Feasibility of six-month outpatient cognitive remediation in schizophrenia: Experience from the randomized controlled integrated social cognition and social skills therapy study
Patients with schizophrenia often have cognitive impairments that contribute to diminished psychosocial functioning. Cognitive remediation therapy (CRT) has proven efficacy and is recommended by evidence-based treatment guidelines. Important moderators of efficacy include integration of CRT into a p...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | Schizophrenia Research: Cognition |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2215001323000082 |
| _version_ | 1797807058074992640 |
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| author | Tim Schuster Agnes Lowe Karolin Weide Daniel Kamp Mathias Riesbeck Andreas Bechdolf Anke Brockhaus-Dumke René Hurlemann Ana Muthesius Stefan Klingberg Martin Hellmich Sabine Schmied Andreas Meyer-Lindenberg Wolfgang Wölwer |
| author_facet | Tim Schuster Agnes Lowe Karolin Weide Daniel Kamp Mathias Riesbeck Andreas Bechdolf Anke Brockhaus-Dumke René Hurlemann Ana Muthesius Stefan Klingberg Martin Hellmich Sabine Schmied Andreas Meyer-Lindenberg Wolfgang Wölwer |
| author_sort | Tim Schuster |
| collection | DOAJ |
| description | Patients with schizophrenia often have cognitive impairments that contribute to diminished psychosocial functioning. Cognitive remediation therapy (CRT) has proven efficacy and is recommended by evidence-based treatment guidelines. Important moderators of efficacy include integration of CRT into a psychiatric rehabilitation concept and patient attendance at a sufficient number of therapy sessions. These conditions can probably best be met in an outpatient setting; however, outpatient treatment is prone to higher rates of treatment discontinuation and outpatient settings are not as well protected as inpatient ones and less closely supervised.The present study investigated the feasibility of outpatient CRT in schizophrenia over a six-month period. Adherence to scheduled sessions and safety parameters were assessed in 177 patients with schizophrenia randomly assigned to one of two matched CRT programs.Results showed that 58.8 % of participants completed the CRT (>80 % of scheduled sessions) and 72.9 % completed at least half the sessions. Predictor analysis revealed a high verbal intelligence quotient as favorable for good adherence, but this factor had only low general predictive power. During the six-month treatment phase, serious adverse events occurred in 15.8 % (28/177) of the patients, which is a comparable rate to that reported in the literature.Our findings support the feasibility of six-month outpatient CRT in schizophrenia in terms of adherence to scheduled sessions and safety. Trial registration number: NCT02678858, DRKS00010033. |
| first_indexed | 2024-03-13T06:16:49Z |
| format | Article |
| id | doaj.art-96f989047b32483683e8f03b2e853dfc |
| institution | Directory Open Access Journal |
| issn | 2215-0013 |
| language | English |
| last_indexed | 2024-03-13T06:16:49Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Schizophrenia Research: Cognition |
| spelling | doaj.art-96f989047b32483683e8f03b2e853dfc2023-06-11T04:14:32ZengElsevierSchizophrenia Research: Cognition2215-00132023-09-0133100285Feasibility of six-month outpatient cognitive remediation in schizophrenia: Experience from the randomized controlled integrated social cognition and social skills therapy studyTim Schuster0Agnes Lowe1Karolin Weide2Daniel Kamp3Mathias Riesbeck4Andreas Bechdolf5Anke Brockhaus-Dumke6René Hurlemann7Ana Muthesius8Stefan Klingberg9Martin Hellmich10Sabine Schmied11Andreas Meyer-Lindenberg12Wolfgang Wölwer13Department of Psychiatry and Psychotherapy, Medical Faculty, University of Düsseldorf, Germany; Corresponding author at: Department of Psychiatry and Psychotherapy, Medical Faculty, University of Düsseldorf/LVR Klinikum Düsseldorf, Bergische Landstrasse 2, 40629 Düsseldorf, Germany.Department of Psychiatry and Psychotherapy, Medical Faculty, University of Düsseldorf, GermanyDepartment of Psychiatry and Psychotherapy, Medical Faculty, University of Düsseldorf, GermanyDepartment of Psychiatry and Psychotherapy, Medical Faculty, University of Düsseldorf, GermanyDepartment of Psychiatry and Psychotherapy, Medical Faculty, University of