Effectiveness of a low support, remotely accessible, cognitive remediation training programme for chronic psychosis: cognitive, functional and cortical outcomes from a single blind randomised controlled trial. Issue 5 (21st September 2017)

• Record Type: Journal Article
• Authors: Donohoe, G.; Dillon, R.; Hargreaves, A.; Mothersill, O.; Castorina, M.; Furey, E.; Fagan, A. J.; Meaney, J. F.; Fitzmaurice, B.; Hallahan, B.; McDonald, C.; Wykes, T.; Corvin, A.; Robertson, I. H.
• Is Part Of: Psychological medicine. Volume 48:Issue 5(2018)
• Page Start: 751
• Page End: 764
• Publication Date: 2017-09-21
• Subjects: Cognition, -- cognitive remediation, -- MRI social function, -- schizophrenia.; Psychiatry -- Periodicals; Medicine and psychology -- Periodicals; Clinical psychology -- Periodicals; 616.89
• DOI: 10.1017/S0033291717001982
• Languages: English
• ISSNs: 0033-2917

Abstract

Abstract : Background: Cognitive remediation (CR) training has emerged as a promising approach to improving cognitive deficits in schizophrenia and related psychosis. The limited availability of psychological services for psychosis is a major barrier to accessing this intervention however. This study investigated the effectiveness of a low support, remotely accessible, computerised working memory (WM) training programme in patients with psychosis. Methods: Ninety patients were enrolled into a single blind randomised controlled trial of CR. Effectiveness of the intervention was assessed in terms of neuropsychological performance, social and occupational function, and functional MRI 2 weeks post-intervention, with neuropsychological and social function again assessed 3–6 months post-treatment. Results: Patients who completed the intervention showed significant gains in both neuropsychological function (measured using both untrained WM and episodic task performance, and a measure of performance IQ), and social function at both 2-week follow-up and 3–6-month follow-up timepoints. Furthermore, patients who completed MRI scanning showed improved resting state functional connectivity relative to patients in the placebo condition. Conclusions: CR training has already been shown to improve cognitive and social function in patient with psychosis. This study demonstrates that, at least for some chronic but stable outpatients, a low support treatment was associated with gains that were comparable with those reported for CR delivered entirely on a 1:1 basis. We conclude that CR has potential to be delivered even in services in which psychological supports for patients with psychosis are limited.