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Trials. 2018 Mar 15;19(1):183. doi: 10.1186/s13063-018-2553-3.

The CIRCuiTS study (Implementation of cognitive remediation in early intervention services): protocol for a randomised controlled trial.

Author information

1
Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK. til.wykes@kcl.ac.uk.
2
South London & Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK. til.wykes@kcl.ac.uk.
3
UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
4
Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
5
University of California, San Diego, 9500 Gilman Dr. (0812), La Jolla, CA, 92093-0812, USA.
6
Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
7
Saïd Business School, University of Oxford, Park End Street, Oxford, OX1 1HP, UK.
8
Psychology Department, University of Sussex, Brighton, Sussex, BN1 9RH, UK.
9
Sussex Partnership NHS Foundation Trust and University of Sussex, Sussex House, Falmer, Brighton, BN1 9RH, UK.
10
Division of Psychiatry, UCL, Mental Health Sciences Unit, 2nd Floor Charles Bell House, 67-73 Riding House Street, London, W1W 7EJ, UK.
11
King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
12
Cambridge & Peterborough NHS Foundation Trust, CAMEO, Block 7 Ida Darwin, Fulbourn Hospital, Cambridge, CB2 5EE, UK.
13
Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
14
Health Services and Population Research Department, Institute of Psychology, Psychiatry and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
15
Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
16
South London & Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK.
17
College of Medical and Dental Sciences, University of Birmingham, 25 Vincent Drive, Birmingham, B15 2F, UK.

Abstract

BACKGROUND:

Cognitive problems in people with schizophrenia predict poor functional recovery even with the best possible rehabilitation opportunities and optimal medication. A psychological treatment known as cognitive remediation therapy (CRT) aims to improve cognition in neuropsychiatric disorders, with the ultimate goal of improving functional recovery. Studies suggest that intervening early in the course of the disorder will have the most benefit, so this study will be based in early intervention services, which treat individuals in the first few years following the onset of the disorder. The overall aim is to investigate different methods of CRT.

METHODS:

This is a multicentre, randomised, single-blinded, controlled trial based in early intervention services in National Health Service Mental Health Trusts in six English research sites. Three different methods of providing CRT (intensive, group, and independent) will be compared with treatment as usual. We will recruit 720 service users aged between 16 and 45 over 3 years who have a research diagnosis of non-affective psychosis and will be at least 3 months from the onset of the first episode of psychosis. The primary outcome measure will be the degree to which participants have achieved their stated goals using the Goal Attainment Scale. Secondary outcome measures will include improvements in cognitive function, social function, self-esteem, and clinical symptoms.

DISCUSSION:

It has already been established that cognitive remediation improves cognitive function in people with schizophrenia. Successful implementation in mental health services has the potential to change the recovery trajectory of individuals with schizophrenia-spectrum disorders. However, the best mode of implementation, in terms of efficacy, service user and team preference, and cost-effectiveness is still unclear. The CIRCuiTS trial will provide guidance for a large-scale roll-out of CRT to mental health services where cognitive difficulties impact recovery and resilience.

TRIAL REGISTRATION:

ISRCTN, ISRCTN14678860 , Registered on 6 June 2016.

KEYWORDS:

Cognition; Cognitive enhancement; Cognitive remediation; Cognitive training; Early psychosis; Functioning; Implementation; Psychological therapy; Recovery; Schizophrenia

PMID:
29544551
PMCID:
PMC5856221
DOI:
10.1186/s13063-018-2553-3
[Indexed for MEDLINE]
Free PMC Article

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