title: Cognitive adaptation training combined with assertive community treatment: a randomised longitudinal trial.
abstract: BACKGROUND
  Cognitive adaptation training (CAT) targets the adaptive behaviour of patients with schizophrenia and has shown promising results regarding the social aspects of psychosocial treatment. As yet, no reports have appeared on the use of CAT in combination with assertive community treatment (ACT). Our purpose was to evaluate the effect of CAT in comparison with ACT, focusing on social functions (primary outcome), symptoms, relapse, re-hospitalisation, and quality of life of outpatients with schizophrenia.
  
  
  METHODS
  The trial was a parallel, randomised, multicentre trial conducted in three centres treating patients with a first episode of schizophrenia disorder. A total of 62 outpatients diagnosed as having schizophrenia were randomly assigned to CAT+ACT or ACT alone. The CAT was conducted in the patient's home and included instruction in prompting for specific actions. The treatment lasted for 6months, and the patients were assessed at baseline and at 6- and 9-month follow-ups.
  
  
  RESULTS
  The results of mixed-effects regression models indicated no significant differences between intervention group and control group at 6 and 9months in any outcome [Global Assessment of Functioning at 6months (p=0.32) and the Health of the Nation Outcome Scales social subscale at 6months (p=0.30)].
  
  
  CONCLUSIONS
  The results from this trial differ from previous CAT trials because use of CAT showed no significant effects. However, the low number of participants may have been responsible for these results. Thus, additional studies are needed to determine whether the use of some elements of CAT can help to make ACT more economically effective.
authors.affiliation: Mental Health Services in the Region of Southern Denmark, Esbjerg, Denmark. jens.peter.hansen@psyk.regionsyddanmark.dk
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Hansen
authors.forename: Birte
authors.initials: B
authors.lastname: Østergaard
authors.forename: Merete
authors.initials: M
authors.lastname: Nordentoft
authors.forename: Lise
authors.initials: L
authors.lastname: Hounsgaard
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003156:Community Mental Health Services / Q000379:methods*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D010045:Outpatients; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D013997:Time Factors; D055815:Young Adult