neurocognition, performance‐based measures of social and adaptive competence, and case manager ratings of real‐world functional behaviour. Changes from baseline to post‐treatment were examined with repeated measures analysis of variance and estimated premorbid intelligence and total months in hospital as covariates. Results The early‐course group had larger improvements in measures of processing speed and executive functions, as well as larger improvements in adaptive competence and real‐world work skills. Duration of illness was inversely associated with improvement in neurocognition and real‐world work skills. Conclusions Treatment of cognitive impairments is feasible in both early‐course and chronic schizophrenia, but the clinical meaningfulness and generalization to functioning appear to be more substantial when delivered early. Cognitive remediation should be considered a tool for early intervention in schizophrenia.