Format

Send to

Choose Destination
Neurosci Biobehav Rev. 2019 Sep 23;107:828-845. doi: 10.1016/j.neubiorev.2019.09.031. [Epub ahead of print]

Multi-outcome meta-analysis (MOMA) of cognitive remediation in schizophrenia: Revisiting the relevance of human coaching and elucidating interplay between multiple outcomes.

Author information

1
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany. Electronic address: lana.kambeitz-ilankovic@uk-koeln.de.
2
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, Germany.
3
Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York, USA.
4
Department of Psychiatry, University of California, San Francisco, USA.
5
Department of Psychiatry, Medical School, University of Minnesota, USA.
6
Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.

Abstract

Cognitive remediation (CR) is nowadays mainly administered in a computerized fashion, yet frequently supplemented by human guidance. The effects of CR on cognitive, functional and clinical outcomes are consistently reported, yet the response is heterogeneous. In order to resolve this heterogeneity, we employed a multi-outcome meta-analytic approach, examined effects of CR on each outcome category separately and estimated directed effects between three outcome categories. We extracted treatment effects from 67 studies that trained patients with schizophrenia (total n = 4067) using either 1) computerized CR modality alone or 2) in combination with supplementary human guidance (SHG). All three outcome domains were significantly improved by CR with small to moderate effect sizes when assessing outcomes across all studies. The comparison between CR administered with SHG revealed largest effects on the cognitive subdomains of working and verbal memory. Structural equation modeling in the single-study data suggests that cognitive gains trigger restoration of psychosocial functioning which in turn facilitates improvement in clinical symptoms.

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center