Cognitive remediation for schizophrenia delivers sustained improvement in cognition, functioning

People with schizophrenia may benefit from cognitive remediation which offers durable improvements in both cognition and psychosocial functioning, as shown in a study.

A team of investigators did a systematic search in PubMed, Scopus, and PsycINFO as well as reference lists of included articles and Google Scholar. Randomized clinical trials of cognitive remediations in patients diagnosed with schizophrenia spectrum disorders with follow-up assessments were included in the meta-analysis.

Two independent reviewers screened the articles and extracted the relevant data. Cohen’s d was used to assess outcomes, including changes in cognition and functioning from baseline to conclusion follow-up. Finally, the investigators examined moderators of the durability of effects.

A total of 2,840 reports were identified, of which 281 full texts were assessed and 130 reports on 67 studies involving 5,334 participants were included in the analysis.

Patients who underwent cognitive remediation achieved statistically significant positive effects that remained at the end of follow-up in global cognition (d=0.23) and in global functioning (d=0.26).

Studies with smaller samples and conducted in single centres reported better cognitive outcomes. On the other hand, better functional outcomes were associated with longer treatment and follow-up duration, techniques for transferring cognitive gains to the real world, integration with psychiatric rehabilitation, group format of delivery, and more female participants in the sample.

“This finding corroborates the notion that cognitive remediation should be implemented more widely in clinical and rehabilitation practice,” the investigators said.