Cognitive remediation therapy during treatment for alcohol dependence.
OBJECTIVE
Cognitive impairments in individuals with alcohol dependence may interfere with the progress of treatment and contribute to the progression of the disease. This study aimed to determine whether cognitive remediation (CR) therapy applied during treatment for alcohol dependence improves cognitive functioning in alcohol-dependent inpatients. A secondary aim was to evaluate whether the benefits of CR generalize to noncognitive clinically meaningful outcomes at the end of inpatient treatment.


METHODS
Forty-one alcohol-dependent patients entering inpatient treatment for alcohol dependence were randomly assigned to receive conventional treatment (n = 21) or an additional 12 sessions of computer-assisted CR focusing on cognitive enhancement in attention/executive function and memory domains (n = 20). Assessments of cognitive abilities in these domains as well as of psychological well-being and alcohol craving were conducted at baseline (at the beginning of inpatient treatment) and after CR (at the end of treatment).


RESULTS
Results indicated that, relative to patients completing conventional treatment, those who received supplemental CR showed significant improvement in attention/executive function and memory domains, particularly in attention (alertness, divided attention), working memory, and delayed memory (recall). In addition, patients receiving CR during alcohol-dependence treatment showed significantly greater improvements in psychological well-being (Symptom Checklist-90-Revised) and in the compulsion aspect of craving (Obsessive Compulsive Drinking Scale-German version).


CONCLUSIONS
CR during inpatient treatment for alcohol dependence is effective in improving cognitive impairments in alcohol-dependent patients. The benefits generalize to noncognitive outcomes, demonstrating that CR may be an efficacious adjunctive intervention for the treatment of alcohol dependence.
Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria. claudia.rupp@i-med.ac.at
Claudia I
CI
Rupp
Georg
G
Kemmler
Martin
M
Kurz
Hartmann
H
Hinterhuber
W Wolfgang
WW
Fleischhacker
D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000628:therapy*; D001288:Attention; D001317:Austria; D003072:Cognition Disorders / Q000209:etiology / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003192:Compulsive Behavior / Q000517:prevention & control; D039721:Diagnostic and Statistical Manual of Mental Disorders; D056344:Executive Function; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008570:Memory, Short-Term; D011939:Mental Recall; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D013813:Therapy, Computer-Assisted; D055815:Young Adult