title: Compensatory cognitive training for psychosis: effects in a randomized controlled trial.
abstract: OBJECTIVE
  Treatments for the cognitive impairments of schizophrenia are urgently needed. We developed and tested a 12-week, group-based, manualized, compensatory cognitive training intervention targeting prospective memory, attention, learning/memory, and executive functioning. The intervention focused on compensatory strategies, such as calendar use, self-talk, note taking, and a 6-step problem-solving method, and did not require computers.
  
  
  METHODS
  In a randomized controlled trial, 69 outpatients with DSM-IV primary psychotic disorders were assigned to receive standard pharmacotherapy alone or compensatory cognitive training + standard pharmacotherapy for 12 weeks. Assessments of neuropsychological performance and functional capacity (primary outcomes) and psychiatric symptom severity, quality of life, social skills performance, cognitive insight, and self-reported everyday functioning (secondary outcomes) were administered at baseline, posttreatment, and 3-month follow-up. Data were collected between September 2003 and August 2009.
  
  
  RESULTS
  Hierarchical linear modeling analyses demonstrated significant compensatory cognitive training-associated effects on attention at follow-up (P = .049), verbal memory at posttreatment and follow-up (P values ≤ .039), and functional capacity (University of California, San Diego Performance-based Skills Assessment) at follow-up (P = .004). The compensatory cognitive training group also differentially improved in negative symptom severity at posttreatment and follow-up (P values ≤ .025) and subjective quality of life at follow-up (P = .002).
  
  
  CONCLUSIONS
  Compensatory cognitive training, a low-tech, brief intervention, has the potential to improve not only cognitive performance but also functional skills, negative symptoms, and self-rated quality of life in people with psychosis.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier: NCT01521026.
authors.affiliation: Department of Psychiatry, University of California, 140 Arbor Drive (0851), San Diego, CA 92103, USA. etwamley@ucsd.edu
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Twamley
authors.forename: Lea
authors.initials: L
authors.lastname: Vella
authors.forename: Cynthia Z
authors.initials: CZ
authors.lastname: Burton
authors.forename: Robert K
authors.initials: RK
authors.lastname: Heaton
authors.forename: Dilip V
authors.initials: DV
authors.lastname: Jeste
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001288:Attention; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D056344:Executive Function; D005260:Female; D006801:Humans; D007858:Learning; D016014:Linear Models; D008297:Male; D008370:Manuals as Topic; D008568:Memory; D010865:Pilot Projects; D011340:Problem Solving; D011614:Psychotherapy, Brief / Q000379:methods*; D011615:Psychotherapy, Group / Q000379:methods*; D011618:Psychotic Disorders / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy*; D014481:United States