Combining social cognitive treatment, cognitive remediation, and functional skills training in schizophrenia: a randomized controlled trial

摘要

This study examined the efficacy of an integrative cognitive remediation program (REHACOP) in improving cognition and functional outcome in patients with schizophrenia. The program combines cognitive remediation, social cognitive intervention, and functional skills training. Few studies have attempted this approach. One hundred and eleven patients diagnosed with schizophrenia were randomly assigned to either the cognitive remediation group (REHACOP) or an active control group (occupational activities) for 4 months (three sessions per week, 90?min). Primary outcomes were change on general neurocognitive performance and social cognition, including theory of mind (ToM), emotion perception (EP), attributional style, and social perception (SP). Secondary outcomes included changes on clinical symptoms (Positive and Negative Syndrome Scale) and functional outcome (UCSD Performance-Based Skills Assessment and the Global Assessment of Functioning). The trial was registered with clinicaltrials.gov (NCT02796417). No baseline group differences were found. Significant differences were found in the mean change between the REHACOP group and control group in neurocognition ( η p 2 = 0 . 138 ), SP ( η p 2 = 0.082 ), ToM ( η p 2 = 0 . 148 ), EP ( η p 2 = 0.071 ), negative symptoms ( η p 2 = 0.082 ), emotional distress ( η p 2 = 0 . 136 ), Global Assessment of Functioning ( η p 2 = 0.081 ), and UCSD Performance-Based Skills Assessment ( η p 2 = 0 . 154 ). The combination of cognitive remediation, social cognitive intervention, and functional skills training demonstrated statistically significant and clinically meaningful changes in neurocognition, social cognition, negative, and functional disability.