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Schizophr Res. 2013 Jun;147(1):68-74. doi: 10.1016/j.schres.2013.03.009. Epub 2013 Apr 9.

Specific vs general cognitive remediation for executive functioning in schizophrenia: a multicenter randomized trial.

Author information

1
Service Universitaire de Réhabilitation, CH Le Vinatier, Bron, France; Cognitive Neuroscience Centre, UMR 5229 CNRS & Claude Bernard University, Université de Lyon, Bron, France. Electronic address: nicolas.franck@ch-le-vinatier.fr.
2
Service Universitaire de Réhabilitation, CH Le Vinatier, Bron, France.
3
CH Sainte-Anne, C3RP & Services de Psychiatrie d'adultes HU & 75G17, Paris, France.
4
Department of Psychology, Institute of Psychiatry, King's College London, UK.
5
CH Saint Jean de Dieu, Lyon, France; Cognitive Neuroscience Centre, UMR 5229 CNRS & Claude Bernard University, Université de Lyon, Bron, France.
6
Pôle universitaire de Psychiatrie, CH Charles Perrens, Bordeaux, France.
7
CH Niort, France.
8
CH Saint Jean de Dieu, Lyon, France.
9
Departement de psychiatrie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
10
CHI de Clermont de l'Oise, Centre CRISALID & Service de Psychiatrie Adulte, U669 INSERM PSIGIAM Paris 5 and 11 Universities, France.
11
CH de Ville-Evrard, France.
12
Laboratoire de Biostatistique Santé, UMR 5558, CNRS Hôpital Lyon Sud, France.

Abstract

BACKGROUND:

This study assesses the benefits of an individualized therapy (RECOS program) compared with the more general cognitive remediation therapy (CRT).

METHODS:

138 participants took part with 65 randomized to CRT and 73 to RECOS. In the RECOS group, participants were directed towards one of five training modules (verbal memory, visuo-spatial memory and attention, working memory, selective attention or reasoning) corresponding to their key cognitive concern whereas the CRT group received a standard program. The main outcome was the total score on BADS (Behavioural Assessment of Dysexecutive Syndrome) and the secondary outcomes were: cognition (executive functions; selective attention; visuospatial memory and attention; verbal memory; working memory) and clinical measures (symptoms; insight; neurocognitive complaints; self-esteem). All outcomes were assessed at baseline (T1), week 12 (posttherapy, T2), and follow-up (week 36, i.e., 6months posttherapy, T3).

RESULTS:

No difference was shown for the main outcome. A significant improvement was found for BADS' profile score for RECOS at T2 and T3, and for CRT at T3. Change in BADS in the RECOS and CRT arms were not significantly different between T1 and T2 (+0.86, p=0.108), or between T1 and T3 (+0.36, p=0.540). Significant improvements were found in several secondary outcomes including cognition (executive functions, selective attention, verbal memory, and visuospatial abilities) and clinician measures (symptoms and awareness to be hampered by cognitive deficits in everyday) in both treatment arms following treatment. Self-esteem improved only in RECOS arm at T3, and working memory improved only in CRT arm at T2 and T3, but there were no differences in changes between arms.

CONCLUSIONS:

RECOS (specific remediation) and CRT (general remediation) globally showed similar efficacy in the present trial.

PMID:
23583327
DOI:
10.1016/j.schres.2013.03.009
[Indexed for MEDLINE]

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