Düsseldorf, GermanyVivantes Klinikum Am Urban, Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Charité Mitte, GermanyRheinhessen-Fachklinik Alzey, Alzey, Germany; LVR-Klinik Bonn, Bonn, GermanyDepartment of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany; Department of Psychiatry and Psychotherapy, University of Oldenburg, Oldenburg, GermanyDepartment of Psychiatry and Psychotherapy, University of Cologne, Cologne, GermanyDepartment of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, GermanyInstitute of Medical Statistics and Bioinformatics, University of Cologne, Cologne, GermanyClinical Trials Center, University of Cologne, Cologne, GermanyCentral Institute for Mental Health, Mannheim, GermanyDepartment of Psychiatry and Psychotherapy, Medical Faculty, University of Düsseldorf, GermanyPatients with schizophrenia often have cognitive impairments that contribute to diminished psychosocial functioning. Cognitive remediation therapy (CRT) has proven efficacy and is recommended by evidence-based treatment guidelines. Important moderators of efficacy include integration of CRT into a psychiatric rehabilitation concept and patient attendance at a sufficient number of therapy sessions. These conditions can probably best be met in an outpatient setting; however, outpatient treatment is prone to higher rates of treatment discontinuation and outpatient settings are not as well protected as inpatient ones and less closely supervised.The present study investigated the feasibility of outpatient CRT in schizophrenia over a six-month period. Adherence to scheduled sessions and safety parameters were assessed in 177 patients with schizophrenia randomly assigned to one of two matched CRT programs.Results showed that 58.8 % of participants completed the CRT (>80 % of scheduled sessions) and 72.9 % completed at least half the sessions. Predictor analysis revealed a high verbal intelligence quotient as favorable for good adherence, but this factor had only low general predictive power. During the six-month treatment phase, serious adverse events occurred in 15.8 % (28/177) of the patients, which is a comparable rate to that reported in the literature.Our findings support the feasibility of six-month outpatient CRT in schizophrenia in terms of adherence to scheduled sessions and safety. Trial registration number: NCT02678858, DRKS00010033.http://www.sciencedirect.com/science/article/pii/S2215001323000082SchizophreniaCognitive remediationAdherenceSafety |
| spellingShingle | Tim Schuster Agnes Lowe Karolin Weide Daniel Kamp Mathias Riesbeck Andreas Bechdolf Anke Brockhaus-Dumke René Hurlemann Ana Muthesius Stefan Klingberg Martin Hellmich Sabine Schmied Andreas Meyer-Lindenberg Wolfgang Wölwer Feasibility of six-month outpatient cognitive remediation in schizophrenia: Experience from the randomized controlled integrated social cognition and social skills therapy study Schizophrenia Research: Cognition Schizophrenia Cognitive remediation Adherence Safety |
| title | Feasibility of six-month outpatient cognitive remediation in schizophrenia: Experience from the randomized controlled integrated social cognition and social skills therapy study |
| title_full | Feasibility of six-month outpatient cognitive remediation in schizophrenia: Experience from the randomized controlled integrated social cognition and social skills therapy study |
| title_fullStr | Feasibility of six-month outpatient cognitive remediation in schizophrenia: Experience from the randomized controlled integrated social cognition and social skills therapy study |
| title_full_unstemmed | Feasibility of six-month outpatient cognitive remediation in schizophrenia: Experience from the randomized controlled integrated social cognition and social skills therapy study |
| title_short | Feasibility of six-month outpatient cognitive remediation in schizophrenia: Experience from the randomized controlled integrated social cognition and social skills therapy study |
| title_sort | feasibility of six month outpatient cognitive remediation in schizophrenia experience from the randomized controlled integrated social cognition and social skills therapy study |
| topic | Schizophrenia Cognitive remediation Adherence Safety |
| url | http://www.sciencedirect.com/science/article/pii/S2215001323000082 |
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