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Schizophr Res. 2017 Jul;185:154-160. doi: 10.1016/j.schres.2017.01.007. Epub 2017 Jan 13.

The relationship of cognitive improvement after cognitive remediation with social functioning in patients with schizophrenia and severe cognitive deficits.

Author information

1
Manhattan Psychiatric Center, 600 E 125th Street, New York, NY 10035, United States; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY 10962, United States; New York University, Department of Psychiatry, New York, NY, United States. Electronic address: Lindenmayer@nki.rfmh.org.
2
Manhattan Psychiatric Center, 600 E 125th Street, New York, NY 10035, United States. Electronic address: sefreg13@g.holycross.edu.
3
Manhattan Psychiatric Center, 600 E 125th Street, New York, NY 10035, United States; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY 10962, United States. Electronic address: Guoxin.Kang1@gmail.com.
4
Manhattan Psychiatric Center, 600 E 125th Street, New York, NY 10035, United States; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY 10962, United States. Electronic address: VOzog@nki.rfmh.org.
5
Manhattan Psychiatric Center, 600 E 125th Street, New York, NY 10035, United States; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY 10962, United States. Electronic address: ILjuri@nki.rfmh.org.
6
Manhattan Psychiatric Center, 600 E 125th Street, New York, NY 10035, United States; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY 10962, United States. Electronic address: AKhan@nki.rfmh.org.
7
Manhattan Psychiatric Center, 600 E 125th Street, New York, NY 10035, United States. Electronic address: AGoldring@nki.rfmh.org.
8
Boston University, Boston, MA, United States. Electronic address: mgurk@bu.edu.

Abstract

BACKGROUND:

This study aims to examine the effects of change in neurocognition on functional outcomes and to examine predictors of change in social functions following a 12-week course of cognitive remediation in patients with schizophrenia and schizoaffective disorder with severe cognitive impairments.

METHOD:

Level of social functioning was assessed using a performance based measure of functional capacity (PSP) in patients prior to and after the completion of 12-week cognitive remediation treatment (CRT). Participants completed a neuropsychological battery (MCCB-MATRICS) and clinical measures at both time points.

RESULTS:

63 subjects with a mean age of 41.4 (SD=12.2) and with 12.2years of education (SD=2.4) were enrolled. There were significant improvements in overall PSP score from baseline to endpoint (p=0.021) as well as in PSP domain A (socially useful activities) (p≤0.001), domain B (personal and social relationships) (p=0.009), and domain D (disturbing and aggressive behaviors) (p=0.003). There was a significant improvement in the composite MCCB score (p=0.020) and the Working Memory (p<0.046). Stepwise logistic regression yielded a significant association for baseline Visual Learning (Wald=6.537, p=0.011, OR=1.195), Speed of Processing (Wald=4.112, p=0.043, OR=0.850) and level of PANSS positive symptoms (Wald=4.087, p=0.043, OR=0.739) with PSP overall improvement.

CONCLUSIONS:

Faster speed of processing, better visual and verbal learning and less prominent positive symptoms were associated with greater functional improvement after a systematic cognitive intervention within a rehabilitative setting.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01036282.

KEYWORDS:

Functioning; Neurocognition; Schizophrenia

PMID:
28094171
DOI:
10.1016/j.schres.2017.01.007
[Indexed for MEDLINE]

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